Affirming Neurodiversity within Applied Behavior Analysis.

Criticisms of applied behavior analysis (ABA) from the autistic community continue to intensify and have an appreciable impact on research, practice, and conversation in stakeholder groups. ABA providers aspire to increase quality of life for autistic people; thus, it is imperative for providers to listen with humility and openness to the population we serve. Autistic individuals have unparalleled expertise in their own lives and their own communities. The concerns raised by the autistic community cannot, morally or ethically, be swept aside. There may be a misguided and harmful tendency to devalue concerns due to the speaker's identification as autistic or due to their difference in professional credentials. The concept of neurodiversity can help the ABA field respond to these concerns and collaborate with the largest stakeholders of our services, the autistic clients we serve. This article summarizes some of the key criticisms that autistic advocates raise concerning ABA, discusses the social model of disability and the neurodiversity paradigm, and proposes practical guidance to help the field of ABA integrate neurodiversity and thereby evolve our research and practice. By openly acknowledging the criticisms against ABA and recognizing how we can do better as a field, we believe we can take practical steps towards a profession and a society that more fully embraces inclusion.

Role of Psychosomatic Medicine in Complex Medical Cases: A Case Study of a Patient With Breast Cancer Who Refused Mastectomy.

Psychosomatic medicine has been known to play a pivotal role in the management of complex medical cases by providing a bridge between the physical disease and psychological distress. This case study focuses on a 42-year-old Saudi female diagnosed with breast cancer and generalized anxiety disorder. In addition to anxiety, the patient had a history of obsessive-compulsive personality traits, which contributed to her reluctance to undergo mastectomy. Significant challenges and noncompliance with treatment were caused by her unwillingness and inadequate interaction with the medical team. An integrated multidisciplinary strategy including psycho-oncological interventions was necessary because of the complexity of this case. Communication issues were addressed through the concerted efforts of the specialist teams. A comprehensive patient-practitioner understanding was established, which enabled the teams to persuade the patient to undergo surgical intervention. Overcoming her initial resistance, the patient eventually complied with the treatment plan, leading to a successful surgery. Postsurgical evaluations using the Hamilton Anxiety Scale indicated a significant reduction in anxiety levels. This case underscores the critical contribution of psychosomatic medicine to healthcare, especially in challenging situations that demand additional resource allocation, further highlighting the importance of an interdisciplinary approach, efficient communication, and patient-practitioner rapport in healthcare outcomes.

The lived experiences of play and the perspectives of disabled children and their parents surrounding brain-computer interfaces.

Brain-computer interfaces (BCI) offer promise to the play of children with significant physical impairments, as BCI technology can enable disabled children to control computer devices, toys, and robots using only their brain signals. However, there is little research on the unique needs of disabled children when it comes to BCI-enabled play. Thus, this paper explored the lived experiences of play for children with significant physical impairments and examined how BCI could potentially be implemented into disabled children's play experiences by applying a social model of childhood disability. Descriptive qualitative methodology was employed by conducting four semi-structured interviews with two children with significant physical impairments and their parents. We found that disabled children's play can be interpreted as passive or active depending on one's definition and perceptions surrounding play. Moreover, disabled children continue to face physical, economic, and technological barriers in their play, as well as play restrictions from physical impairments. We urge that future research should strive to directly hear from disabled children themselves, as their perspectives may differ from their parents' views. Also, future BCI development should strive to incorporate video games, recreational and entertainment applications/platforms, toys and switch-adapted toys, and power wheelchairs to better support the play of children with significant physical impairments.Implications for RehabilitationAssistive technology research should strive to examine the social, infrastructural, and environmental barriers that continue to disable and restrict participation for disabled children and their families through applying a social model of childhood disability and other holistic frameworks that look beyond individual factorsFuture research that examines the needs and lives of disabled children should strive to directly seek the opinions and perspectives of disabled children themselvesBrain-computer interface development should strive to incorporate video games, recreational and entertainment applications/platforms, toys and switch-adapted toys, and power wheelchairs to better support the play of children with significant physical impairments.

COVID-19 pandemic among adults with intellectual disabilities: Implementing a social model of disability in crisis and trauma situations.

A growing body of evidence has attested to the higher impact of COVID-19 on individuals with intellectual disabilities (IDs) than on members of the general population during the pandemic, mainly showing their higher vulnerability. However, we believe it is important to better understand how their situation interacts with the specific circumstances of the pandemic. In this article we discuss recent findings regarding individuals with IDs through the lens of two theories - the social disability model and the ecological model of trauma and recovery - and propose an integration, namely a social model of disability in crisis and trauma situations. Such a model allows for a wider perspective on understanding the way people living with disabilities (PLWDs) cope in these situations, integrating the individual aspects of coping with the social and environmental ones.

Who needs the social model of disability?

Over the past two decades, there has been a growing shift away from the Social Model of Disability (SMD) in both theory and practice. This article aims to substantiate the relevance of SMD by addressing the main arguments against it and by identifying why and for whom it is still relevant. In the introductory section, we focus on the recent production of multiple disability models in order to contextualize their emergence and elucidate the reasons behind their proliferation. In the main section of the article, we critically engage with three lines of criticism against SMD in order to explain why it remains relevant and for whom. Our main point is that, in the context of the neoliberal capitalist era, the SMD is indispensable for all disabled persons who have been denied their dignity, both in material and cultural terms.

Social Model Recovery and Recovery Housing.

Recovery housing is an important resource for many in their recovery from alcohol and other drug use disorders. Yet providers of recovery housing face a number of challenges. Many of these challenges are rooted in stigma and bias about recovery housing. The ability to describe the service and purported mechanisms of action vis-a-vis an overarching framework, approach, or orientation could also go a long way in adding credence to recovery housing as a service delivery mechanism. Several aspects of social model recovery are often explicitly built or organically reflected in how recovery housing operates, yet describing recovery housing in these terms often does little to demystify key features of recovery housing. To more fully cement social model recovery as the organizing framework for recovery housing this article aims to: review the history, current status, and evidence base for social model recovery; comment on challenges to implementing the social model in recovery housing; and delineate steps to overcome these challenges and establish an evidence base for social model recovery housing.

Giving and Receiving Help among Persons Entering Sober Living Houses.

Giving and receiving help are integral to creating the social environments necessary to support recovery. However, studies assessing the effects of helping behaviors have focused primarily on the benefits derived from giving help to others in 12-step programs and treatment. The current study examined the frequency of giving and receiving help among 188 persons entering sober living houses (SLHs), a type of recovery home that is common in California. Helping was assessed in three contexts: the SLH, 12-step meetings they attended, and interactions with their family and friends. Residents who gave help to others in one of these contexts tended to also receive help in that context. Residents who reported giving or receiving help in one context tended to report giving and receiving help in other contexts. Study findings suggest helping in recovery occurs in a broader, more reciprocal manner than currently conceptualized. Studies should address how giving and receiving help in different contexts affects recovery outcomes. Research is also needed to describe the determinants of giving and receiving help. Considerations for facilitating help among SLH residents are described.

The United Nations Convention on the Rights of Persons with Disabilities and Social Work: Evidence for Impact?

The United Nations Convention on the Rights of Persons with Disabilities (hereafter CRPD) has provided a radical imperative for the reform of mental health and capacity legislation around the world. The interpretation of the CRPD has been controversial, ranging from the complete abolition of detention, forcible treatment, and substitute decision-making to accepting that elements of these measures need to be retained based on non-discriminatory criteria, additional safeguards, and a comprehensive shift towards supported decision-making. While the potential effects of the CRPD on mental health social work and social work generally are considerable given their shared commitment towards social justice, to date there has been no review of research evidence exploring their relationship. In addressing this knowledge gap, this study held a preliminary discussion with practitioners and academics at the European Association of Social Work Mental Health Special Interest Group in Amsterdam 2022, followed by a scoping literature review on the question: What impact, if any, has the CRPD had on social work practice? The review produced four main findings: impact on legislation; positive impact on practice; limited impact on practice; and impact on social work education and research. In sum, while there were some positive indications of social work and mental health social work practice being influenced by the CRPD, these were scant. Barriers to change included tendencies among some social workers to practise substitute decision-making, in part related to resourcing and policy contexts, and understandings of disability aligned to individualised/medical rather than social perspectives. The results indicate that legal reform on its own is insufficient to impact social work practice, and that realising the potential of the CRPD will necessitate good quality training, as well as improving social workers' knowledge of the human rights of people with mental impairment.

[The certain issues of supporting non-barrierness of objects and services for not mobile citizen].

The article presents analysis of establishing conditions to adapt the environment and to remove barriers for not mobile citizen (the disabled with disorders of musculoskeletal system). In the process of analysis of possibilities to organize non-barrier environment for not mobile citizen the national and foreign normative legal acts, international conventions, materials of national and foreign experts, Internet sources were used. The analysis of current international regulation of non-barrier urban environment for not mobile citizen demonstrates gradual transition from medical concept of disability to social one. The disabled society model surmises that people are disabled to the extent that the environment prevents them from fulfilling their needs and receiving necessary services. The importance of development of municipal and regional quality standards of accessibility of the environment and services for the disabled increases. It is necessary to eliminate informational, communicative and other barriers for this contingent of citizens. The consequences of impact of the COVID-19 pandemic on paradigm alteration in the field of strategy of adaptation of municipalities to needs of not mobile citizen are analyzed. The analysis of interaction between non-barrier environment and not mobile citizen permits to consider this process as an element of their post-medical rehabilitation. Only application of integrated intersectoral approach can positively effect on solution of problems in this area.

Outcomes Among Sober Living House Residents Who Relapse: Role of Recovery Capital.

Studies show individuals living in residential recovery homes on average make significant improvements in multiple areas of functioning. Residents who achieve and maintain complete abstinence have particularly good outcomes. Residents who relapse after entering the houses have been studied minimally. The current study examined outcomes for 197 residents who relapsed within six months after entering sober living houses (SLHs), which is one type of residential recovery home that is common in California. Despite having relapsed, these residents made significant improvements between entry into the house and 6-month follow-up on measures of percent days abstinent from alcohol and drugs (PDA), psychiatric symptoms, severity of employment problems, and stable housing. Higher recovery capital predicted higher PDA (coefficient = 0.28, SE = 0.09, p = .001) and lower severity of employment problems (coefficient = -0.00, SE = 0.00, p = .007). Recovery capital showed a significant decrease between baseline and 6-month follow-up among persons who relapsed and were no longer living in the house. SLH providers can draw upon social model recovery principles to enhance recovery capital. However, residents should also seek other sources of recovery capital outside the SLH, which may be particularly important for individuals who leave the home.

Toward the development of a training program that promotes a "social model of disability" for physical therapists: a discussion on experiential learning surrounding the use of "acceptance of disability" by physical therapists.

[Purpose] This study aimed to extract knowledge for the development of a training program for creating a social model of disability for physical therapists, focusing on the experiential learning of those physical therapists who did not use acceptance of disability according to their subjective judgment. [Participants and Methods] The study included 11 physical therapists who were interviewed about their use of acceptance of disability and the circumstances leading to its non-use. [Results] The study identified the past and current use of acceptance of disability, as well as cases and reasons for its discontinuation, along with changes in clinical content. [Conclusion] The study extracted knowledge for the development of training programs in line with the components of the experiential learning model.

Moving Social Model Recovery Forward: Recent Research on Sober Living Houses.

Social model recovery is a peer centered approach to alcohol and drug problems that is gaining increased attention. This approach is well-suited to services in residential settings and typically includes living in a shared alcohol- and drug-free living environment where residents give and receive personal and recovery support. Sober Living Houses (SLHs) are recovery residences that explicitly use a social model approach. This paper describes recent research on SLHs, including new measures designed to assess their social and physical environments. We conclude that our understanding of social model is rapidly evolving to include broader, more complex factors associated with outcomes.

Assessment, life circumstances, curriculum and skills: Barriers and enablers to student mental wellbeing in distance learning.

Student mental wellbeing is increasingly a priority for universities, and this is particularly critical in a distance learning context. Studies have found that studying, academic pressure, university culture and systems can affect students' mental health. There are increasing calls for universities to take a compassionate, holistic approach to supporting student wellbeing, and identify the barriers that are created by university cultures, systems, pedagogies, curricula, tuition and assessment practices. This study aimed to identify barriers and enablers to student mental wellbeing in distance learning, and students' recommendations for changes to be made. Using a student survey (N = 584), we identified that assessment and life circumstances were the most significant barriers, while the greatest enablers were building study skills, the people in students' lives, and curriculum and module content. The study revealed significant demographic differences in how students experience barriers and enablers, and how likely they feel they are to benefit from solutions. Students with disclosed mental health difficulties were consistently more likely to experience barriers than students without a disclosure, while enablers were experienced by all demographic groups. The study concludes that assessment should be prioritised as an area for action.

Urban precarity and youth mental health: An interpretive scoping review of emerging approaches.

Circumstances of living are key to shaping emotional and affective experiences, long term health, wellbeing and opportunities. In an era characterised by rapid urbanisation across the majority of the world, there is increasing interest in the interaction between mental health and urban environments, but insufficient attention is paid to how mental health is situated in space and time. Socio-economic inequalities are prevalent in many urban environments globally, making conditions of living highly precarious for some social groups including young people. There remains a large volume of unmet mental health service needs, and young people are impacted by uncertain economic futures. The purpose of this scoping review is to develop an interdisciplinary and globally-informed understanding of the urban conditions which affect youth mental health across a range of scales, and to identify protective factors which can promote better youth mental health. We seek to broaden the scope of urban mental health research beyond the physical features of urban environments to develop an interpretive framework based on perspectives shared by young people. We illustrate how concepts from social theory can be used as an integrative framework to emphasise both young people's lived experiences and the wider cultural and political dynamics of urban mental health.

Social Model Hospice Residential Care Homes: Whom Do They Really Serve?

BACKGROUND: Most prefer to die at home, but the Medicare Hospice Benefit does not cover custodial care, making it difficult for terminally ill patients with housing insecurity and/or caregiver instability to access hospice care at home. OBJECTIVES: To examine the characteristics of patients who received end-of-life care in community-run, residential care homes (RCHs) operating under the social model hospice. METHODS: A retrospective chart review of 500 residents who were admitted to one of three RCHs in Upstate New York over a 15-year period (2004-2019). RESULTS: Patients served by the RCHs included 318 (63.6%) women and 182 (36.4%) men aged 34-101 (M = 77.8). The majority (94.9%) were Caucasian and most had cancer diagnoses (71.6%). Prior to admission, most (93%) patients resided in a private residence, and nearly half (47%) lived alone, but most (81.7%) had full- or part-time caregivers. Nearly all patients were admitted either directly from a hospital (47.5%) or private home (47.2%). Over half (52%) were admitted to RCHs within a month of hospice enrollment, and 20.1% enrolled concurrent with admission. While the average length of stay was 21 days, 50% died within 10 days of admission. CONCLUSIONS: Community-run RCHs represent a unique approach for improving access to hospice home care for patients with home insecurity and/or caregiver instability, yet most patients had prior caregiver coverage and were admitted from a hospital or home setting, suggesting there is a need for community care settings for patients unable to remain at home in the final weeks or days prior to death.

The Perspectives of Preservice Kinesiology Students Concerning Autism and Physical Activity: Differences by Adapted Physical Activity Exposure.

BACKGROUND: This study investigated the effect of an adapted physical activity (APA) course on knowledge and perceptions of preservice trainees regarding physical activity (PA) and autism spectrum disorder in 3 areas: knowledge/perspectives, importance and ease of improving developmental domains, and importance and ease of improving motor skills. METHODS: Four hundred upper-level undergraduate students were recruited to participate in this survey-based study (251 APA students and 149 non-APA students participated). Survey data were analyzed using multivariate analyses of variance. RESULTS: Participants estimated that the moderate to vigorous PA recommendations are 39.34 minutes per day, that 46.65% of moderate to vigorous PA occurs during school, and that 61.03% of children have motor difficulties. Participants perceived activities of daily living, sleep habits, and heart health as the easiest domains to improve, and problem behaviors, social skills, and self-esteem as the most difficult domains to improve. Knowledge/perspectives regarding autism spectrum disorder and PA were different by APA exposure (F12,324 = 3.11, P < .001). Differences included self-efficacy in providing PA advice, knowledge of PA guidelines, and willingness to provide motor assessment referrals. Students differed by APA exposure in the importance of developmental domains (F8,381 = 4.37, P < .001) but not ease of improving those domains. CONCLUSION: Results suggest that APA education and contact with children with disabilities improves self-efficacy, perspectives, and knowledge of PA and motor concerns in children with autism spectrum disorder.

Social Model Hospice Homes: Bridging the Gap in End-of-Life Care Delivery.

Background: People prefer to die at home, if given a choice. However, data show that less than half of hospice patients get to do so, as many lack the social resources needed for end-of-life (EOL) care to be supported at home. The Social Model Hospice Home (SMHh) is an emerging model of care and offers an option for individuals whose EOL care cannot be fully supported by their available social network. An SMHh is a community-supported home staffed with round the clock caregivers dedicated to closing this social gap in EOL care delivery. Objective: This study aimed to enhance and clarify the reasons for successful outcomes of the SMHh concept. Methods: This study used a qualitative descriptive approach. Twenty-three semistructured interviews were conducted with the participants. Located throughout North America, participants consisted of staff, volunteers, guests, family members of previous guests, board members, and administrators of SMHh programs. Results: Over the course of the study, five major themes were developed: (1) physical attributes of the home, (2) volunteer base, (3) attention to detail, (4) structure of accountability, and (5) practice of compassionate honesty. These themes reveal the beginning of an explanatory theory of why the SMHh concept can support the delivery of effective, high-quality EOL care. Conclusions: The result of this study substantiates SMHh as a viable alternative to traditional in-home or institution-based EOL care. As the SMHh movement develops, more research is needed to explore and understand how this emerging model of care can be implemented on a larger scale.

Relationship between proximity and physiological stress levels in hunter-gatherers: The Hadza.

In recent years there has been a great deal of documentation on how social relationships are related to various aspects of human wellbeing. However, until recently most studies investigating the effects of social relationships on wellbeing have applied social network measures to reported social contacts. Recent advances in the application of bio-loggers in biological studies have now made it possible to quantify social relationships based on in-person, rather than self-reported, social interactions. We used GPS-derived in-camp and out-of-camp proximity data to analyse how in-person proximity is related to Hair Cortisol Concentration (HCC) among Hadza hunter-gatherers. Time spent in close proximity to other camp members was associated with higher HCC, especially in women. In contrast, individuals who spent more time in close out-of-camp proximity to their best friend experienced lower HCC. Our study suggests that physiological costs related to group living might be mitigated by in-person interactions with close friends. We also find that the location (i.e., in-camp vs out-of-camp) of proximity to others and self-perceived friends is associated with HCC among the Hadza.

Measuring Architecture in Recovery Homes: Recovery Home Architecture Scale.

Background: The settings where we live shape our daily experiences and interactions. Social environment and physical setting characteristics may be particularly important in communal living services, such as recovery homes for alcohol and drug disorders. Objectives: This paper describes the measurement and mobilization of architectural characteristics in one type of recovery home, sober living houses (SLHs). The Recovery Home Architecture Scale (RHAS) is a 25-item measure comprised of six subscales designed to assess architecture in SLHs. Results: Using a sample of 528 individuals residing in 41 houses, we found the RHAS had good interrater reliability, factor structure, and internal consistency. The measure also showed modest construct validity. The RHAS was not associated with length of stay (LOS) but did interact with a measure of the social environment that predicted LOS, the Recovery Home Environment Scale (RHES). Conclusions: Future studies should include a more diverse sample of SLHs and assess how house management, recovery capital, and other factors work in concert with architecture.