Individuals With Moderate to Severe Intellectual Disabilities: Perceptions of Community

PURPOSE: The purpose of this study was to understand how people with moderate to severe intellectual disabilities perceive community and determine their levels of engagement in a specific context. The Model of Human Occupation (MOHO) was utilized as the theoretical background to guide this study with a focus on the concept of volition. Currently there is limited published research specific to the target population included in this study and the topic of interest, perceptions of community. The specific research question was ‘how do individuals with moderate to severe intellectual disabilities perceive community?’ Research in this area is needed to understand the lived experiences of individuals with moderate to severe intellectual disabilities and maximize individuals participation in meaningful occupations.

DESIGN: This study used an exploratory qualitative design. Through convenience sampling and distribution of flyers, ten participants were recruited to participate in the project. Inclusion criteria was to attend the community-based day center where the study took place, have a diagnosis of either moderate or severe intellectual disability, and receive funding from government waivers to attend the community-based day center.

METHOD: Interviews and observations guided by the Volitional Questionnaire (VQ) were used to obtain subjective information on how participants perceive community. Themes were created from analyzing the interviews using MaxQDA and observations were analyzed by using descriptive statistics.

RESULTS: From the results of the interviews, the three components to consider when defining a community are social interactions, activity engagement, and context. Results from the observations show that motivation to engage in activities among participants varied. However, motivation among participants increased when they were offered activities that they enjoy and/or when they are provided with the appropriate level of support from staff when needed. In considering the data as a whole, the results show that context has an impact on how individuals perceive community and their level of engagement varies in a specific environment.

CONCLUSION: It is important to evaluate the dynamic interplay between persons and their contexts to understand how individuals with moderate to severe intellectual disabilities perceive their community. The data supports that individuals with moderate to severe intellectual disabilities identify a community as a place in which they have opportunities to socially interact with individuals of all abilities and engage in pleasurable activities. This also supports the assumption of the Model of Human Occupation that an individual’s perceptions of community may be influenced by their social and physical environment as the environment tends to have an impact on the decisions a person makes and the meaning they assign to occupations they participate in. Occupational therapists have the skills and knowledge to produce evidence based research to gain more insight about this population. Occupational therapists can also support this population by advocating and collaborating with policy makers to better serve this population and truly maximize their participation in everyday occupations which will ultimately improve their health and quality of life.

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