Diane Morin

Public attitudes towards intellectual disability: a multidimensional perspective

BACKGROUND Public attitudes towards persons with intellectual disabilities (IDs) have a significant effect on potential community integration. A better understanding of these can help target service provision and public awareness programmes. OBJECTIVE The objective of the present study is threefold: (1) describe public attitudes towards persons with ID along affective, cognitive and behavioural dimensions; (2) compare and contrast attitudes according to sex, age, education and income, as well as frequency and quality of contacts with persons with ID; and (3) ascertain whether the level of functioning has an effect on attitudes. METHODS The Attitudes Toward Intellectual Disability Questionnaire (ATTID) was administered by phone to 1605 randomly selected adult men and women, stratified by region in the province of Québec, Canada. The ATTID uses a multidimensional perspective of attitudes that reflect affective, cognitive and behavioural dimensions. RESULTS The results showed that public attitudes were generally positive regarding all three attitudinal dimensions. Public attitudes towards persons with ID are presented in terms of the five factors measured through the ATTID: (1) discomfort; (2) sensibility or tenderness; (3) knowledge of causes; (4) knowledge of capacity and rights; and (5) interaction. Attitude factor scores vary as a function of participant characteristics (sex, age, education and income) and the degree of knowledge about ID, the number of persons with ID known to the participants, as well as the frequency and quality of their contacts with these persons. Men had greater negative attitudes than women as regards the discomfort factor, while women had more negative attitudes regarding the knowledge of capacity and rights factor. More positive attitudes were revealed among younger and more educated participants. Attitudes were generally not associated with income. Public attitudes tended to be more negative towards people with lower functioning ID. CONCLUSION These results yield useful information to target public awareness and education.

A Comparison of the Prevalence of Chronic Disease Among People with and Without Intellectual Disability

Some studies have reported the presence of health disparities in people with intellectual disability. This study compared the prevalence of chronic health conditions between people with and without intellectual disability (ID). Health-related data for 791 people with ID were collected through a province-wide mail survey in Quebec, Canada. The distribution of chronic health conditions reported was compared to the data on the health status of the general population. People with ID had higher reported rates of heart disease and thyroid disorder than the general population. We also found that people with ID were less likely to report suffering from arthritis, migraines, back or spinal pain, and food allergies. Significant health differences were found when the ID sample was stratified by etiology (i.e., Down syndrome) and severity of intellectual deficits. We discuss these results and the need for future research to understand the differences found in the health status of people with ID.

Validation of the attitudes toward intellectual disability – ATTID questionnaire

BACKGROUND Individuals with an intellectual disability (ID) continue to experience major obstacles towards social, educational and vocational integration. Negative attitudes toward persons with ID has remained relevant over time and has led to discrimination and stigma. OBJECTIVE The present study describes the development of a new questionnaire for tapping into the general populations attitudes toward individuals with ID and addresses its psychometric properties. METHODS Adopting a multidimensional perspective, the Attitudes Toward Intellectual Disability Questionnaire (ATTID) was developed from a series of previously validated instruments and principles from the Montreal Declaration on Intellectual Disability (2004). The ATTID was administered by phone to 1605 randomly selected adult men and women, stratified by region in the Province of Quebec, Canada. RESULTS The ATTID yielded a five-factor structure overlapping the tri-partite model of attitudes. The cognitive component was represented by two factors: knowledge of capacity and rights and knowledge of causes of ID. The affective component tapped into two factors: discomfort and sensitivity/compassion. Finally, the behavioural component emerged as a single factor. The ATTID had good internal consistency with Cronbachs alpha coefficients ranging from 0.59 to 0.89 for the five factors and of 0.92 for the overall questionnaire. Test-retest reliability yielded correlations from 0.62 to 0.83 for the five factors. CONCLUSION The ATTID can be used to measure attitudes among different populations and allows comparisons over time within the same population as a function of various intervention strategies for de-stigmatising ID.

Translation and Cultural Adaptation of the Supports Intensity Scale in French

The Supports Intensity Scale (SIS) was translated into French. The French version was then validated using a sample of 245 persons with intellectual disabilities between the ages of 16 and 75 years. The internal consistency was excellent (.98). Correlations with age and levels of intellectual disabilities were evidence of good construct validity. These psychometric results replicate the psychometric characteristics reported on the original SIS version. Our findings show that the SIS-F is a good measure of intensity of support needs of individuals with developmental disabilities.

Intellectual disability and co-occurring mental health and physical disorders in aggressive behaviour.

BACKGROUND Mental and physical health problems are more prevalent among individuals with an intellectual disability (ID) than in the general population. Studies suggest that there may be significant associations between these co-occurring disorders and aggressive behaviour, but few studies have taken into account multiple mental and physical problems, as well as their level of severity. OBJECTIVES The main goal of this study was to identify the associations between different types of aggressive behaviour and various types of physical and mental health problems. METHODS These associations were explored through a cross-sectional study of 296 adult men and women with mild or moderate ID living in the community and receiving ID services. Information was gathered through interviews with ID participants, case managers and file review. RESULTS The results show that individuals with ID who have more mental and physical health problems have higher odds of displaying aggressive behaviour than those with fewer and less severe physical health problems. DISCUSSION These results can help guide future prevention and intervention strategies for persons with ID who display aggressive behaviour or who are at risk of become aggressive.

Exploring the Relations between In-service Training, Prior Contacts and Teachers’ Attitudes towards Persons with Intellectual Disability

This study investigates the relations between teachers’ attitudes towards persons with intellectual disability (ID), in-service training on ID, and prior contacts with persons with ID. A sample of Canadian elementary school teachers (N = 118) completed the Attitudes Toward Intellectual Disability Questionnaire, which measures cognitive, affective and behavioural components of attitudes towards persons with ID. Correlational and multivariate regression analyses were performed. Frequent contacts with persons with ID and experience of including a child with ID increased the likelihood of reporting prior positive contacts with persons with ID. In turn, this was associated with less discomfort towards persons with ID and more willingness towards interactions. In-service training on ID was related to better knowledge of rights and capabilities of persons with ID. Experience of including a child with ID in general education classrooms increased the likelihood to report feeling competent in teaching children with ID, which predicted more willingness to include children with ID.

Reliability of the Supports Intensity Scale (French Version)

The definition of intellectual disability, according to the American Association on Intellectual and Developmental Disabilities, includes the assumption that adequate supports should improve a persons functioning. Consequently, support needs have to be assessed to plan services for persons with intellectual disability. The Supports Intensity Scale (SIS; J. R. Thompson et al., 2004) is a standardized instrument for assessing support needs and their intensity. This study was designed to estimate the interrespondent, interinterviewer coefficients of the French version of the SIS. Approximately 40 persons with intellectual disabilities from Quebec, a Canadian province, participated in this study. For each participant, 2 respondents and 2 interviewers were identified and 3 French SIS questionnaires were filled out. Results are presented and discussed compared with those obtained with the original, English-based SIS.

Support Needs of Individuals With Mild and Moderate Intellectual Disabilities and Challenging Behaviors

This exploratory study examined relationships between support needs assessed with the French version of the Supports Intensity Scale (SIS; Thompson et al., 2004) and challenging behaviors as assessed with the Scales of Independent Behavior--Revised (Bruininks, Woodcock, Weatherman, & Hill, 1996). The Sample included 191 persons between 16 and 75 year old, with either a mild or moderate intellectual disability. Using correlation and inferential analysis, it was found overall that high frequency in challenging behaviors was related to a need for greater support intensity, particularly social support, and maintenance of emotional well-being. The findings highlighted the importance of establishing specific support measures that target social skills, receptive and expressive communication, and the management of stress and anger.

Self-Injurious Behavior and Stereotypies

Mental retardation is characterized by significant intellectual limitations and poor adaptive behavior appearing before the age of 18 (Aman, Hammer, & Rojahn, 1993; Luckasson et al., 1992; Tasse, Aman, Rojahn, & Kern, in press). It is a persistent condition caused by a variety of biological and psychosocial determinants. Mental retardation manifests on a continuum of severity with a rapidly decelerating rate of occurrence as the behavioral and intellectual limitations increase. Neurological illnesses such as cerebral palsy, spina bifida, and seizure disorders frequently accompany mental retardation but without causal connection. In addition, individuals with mental retardation are highly vulnerable for psychopathology. Ever since the landmark Isle of Wight epidemiological studies conducted between 1964 and 1974 (Rutter, Tizard, Yule, Graham, & Whitmore, 1976), we have known that individuals with mental retardation have an elevated risk for psychiatric disorders such as schizophrenia and depression. Besides, many develop severe behavior disorders during their lives, such as aggressive and destructive behavior, violent tantrum behavior, or stereotyped and self-injurious behaviors.

Norms of the Attitudes Toward Intellectual Disability Questionnaire.

BACKGROUND The Attitudes Toward Intellectual Disability Questionnaire (ATTID) has demonstrated good psychometric qualities for measuring the attitudes of different groups of adults in the general population toward intellectual disability (ID). A significant advantage of the ATTID is that it addresses the concept of attitudes using a three-dimensional model (affective, cognitive and behavioural). To our knowledge, there are no normative data published regarding attitudes toward ID on general population-based samples. METHODS The sample of 1605 men and women was stratified to be representative of the general adult population of Quebec. The ATTID was administered by phone interview through an independent survey firm. RESULTS Normative data are presented as percentile scores associated with the raw score of the ATTID by gender and age categories. Analysis of the variance yielded significant differences in attitude by gender and age. The directions and the strength of these associations vary according to each of the five factors used to define attitudes. CONCLUSION These norms will provide an essential tool to compare different groups and assess the effectiveness of various public campaigns to encourage more positive attitudes towards persons with ID. These norms would also allow international comparisons.