FAKTORI PROBLEMA U PONAŠANJU I TIP STANOVANJA OSOBA SA INTELEKTUALNOM OMETENOŠĆU
Sažetak
Problemi u ponašanju odraslih osoba sa intelektualnom ometenošću (IO) kao što su agresija, autoagresija i destruktivno ponašanje često mogu da budu izazvani spoljašnjim faktorima kao što su: frustracije, osujećenje potreba, ograničeni izbor aktivnosti ili neadekvatna komunikacija.
Ovo istraživanje rađeno je sa ciljem da se utvrdi uticaj tipa stanovanja na prisustvo različitih faktora rizika problema u ponašanju kod osoba sa IO. U istraživanju polazimo od pretpostavke da intenzitet i pojavni oblici problema u ponašanju osoba sa IO zavise od tipa stanovanja.
Uzorak čine 122 odrasle osobe sa umerenom IO između 17 i 79 godina starosti (AS=39,95; SD=13,90). Celokupan uzorak podeljen je u tri poduzorka: prvi poduzorak ispitanika čine osobe sa IO koje su smeštene u ustanovama stacionarnog tipa (n=51), drugi poduzorak ispitanika čine odrasle osobe sa IO koje žive u svojim primarnim porodicama (n=38) i treći poduzorak ispitanika čine osobe sa IO koje su obuhvaćene programom stanovanja uz podršku (n=33). Za potrebe istraživanja korišćen je „Upitnik o funkcijama ponašanja” (Matson & Vollmer, 1995).
Rezultati istraživanja pokazuju da tip stanovanja odraslih osoba sa IO utiče na izraženost prisustva faktora problema u ponašanju. Dobijene su statistički značajne razlike u svim varijablama koje pokazuju različite uzroke problema u ponašanju u odnosu na tip stanovanja. U poduzorku ispitanika koji žive u programu stanovanja uz podršku, prisustvo različitih faktora problema u ponašanju je statistički značajno manje zastupljeno u poređenju sa ostala dva poduzorka (p=0,000). Ispitanici koji žive u porodicama i u instituciji su imali približne rezultate, osim u varijabli materijalnog uzroka problematičnog ponašanja, gde su se ispoljile statistički značajne razlike između sva tri poduzorka. Starost ispitanika nema statistički značajan efekat na zastupljenost faktora koji utiču na ispoljavanje problema u ponašanju.
Ključne reči: stanovanje uz podršku, uzroci problema u ponašanju, QABF
Reference
Advokat, C. D., Mayville, E. A., & Matson, J. L. (2000). Side effect profiles of atypical antipsychotics or no psychotropic medications in persons with mental retardation. Research in Developmental Disabilities, 21, 75-84.
American Association on intellecual and developmental disabilities. Preuzeto sa: http://www.aaidd.org / 27.01.2015.
Borthwick-Duffy, S. (1994). Epidemiology and prevalence of psychopathology in people with mental retardation. Journal of Consulting and Clinical Psychology, 62, 17-27.
Bratković, D. Rozman, B. (2006). Čimbenici i kvalitet življenja osoba sa intelektualnim teškoćama. Hrvatska revizija za rehabilitacijska istraživanja, 42(2), 101-112.
Brojčin, B., & Glumbić, N. (2012). Internalizing forms of problem behavior in school-age children with mild intellectual disability. Specijalna edukacija i rehabilitacija, 11(1), 3-20.
Brown, J. F., Brown, M. Z., & Dibiasio, P. (2013). Treating Individuals With Intellectual Disabilities and Challenging Behaviors With Adapted Dialectical Behavior Therapy. Journal of Mental Health Research in Intellectual Disabilities, 6(4), 280-303. doi:10.1080/19315864.2012.700684
Burchard, S. N. (1999). Normalization and residential services: The Vermont studies. In R. J. Flynn & R. A. Lemay (Eds.), A quarter-century of normalization and social role valorization: Evolution and impact. 181-194. Ottawa, ON: University of Ottawa Press.
Campbell, S.B. (2006). Maladjustment in preschool children: A developmental psychopathology perspective. In K. McCartney K. & D. Phillips (Eds.) Blackwell Handbook of Early Childhood Development (pp. 358-377). Blackwell publishing.
Cheng, H. C., Chen, H. Y., Tsai, C. L., Chen, Y. J., & Cherng, R. J. (2009). Comorbidity of motor and language impairments in preschool children of Taiwan. Research in Developmental Disabilities, 30, 1054–1061.
Deb, S., Kwok, H., Bertelli, M., Salvador-Carulla, L., Bradley, E., Torr, J. Barnhill, J., FOR THE GUIDELINE DEVELOPMENT GROUP OF THE WPA SECTION ON PSYCHIATRY OF INTELLECTUAL DISABILITY. (2009). International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities. World Psychiatry, 8(3), 181-186.
Emerson, E. (2005). Challenging behaviour: Analysis and intervention with people with learning difficulties. Cambridge: Cambridge University Press.
Emerson, E., & Hatton, C. (1994). Moving Out: Relocation from Hospital to Community London: Her Majesty's Stationery Office.
Emerson, E., & Einfeld, S.L. (2011). Challenging behaviour. Cambridge, UK: Cambridge University Press.
Einfeld, S. L., Piccinin, A. M., Mackinnon, A., Hofer, S. M., Taffe, J., Gray, K. M., Tonge, B. J. (2006). Psychopathology in Young People With Intellectual Disability. Journal of the American Medical Association, 296(16), 1981–1989.
Felce, D., Lowe, K., Beecham, J., & Hallam, A. (2000). Exploring the relationships between costs and quality of services for adults with severe intellectual disabilities and the most severe challenging behaviors in Wales: A multivariate regression analysis. Journal of Intellectual & Development Disability, 26(1), 109.
Felce, D., and Emerson, E. (2001) Living With Support in a Home in the Community: Predictors of Behavioral Development and Household and Community Activity. Mental Retardation and Developmental Disabilities Research Reviews, 7(2), 75-83.
Gardner, W. I., & Moffatt, C. W. (1990). Aggressive behaviour: Definition, assessment, treatment. International Review of Psychiatry, 2, 91-100.
Garcia, M. J., & Matson, J. L. (2008). Akathisia in adults with severe and profound intellectual disability: A psychometric study of MEDS and ARMS. Journal of Intellectual and Developmental Disability, 33, 171–176.
Golding, L., Emerson, E., & Thornton, A. (2005). An evaluation of specialized community based residential supports for people with challenging behaviour. Journal of Intellectual Disabilities, 9, 145-154.
Kaljača, S., Dučić, B. (2010). Deinstitucionalizacija i kvalitet života u zajednici osoba sa intelektualnom ometenošću. Beogradska defektološka škola, 16(2), 47, 407-417.
Kim, S., Larson, S. A., & Lakin, K. C., (2001). Behavioural outcomes of deinstitutionalisation for people with intellectual disability: a review of US studies conducted between 1980 and 1999. Journal of Intellectual & Developmental Disability, 26(1), 35-50.
Krauss, M. W., & Erickson, M. E. (1988). Informal support networks among aging mentally retarded persons: Results from a pilot study. Mental Retardation, 26, 197-201.
Krauss, M. W., Seltzer, M. M., & Goodman, S. J. (1992). Social support networks of adult whit mental retardation who live at home. American Journal on mental Retardation, 96, 432-441.
Luiselli, J. K., & Slocumb, P. R. (1983). Management of multiple aggressive behaviors by differential reinforcement. Journal of Behavior Therapy and Experimental Psychiatry, 14, 343-347.
Mansell, J., Elliott, T., Beadle-Brown, J., Ashman, B. and Macdonald, S. (2002). Engagement in meaningful activity and ‘active support’ of people with intellectual disabilities in residential care. Research in Developmental Disabilities, 23(5), 342-352.
Matson, J. L., & Vollmer, T. R. (1995). User’s guide: Questions about behavioral function (QABF). Baton Rouge, LA: Scientific Publishers.
Matson J. L. & Boisjoli, J. A. (2007). Multiple versus single maintaining factors of challenging behaviours as assessed by the QABF for adults with intellectual disabilities. Journal of Intellectual & Developmental Disability, 32(1),: 39-44.
Matson, J. L., Boisjoli, J. A., Gonzalez, M. L., Smith, K. R., & Wilkins, J. (2007). Norms and cut off scores for the Autism Spectrum Disorders Diagnosis for Adults (ASDDA) with intellectual disability. Research in Autism Spectrum Disorders, 1, 330-338.
Matson, J. L. Dempsey, T. & Rivet, T. T. (2009). The interrelationships of psychopathology symptoms on social skills in adults with autism or PDD-NOS and intellectual disability. Journal of Developmental and Physical Disabilities, 21,39-55.
Matson, J. L., & Mahan, S. (2010). Antipsychotic drug side effects for persons with intellectual disability. Research in Developmental Disabilities, 31, 1570-1576.
Matson, J. L., Mayville, E. A., Bielecki, J., Barnes, W. H., Bamburg, J. W., & Baglio, C. S. (1998). Reliability of the Matson Evaluation of Drug Side Effects Scale (MEDS). Research in Developmental Disabilities, 19, 501-506.
Matson, J. L., Rivet, T. T., & Fodstad, J. C. (2010). Atypical antipsychotic adjustments and side-effects over time in adults with intellectual disability, tardive dyskinesia, and akatheisia. Journal of Developmental and Physical Disabilities, 22, 447-461.
Matson, Ј. L., Kozlowski, A. M., Worley, J. A., Shoemaker, M. E., Sipes, M., Horovitz, M. (2011). What is the evidence for environmental causes of challenging behaviors in persons with intellectual disabilities and autism spectrum disorders? Research in Developmental Disabilities, 32(2), 693–698.
Merz, E. C. & McCall, R. B. (2010). Behavior problems in children adopted from psychosocially depriving institutions. Journal of Abnormal Child Psychology, 38, 459-470.
Miniscalco, C., & Gillberg, C. (2009). Non-word repetition in young school-age children in language impairment and/or neuropsychiatric disorder. Research in Developmental Disabilities, 30, 1145-1154.
Nord, G. B., Wieseler, N. A., & Hanson, R. H. (1998). The assessed crisis service needs of clients in community based programs serving persons with developmental disabilities. Behavioral Interventions, 13, 169-179.
O'Brien, P., Thesing, A., Tuck, B., Capie, A., (2001). Perceptions of change, advantage and quality of life for people with intellectual disability who left a long stay institution to live in the community. Journal of Intellectual and Developmental Disability, 26(19), 67-82.
Paclawskyj, T. R., Matson, J. L., Rush, K. S., Smalls, Y., & Vollmer, T. R. (2000). Questions about behavioral function (QABF): A behavioral checklist for functional assessment of aberrant behavior. Research in Developmental Disabilities, 21, 223-229.
Ramirez, S. Z., & Lukenbill, J. (2008). Psychometric Properties of the Zung Self-Rating Anxiety Scale for Adults with Intellectual Disabilities (SAS-ID). Journal of Developmental and Physical Disabilities, 20(6), 573-580.
Symons, F. J. (2005). Readers’ reaction: Self-injurious behavior and sequential analysis: Context matters. American Journal on Mental Retardation, 110(4), 323-326.
Spreat, S., & Conroy, J. (1998). Use of psychotropic medications for persons with mental retardation who live in Oklahoma nursing homes. Psychiatric Services, 49, 510-512.
Strachan, R., Shaw, R., Burrow, C., Horsler, K., Allen, D., & Oliver, C. (2009). Experimental functional analysis of aggression in children with Angelman syndrome. Research in Developmental Disabilities, 30, 1095-1106.
Swender, S. L., Matson, J. L., Mayville, S. B., Gonzalez, M. L., & McDowell, D. (2006). A functional assessment of handmouthing among persons with severe and profound intellectual disability. Journal of Intellectual and Developmental Disability, 31, 95-100.
Tiger, J. H., Fisher, W. W., Toussaint, K. A., & Kodak, T. (2009). Progressing from initially ambiguous functional analyses: Three case examples. Research in Developmental Disabilities, 30, 910-926.
Walsh, P. N., Emerson, E., Lobb, C., Hatton, C., Bradley, V., Schalock, R. L., and Moseley, C. (2010). Supported accommodation for people with intellectual disabilities and quality of life: an oerview. Journal of Policy and Practice in Intellectual Disabilities, 7, 137-142.
Widrick, G. C., Bramley, J. A., & Frawley, P. J. (1997). Psychopathology in adults with mental retardation before and after deinstitutionalization. Journal of Developmental and Physical Disabilities, 9(3), 223-242.
Wilkins, J., & Matson, J. L. (2009). A comparison of social skills profiles in intellectually disabled adults with and without ASD. Behavior Modification, 33, 143-155.
White, D. A., Dodder, R. A. (2000). The Relationship of Adaptive and Maladaptive Behaviour to Social Outcomes for Individuals with Developmental Disabilities, Disability & Society, 6, 879-908.
Wolfensberger, W. (1998). A brief introduction to social role valorization: A high-order concept for addressing the plight of societally devalued people, and for structuring human services (3rd ed., rev.) Syracuse, NY: Syracuse University, Training Institute for Human Service Planning, Leadership and Change Agentry.
Young, L. (2006). Community and cluster centre residential services for adults with intellectual disability: Long-term results from an Australian-matched sample. Journal of Intellectual Disability Research, 50, 419-431.
Young, L., & Ashman, A. F. (2004). Deinstitutionalization for older adults with severe mental retardation: Results from Australia. American Association on Mental Retardation, 109(5), 397-412.
Young, L., Sigafoos, J., Suttie J., Ashman A., Grevell P. (1998). Deinstitutionalisation of persons with intellectual disabilities: A review of Australian studies. Journal of Intellectual and Developmental Disability, 23(2), 155-170.