Published: 31 March 2021 at 10:33
Training and flexibility needed to help those with severe intellectual disabilities
A new study examining how people with severe and profound intellectual disabilities resist activities while in care recommends that institutions improve training to help carers better understand non-verbal cues, as well as offer greater flexibility to allow individual preferences to take priority over institutional schedules.
The research, published in the journal Sociology of Health and Illness, investigated how people with limited language ability expressed their wishes and preferences, and how their support workers responded. It was carried out at a residential home and a day care centre in the UK.
The study, by Dr Clare Nicholson of St Mary’s University, Twickenham, and Dr Mick Finlay and Dr Steven Stagg of Anglia Ruskin University (ARU), involved taking notes and filming everyday interactions such as feeding, drinking, art and music activities, and physiotherapy, over the course of a year.
The research found that the service users signalled in very subtle ways, usually non-verbally, when they did not want to do something. For people with severe disabilities, how well their care workers recognise and respond to these subtle behaviours is crucial to their autonomy and empowerment.
Behaviour which appeared to signal resistance to activities included pretending to be asleep, dropping tools such as paint brushes, turning the head or the gaze away from the care worker, pushing objects away, dragging feet along the ground to slow movement in a wheelchair, and making loud vocalisations.
When these behaviours were not responded to by care workers, who instead continued with the activity, the person would sometimes escalate their resistance to behaviour involving self-injury, such as thrashing their body around in a wheelchair, striking their own face, and digging their fingernails into their hands.
In addition to encouraging care workers to adopt greater flexibility around which activities take place and when, the authors believe further training using real life examples, such as those outlined in the study, could help staff better understand some of the common signs of resistance.
Co-author Dr Mick Finlay, Reader in Social Psychology at Anglia Ruskin University (ARU), said: