Academic journal article International Public Health Journal

The Cascading Transition Model: Easing the Challenges of Transition Experienced by Individuals with Autism and Their Support Staff

Academic journal article International Public Health Journal

The Cascading Transition Model: Easing the Challenges of Transition Experienced by Individuals with Autism and Their Support Staff

Article excerpt

Introduction

Quality of Life in the field of intellectual and developmental disabilities (IDD) is a well-developed concept and avenue of enquiry, and as Brown and Faragher (1) suggested, the concept of quality of life (QOL) over the last four decades has helped to promote a gradual change in our perception of individuals with IDD. Woodill et al (2) contend that QOL was not intended to be exclusionary, but that it must apply to all, including individuals who are challenged by disabilities. Approaches based on QOL must be capable of supporting and empowering interaction between individuals and their environment and include the belief and acceptance of the notion that individuals, regardless of their abilities and/or challenges have their own views about what constitutes quality of life for them.

The concept of QOL can now be considered not only as a theoretical academic topic, but as a concept with practical applications. Investigators such as Woodill et al (2), Renwick, Brown and Raphael (3) and Felce and Perry (4) suggested that in QOL it is crucial to integrate the principles of quality of life into practice. Professionals in the field of QOL are examining how we can utilize its basic principles to better the lives of people with all disabilities.

Brown and Faragher (1) iterated that QOL has come to include social well-being, holism, choice, personal control, perception, and self-image. The inclusion of such perceptual aspects in the definition of QOL has meant that it has become important to include both objective and subjective perspectives in our measuring tools. This shift in belief from a sole reliance upon traditional "objective" measurement techniques has given a voice to the internal aspects of the experiences, wishes, wants, opinions and choices of people with IDD. This has enabled the creation of a better balance between the internal subjective or perceptual aspects of QOL and the more external objective aspects. It is therefore possible to build a bridge between the rhetoric and the practice, and as demonstrated in Baum's examination of the QOL of direct care staff, make the application of QOL principles and approach both feasible and useful in many situations and settings. As a result, key concepts and principles which developed in the field of developmental and intellectual disabilities can now be applied in a wide variety of contexts, and in very specific instances, as this book attests.

Brown and Faragher (1) emphasized that, for individuals with IDD, the application of QOL concepts to service support models can have a significant impact. An improvement in functioning may occur when an individual moves from a difficult, negative environment to a supportive environment guided by QOL principles. As they suggest, the positive environment can often have a limiting impact on any previous negative experiences. Their notion echoes Feuerstein's (5,6), who was a pioneer in the field of rehabilitation of cognitive development of people with IDD. Feuerstein (5,6) argued that with a change in approach such as the provision of mediated learning experiences, remediation could and did occur. Feuerstein showed that with intentional mediated learning experiences, negative societal belief systems can be changed resulting in a more optimistic and encouraging environmental outlook and practice.

How important is the application of QOL principles to the creation of supportive and human environments?

A widening of the understanding of quality of life has emphasized the right of individuals with intellectual and developmental disabilities to become a part of, and live in the community rather than in institutions which for many years were the recommended solution of choice. One good example of the importance of applying QOL principles to real life situation is Felce's (7) exploration of the impacts of moving from institutional to community based alternatives. He found that positive living environments further enhanced individuals' QOL and increased chances of behavioural improvement. …

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