Improve Children with Intellectual and Developmental Disabilities, their Caregivers, and the Agency with Mindfulness

Improve Children with Intellectual and Developmental Disabilities, their Caregivers, and the Agency with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness practices could be helpful for these caregivers because they encourage a nonjudgmental interpretation of their child’s situation, and increased acceptance of their reality.” – Emily Nauman

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost exacting a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Caring for children with intellectual and developmental disabilities can be particularly difficult. Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have a one or more developmental disabilities.

 

The challenges of caring for a child with intellectual and developmental disabilities require that the caregiver be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to the child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation, it improves the ability to maintain attention and focus in the face of high levels of distraction, and can reduce burnout.

 

In today’s Research News article “Comparative Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) and Positive Behavior Support (PBS) in a Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223775/) Singh and colleagues recruited caregivers from a home for children with intellectual and developmental disabilities. They were randomly assigned to receive either Mindfulness-Based Positive Behavior Support (MBPBS) of Positive Behavior Support (PBS).  The interventions were for 10 weeks and consisted of “an 8-h day on the first day of week 1 of training, followed by daily practice for 4 weeks. . .  a second part included five 8-h days (i.e., 40 h) during week 5, followed by daily practice for 4 weeks. . . and third part was again an 8-h day on the first day of week 10, followed by daily practice for the rest of the week.” During the next 30 weeks data were collected. The caregivers were measured before and after training for compassion satisfaction, compassion fatigue, perceived stress, professional quality of life, and meditation practice. The children’s behavior was rated for aggressive events, staff injury, and peer injury. The agency was evaluated for the use of physical restraints, emergency medication, staffing, and cost effectiveness.

 

They found that both interventions produced significantly increased compassion satisfaction, and decreased perceived and traumatic stress, and burnout for the caregivers. The Mindfulness-Based Positive Behavior Support (MBPBS) group, however, had significantly greater improvements than the Positive Behavior Support (PBS) group. Similar results were found for the children’s behavior with both treatments producing significant decreases with aggression, staff injuries, and peer injuries. Once again, the mindfulness group had significantly superior results. For the agency outcomes Mindfulness-Based Positive Behavior Support (MBPBS) produced significantly reduced use of physical restraints, emergency medication, and one-on-one staffing. In addition, the mindfulness treatment had significantly greater cost effectiveness.

 

These are very encouraging results that demonstrate that Mindfulness-Based Positive Behavior Support (MBPBS) is highly effective in improving the situation for staff, children, and the agency in an institution for children with intellectual and developmental disabilities. It increased

caregivers’ well-being and the children’s behavior, and decreased the strains on the agency. Amazingly, the mindfulness-based treatment was even more cost-effective.

 

So, improve children with intellectual and developmental disabilities, their caregivers, and the agency with mindfulness.

 

“the greater effects associated with mindfulness techniques may be due to “the immediacy of physiologic relaxation responses incurred in mindfulness practice, including strengthened attention to bodily sensations, and less reliance on rumination or other automatic emotions.” – Summer Allen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Singh, N. N., Lancioni, G. E., Medvedev, O. N., Myers, R. E., Chan, J., McPherson, C. L., Jackman, M. M., & Kim, E. (2020). Comparative Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) and Positive Behavior Support (PBS) in a Randomized Controlled Trial. Mindfulness, 11(1), 99–111. https://doi.org/10.1007/s12671-018-0895-2

 

Abstract

Caregivers of individuals with intellectual and developmental disabilities are often stressed due to the demands of the job, including the nature and severity of challenging behaviors of the clients, work conditions, degree of management support for the staff, and the demands of implementing some interventions under adverse conditions. Mindfulness-Based Positive Behavior Support (MBPBS) and PBS alone have been shown to be effective in assisting caregivers to better manage the challenging behaviors of clients with intellectual and developmental disabilities. The aim of the present study was to undertake a head-to-head assessment of the effectiveness of MBPBS and PBS alone in a 40-week randomized controlled trial. Of the 123 caregivers who met inclusion criteria, 60 were randomly assigned to MBPBS and 63 to PBS alone, with 59 completing the trial in the MBPBS condition and 57 in the PBS alone condition. Results showed both interventions to be effective, but the caregiver, client, and agency outcomes for MBPBS were uniformly superior to those of PBS alone condition. In addition, the MBPBS training was substantially more cost-effective than the PBS alone training. The present results add to the evidence base for the effectiveness of MBPBS and, if independently replicated, could provide an integrative health care approach in the field of intellectual and developmental disabilities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223775/

 

Improve Psychomotor Perform of Intellectually Disabled Children with Yoga

Improve Psychomotor Perform of Intellectually Disabled Children with Yoga

 

By John M. de Castro, Ph.D.

 

“Special needs experts agree that yoga activities make a positive impact on individuals with special needs.  These activities improve mobility, strength, and digestion for individuals with disabilities.” – Cara Batema

 

Intellectual disabilities involve below average intelligence and relatively slow learning. They are quite common, affecting an estimated 10% of individuals worldwide. These disabilities present problems for the children in learning mathematics, reading and writing. These difficulties, in turn, affect performance in other academic disciplines. The presence of intellectual disabilities can have serious consequences for the psychological well-being of the children, including their self-esteem and social skills. In addition, anxiety, depression, and conduct disorders often accompany learning disabilities. Not as well known is that children with intellectual disabilities also have motor problems.

 

Mindfulness training has been shown to improve attentionmemory, and learning and increase success in school. Exercise has been shown to improve psychomotor performance in children with intellectual disabilities. Yoga is both a mindfulness practice and an exercise that also tends to improve motor ability. So, it would make sense to explore the application of yoga training for the treatment of children with intellectual disabilities.

 

In today’s Research News article “Effect of yoga practices on psycho-motor abilities among intellectually disabled children.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165980/ ), Pise and colleagues recruited children aged 10 to 15 years from a school for the intellectually disabled. They were randomly assigned to a no-treatment control group or to receive yoga training for 1 hour per day, 5 days per week, for 12 weeks. The practice consisted of relaxation, postures, breathing exercises, and meditation. They were measured before and after training for balance, eye-hand coordination, agility, and reaction time.

 

They found that in comparison to baseline after the yoga training there were significant increases balance, eye-hand coordination, and agility, and decreases in reaction time. In comparison to the no treatment control group, the yoga group after training had significantly greater balance and faster reaction times. Hence, yoga practice appears to improve motor performance in children with intellectual disabilities.

 

 

These results were obtained with a no-treatment control condition. They need to be repeated with an active control condition such as a different exercise to determine if it was yoga practice itself or the exercise provided by yoga practice that was responsible for the improvements. But, nonetheless, the results suggest that yoga practice may be beneficial for children with intellectual disabilities. Improved motor ability might affect their performance in activities and sports and thereby improve their self-esteem.

 

So, improve psychomotor perform of intellectually disabled children with yoga.

 

“Yoga for special needs classes provide a sense of belonging and community. These adaptive yoga classes focus on building strength, developing regulation skills through breathing, improving mobility and maintaining/improving overall health and emotional well-being.” – Project Yoga

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Pise, V., Pradhan, B., & Gharote, M. (2018). Effect of yoga practices on psycho-motor abilities among intellectually disabled children. Journal of exercise rehabilitation, 14(4), 581-585. doi:10.12965/jer.1836290.145

 

Abstract

The children with intellectual disabilities show disorders at motor development and coordination. Hence, the objective of this study was to see the effect of yoga practices on psycho-motor abilities of intellectually disabled children. Seventy intellectually disabled children were divided into experimental group and control group. Both experimental and control group were assessed on the first day and after 12 weeks of the yoga intervention for static balance, eye hand coordination, agility and reaction time. The subjects of experimental group then underwent a training of yoga practices, for 1 hr for a total period of 12 weeks. The result of within group comparison revealed significant improvement in static balance, eye hand coordination, agility, and reaction time (P< 0.001) in subjects of yoga group however no change was observed in control group. The present study demonstrated that 12 weeks of yoga is effective in improving psycho-motor abilities of intellectually disabled children.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165980/

 

Improve Caregiving for Developmental Disabilities with Mindfulness

By John M. de Castro, Ph.D.

 

“mindfulness practices could be helpful for . . . caregivers because they encourage a nonjudgmental interpretation of their child’s situation, and increased acceptance of their reality. Mindfulness practices also help people observe their thoughts and behaviors with less reactivity and judgment, which could enable caregivers to better respond to the emotional and physical difficulties they encounter.” –  Emily Nauman

 

Four in ten adults in the U.S. are caring for an adult or child with significant health issues, up from 30% in 2010. Caring for a loved one is an activity that cuts across most demographic groups, but is especially prevalent among adults ages 30 to 64, a group traditionally still in the workforce. Caring for children and adults with intellectual and developmental disabilities can be particularly difficult. Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have a one or more developmental disabilities.

 

Today, most people with intellectual and developmental disabilities live with their families. This places many stresses on the caregivers and their families and stretches their financial resources. Due to these issues, people with severe cases of intellectual and developmental disabilities are often cared for in community and group homes. The staff of these homes, like family caregivers are under high levels of stress for many reasons including that many individuals with intellectual and developmental disabilities are highly aggressive and at time combative.  They sometimes require physical restraint and can cause injuries to the caregiver and to other patients. In addition, the high levels of stress and injury results in many staff leaving. It should be clear that there is a need for methods to reduce the stress, and burnout of caregivers in community and group homes. Mindfulness training has been found to be helpful for caregivers in the home setting. So it would be reasonable to expect that mindfulness training may also be helpful for caregivers in community and group homes.

 

In today’s Research News article “Caregiver Training in Mindfulness-Based Positive Behavior Supports (MBPBS): Effects on Caregivers and Adults with Intellectual and Developmental Disabilities”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1202660149757909/?type=3&theater

or see below, or for a full text see:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746712/

Singh and colleagues implemented a 10-week Mindfulness-Based Positive Behavior Support (MBPBS) training for caregivers of individuals with intellectual and developmental disabilities in community and group homes. The training added practice with meditation to a standard Positive Behavior Support (PBS) program. The PBS program “is designed to decrease an individual’s problem behaviors by teaching new skills, modifying the environment where the problem behaviors occur, and enhancing quality of life.” It was hypothesized that the addition of mindfulness training would magnify and supplement the effectiveness of the PBS program.

 

Singh and colleagues found that the MBPBS training resulted in a significant decrease in the use of physical restraint and significant decreases in injuries to staff and other patients. There were also significant reductions in the staff’s perceived stress levels and turnover rate. The reduced stress and injuries resulted in a highly significant reduction in institutional costs. These results clearly demonstrate that the MBPBS training is effective for caregivers. It is not clear, however, whether the meditation training was responsible, the Positive Behavior Support training or both. It remains for future research to identify which components are necessary and sufficient for improvement of caregivers well-being.

 

Regardless, it is clear that the combination of meditation to Positive Behavior Support (PBS) training produces important improvements for the staff, patients, and institution in caregiving for individuals with intellectual and developmental disabilities in community and group homes.

 

“caregivers and patients found that the mindfulness training actually helped improve their relationships with each other. Mindfulness places both people in the present and in positive emotion; the two sides share this experience with a bit of freedom from the baggage of their history. . . . such gentle, positive interaction helped defuse the ongoing stress of a caregiver dynamic, and it helped build a stronger relationship in the present.”Adam Perlman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

Study Summary

Singh, N. N., Lancioni, G. E., Karazsia, B. T., & Myers, R. E. (2016). Caregiver Training in Mindfulness-Based Positive Behavior Supports (MBPBS): Effects on Caregivers and Adults with Intellectual and Developmental Disabilities. Frontiers in Psychology, 7, 98. http://doi.org/10.3389/fpsyg.2016.00098

 

Abstract

Caregivers often manage the aggressive behavior of individuals with intellectual and developmental disabilities that reside in community group homes. Sometimes this results in adverse outcomes for both the caregivers and the care recipients. We provided a 7-day intensive Mindfulness-Based Positive Behavior Support (MBPBS) training to caregivers from community group homes and assessed the outcomes in terms of caregiver variables, individuals’ behaviors, and an administrative outcome. When compared to pre-MBPBS training, the MBPBS training resulted in the caregivers using significantly less physical restraints, and staff stress and staff turnover were considerably reduced. The frequency of injury to caregivers and peers caused by the individuals was significantly reduced. A benefit-cost analysis showed substantial financial savings due to staff participation in the MBPBS program. This study provides further proof-of-concept for the effectiveness of MBPBS training for caregivers, and strengthens the call for training staff in mindfulness meditation.