Socially assistive robotics and older family caregivers of young adults with Intellectual and Developmental Disabilities (IDD): A pilot study exploring respite, acceptance, and usefulness.

INTRODUCTION: The need for caregiver respite is well-documented for the care of persons with IDD. Social Assistive Robotics (SAR) offer promise in addressing the need for caregiver respite through 'complementary caregiving' activities that promote engagement and learning opportunities for a care recipient (CR) with IDD. This study explored the acceptability and usefulness of a SAR caregiver respite program responsive to feedback from both young adults with IDD and their older family caregivers (age 55+). METHOD: Young adults with IDD and caregiver dyads (N = 11) were recruited. A mixed methods research design was deployed in three phases: Phase I with four focus groups to inform the program design; Phase II for program demonstration and evaluation with pre- and post-surveys; and Phase III with post-program interviews for feedback and suggestions. RESULTS: Both young adults with IDD and their caregivers scored favorably the social presence of, social engagement, and satisfaction with robot Pepper. Though there was no significant improvement of caregiving burden/stress as well as well-being of the young adults with IDD based on surveys, results from interviews suggested that the SAR may offer physical/emotional respite to caregivers by providing companionship/friendship as well as promoting independence, safety/monitoring, and interactive engagement with children. DISCUSSION: SAR has potential in providing respite for older family caregivers. Future studies need a longer program design and larger sample size to develop a promising intervention and test its feasibility and efficacy.

The "humane in the loop": Inclusive research design and policy approaches to foster capacity building assistive technologies in the COVID-19 era.

The COVID-19 pandemic is emerging as a driver of greater reliance on wireless technologies, including intelligent assistive technologies, such as robots and artificial intelligence. We must integrate the humane "into the loop" of human-AT interactions to realize the full potential of wireless inclusion for people with disabilities and older adults. Embedding ethics into these new technologies is critical and requires a co-design approach, with end users participating throughout. Developing humane AT begins with a participatory, user-centered design embedded in an iterative co-creation process, and guided by an ethos prioritizing beneficence, user autonomy and agency. To gain insight into plausible AT development pathways ("futures"), we use scenario planning as a tool to articulate themes in the research literature. Four plausible scenarios are developed and compared to identify one as a desired "humane" future for AT development. Policy and practice recommendations derived from this scenario, and their implications for the role of AT in the advancement of human potential are explored.

A systematic review of the psychosocial impact of emotional numbing in US combat veterans.

CONTEXT: Previous studies have linked posttraumatic emotional numbing symptoms in US combat veterans with an adverse impact in multiple important life domains. OBJECTIVES: We updated and evaluated the evidence examining the psychosocial impact of combat-related emotional numbing, including ethnoracial and gender differences. METHOD: We reviewed 1,209 articles published betwen January 2012 and 2018 and selected 24 studies for inclusion. We assessed the overall study quality as fair using a national quality assessment tool. RESULTS: Studies found emotional numbing to wield adverse effects in the areas of symptom nonimprovement, mental health difficulties, increased service utilization, poor relationship functioning, reduced quality of life, substance use disorders, suicidality, and aggression/violence. We also found evidence of ethnoracial and gender differences in veterans' posttraumatic stress disorder-related emotional numbing symptoms. CONCLUSION: Clinicians should incorporate findings on emotional numbing into assessment, treatment planning, and monitoring, to improve treatment retention and psychosocial outcomes. Implications for ethnoracial and gender differences require further exploration.

Telework rationale and implementation for people with disabilities: considerations for employer policymaking.

BACKGROUND: Telework has been promoted as a viable workplace accommodation for people with disabilities since the 1990s, when information and communication technologies (ICT) had developed sufficiently to facilitate its widespread adoption. This initial research and accompanying policy recommendations were prescriptive in nature and frequently aimed at employers. OBJECTIVE: This article adds to existing policy models for facilitating successful telework outcomes for people with disabilities. Drawing upon two studies by the Rehabilitation Engineering Research Center on Workplace Accommodations, we expound on employee-side considerations in the implementation of telework. METHODS: Our policy model utilizes established typologies for policy evaluation to develop a process model that considers rationales and implementation factors for telework among people with physical disabilities. RESULTS: Telework may be used as an accommodation for disability, but employee rationales for telework are more complex, involving work-life balance, strategies for pain and fatigue not formally recognized as disability, and expediency in travel and transportation. Implementation of telework as a component of workplace operations is similarly multifaceted, involving non-technology accommodations to realize job restructuring left incomplete by telework. CONCLUSIONS: Our model grounds new empirical research in this area. We also renew our call for additional research on effective telework practices for people with disabilities.

Community-based day-care services for people with intellectual disabilities in Georgia: a step towards their social integration.

This article discusses the role of community-based day-care services in the lives of adults with intellectual disabilities in the Republic of Georgia. The study explores the impact of this service on users' social-adaptive skills, social life and sense of happiness, comparing service users and a matched comparison group. A mixed-methods approach was used to assess the influence of day-care-centre services on social adaptation and integration. Results indicated that the level of social-adaptive skills was higher for day-care-centre participants than for the comparison group along several key dimensions. Similarly, the level of social integration was higher for the day-care-centre group, although the two groups did not differ significantly on reported happiness. The findings from this study revealed that day-care-centre participants with intellectual disabilities enjoyed a greater degree of social interaction and socializing opportunities than their non-participant peers.

Macro practice teaching and curriculum development from an evidence-based perspective.

This article contributes to the discourse around evidence-based practice (EBP) as an organizing principle and guiding framework for macro-practice education as it has developed in the George Warren Brown School of Social Work at Washington University in St. Louis. In examining the first five years of implementing evidence-based education at the macro level, some lessons learned are provided. This learning has opened the door for continuing the dialogue on surmounting the challenges around training macro social workers in evidence-based practices. The overarching challenge in integrating EBP into the curriculum lies in the complexity of the multi-dimensional conceptualization of evidence.

Using telework to enhance return to work outcomes for individuals with spinal cord injuries.

Return-to-work is an area of critical concern for individuals with a spinal cord injury (SCI), because of the psychological, psychosocial and economic benefits of employment. Although the majority of individuals with SCI are employed pre-injury, they are impeded from maintaining those jobs due to personal, organizational and systems level barriers. Telework, which permits home-based work through the use of Information and Communication Technologies (ICT), alleviates many of return-to-work barriers for individuals with SCI, including job demands, mobility limitations, transportation needs and fatigue imposed by medical complications. For telework to fulfill its potential as a return-to-work strategy, rehabilitation professionals and employers must assess and enhance the readiness of the individual, workgroup and organization within the context of a disability management program. Strategies for successfully implementing telework as a return-to-work strategy for individuals with SCI are discussed, along with implications for future research.

Partnering with the 21st century workplace: leveraging workplace ecology.

The 'accessible' job market of the 1990's has given way to a challenging job market in a climate of economic uncertainty in the early Twenty-First Century. For vocational rehabilitation professionals this change requires the strategic use of workplace supports to increase the value and sustainability of work performed by people with disabilities in competitive jobs. An analytical framework for leveraging the natural supports of the workplace is provided by the workplace ecology as a bounded environment in which relationships between workers and supervisors promote learning and enhanced performance. The dynamics of the workplace ecology are explored with particular reference to workers with disabilities receiving supported employment services. Recommendations are made for leveraging the workplace ecology to the benefit of the supported worker. Implications for supported employment services in the new millennium are discussed.

Acute predictors of return to employment after traumatic brain injury: a longitudinal follow-up.

OBJECTIVE: To investigate the relation between selected acute injury and patient characteristics and subsequent return to work 1 to 5 years postinjury. DESIGN: Longitudinal design with prospectively collected data. Data were collected on patients at the time of injury and each year postinjury for up to 5 years. SETTING: Four medical centers in the federally sponsored Traumatic Brain Injury Model Systems project that provide emergency medical services, intensive and acute medical care, inpatient rehabilitation, and a spectrum of community rehabilitation services. PARTICIPANTS: Patients were selected from a national database of 538 rehabilitation inpatients admitted to acute care within 8 hours of traumatic brain injury (TBI) and seen at 1 to 5 years follow-up. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Employment status (employed vs not employed) at 1 to 5 years postinjury. Logistic regression analyses were performed to determine the extent to which selected variables predicted employment status at years 1 to 5 postinjury. RESULTS: At year 1 postinjury, preinjury productivity, age, education, and rehabilitation length of stay were all significantly associated with postinjury employment. Preinjury employment and productivity and age significantly predicted employment at postinjury year 2. At year 3 postinjury, preinjury productivity, age, and FIMtrade mark instrument discharge score significantly predicted employment status. Age was significantly associated with employment status at year 4 postinjury. Preinjury employment and productivity and Disability Rating Scale discharge score were found to be significant predictors of postinjury employment at year 5 follow-up. CONCLUSIONS: The relationship between certain acute injury and patient variables (eg, age, preinjury productivity, education, discharge FIM) and subsequent return to work may provide rehabilitation professionals with useful information regarding the intensity and types of services needed for individuals in the vocational rehabilitation planning process.

Denial in addiction: toward an integrated stage and process model--qualitative findings.

Focus groups were conducted at five chemical dependency treatment facilities assessing residents' (N = 65) conceptualizations of denial and the role it may have played in the pathogenesis and progression of their substance use disorders. Two of the authors read verbatim transcripts of the focus group proceedings and independently developed models of denial based on those data. The first reader identified a core set of interpersonal and attributional processes that appeared to explain why many participants did not perceive their substance abuse and associated problems as clearly aberrant and/or chose not to self-identify as alcohol or other drug dependent until late in the course of their chemical dependency. The second reader identified five stages that clients appeared to pass through as they progressed from no awareness of their substance use disorder to full awareness. A second set of readers then independently developed an integrated stage and process model of denial that incorporated elements of the models identified earlier. Though obviously exploratory in nature, these findings suggest that denial is a far more complex and dynamic set of intra- and interpersonal processes than is generally recognized.

Disability and job stress: Implications for vocational rehabilitation planning.

Because people with disabilities often experience an increased risk for physical and psychological complications of job stress, vocational rehabilitation professionals must be able to (a) identify individual and work-environmental risk factors for job stress and (b) design appropriate interventions to minimize those risk factors. The purpose of this article is to (a) present two models of occupational stress, (b) examine factors common to each of these models that are associated with employee health and well-being, and (c) suggest implications for rehabilitation planning.