Running Head: OCCUPATIONAL PROFILE AND INTERVENTION PLAN 1

Occupational Profile and Intervention Plan

Kerielle Williams
Touro University Nevada











OCCUPATIONAL PROFILE AND INTERVENTION PLAN 2
Occupational Profile
Client
The client is a 47 year old Caucasian male. His primary language is English. He has one
notably long scar down the center of his back due to a surgical procedure. The clients mother
and father are his closest family members. He also has an uncle that he visits from time to time.
He is an only child. The clients primary caregivers are his parents, most specifically his mother.
During the day, he attends the Enable program at Opportunity Village (OV). While he is at OV
he has several staff members that aid in his care, however, his mother is predominately his
caregiver. The client has no significant others at this time, nor has he had any in the past. It has
been reported in his medical chart at OV that the client does not have any actual friends either.
Need for Services
As reported in his medical charts, the clients personal current concerns are his lack of
overall independence. He is extremely dependent on the care provided to him by his mother.
This dependence has negatively impacted his socialization skills as well as his ability to
complete any of his Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living
(IADLs). Another current concern of the client as well as his family is the fact that he hopes to
one day return to work at OVs work program where he was once employed.
Areas of occupations
Successful occupations. The client is successful in a limited number of areas of
occupations. The areas of occupations that he is most successful in are rest and sleep and leisure.
The client is reported to sleep approximately eight to ten hours a night. However, his mother is
the primary caregiver and she is responsible for the clients sleep preparation routine as well as
moderate assistance in his sleep participation. The client is somewhat successful in the
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occupation of play, mainly in the area of play participation. He has been observed doing simple
puzzles that his mother chooses for him.
Problem occupations. The client has many areas of occupations that are causing
problems for him. The areas of occupation that are causing the client the most difficulty would
be the ADLs, IADLs, education, work, and social participation. A specific ADL in which the
client is having difficulty with would be toileting and toilet hygiene. The client is dependent in
all aspects of toileting and toilet hygiene and requires an external catheter at bedtime. Almost all
the other areas encompassed in the area of ADLs, such as bathing, dressing, functional mobility
and personal device care would be classified as problem areas for the client. In regards to
dressing, it was noted in his file that he cannot dress with any clothing that require fasteners, and
cannot independently put his shoes on.
In response to the client's inability to complete his IADLs, the client struggles in almost
all of these sections, including care of others, care of pets, communication management, driving
and community mobility, financial management, health management and maintenance, home
establishment and management, meal preparation and cleanup, safety and emergency
maintenance, as well as shopping. All of these IADLs are significant issues for the client. For
instance, it was reported in his charts that the he cannot participate in any food preparation
except for getting simple ingredients when given specific instructions.
The clients education is very much so problematic for him. Mostly due to his diagnosis
of Intellectually Disabled (ID), the clients formal education participation, informal personal
educational needs, as well as informal personal education participation are all areas in which he
is delayed in comparison to his same-aged peers.
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Although the client was once employed by Opportunity Village (OV), the client is no
longer working at this time. Therefore, his employment seeking, acquisition, and job
performance are sections under the areas of occupation of work and are all issues of concern for
the client.
Lastly, the client has a problem with the area of social participation. He has difficulty in
socializing in the community with family as well as with his peers.
Contexts and Environments
Support participation. The context and environments that support the client in his
ability to participate in a variety of areas of occupational performance would be primarily
cultural, physical, and social. The physical environment of OV is supportive of the client because
there are many activities which are offered to the client that would allow him the opportunity to
participate with peers in hopes to increase his social participation skills. OV also facilitates a
chance for the client to increase his social skills with not only other peers and members of the
program, but also with the OV staff members.
The cultural environment that benefits his ability to participate in occupations would be
the environment found within his family. His family is very dedicated and involved, which can
be rare given this particular population of individuals. The clients family and caregivers make it
a point to take him out in the community at least weekly, if not daily. He currently attends the
day program at OV twice a week.
Inhibit participation. The context and environments that inhibit the client in his overall
occupational performance would be personal. In terms of person context, he is a 47 year old male
that is dependent upon others in almost all aspects of daily life. The client's personal
characteristics have hindered his success in various occupations. For instance, he has a short
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attention span and is easily distracted. He requires maximal assistance with verbal cueing to
remain on a task of any sort. He is unable to copy a straight line or shape. He cannot use utensils
or pour a glass of liquid. The client has no concept of money, in his charts it is noted that he
wishes to "spend all his money on hamburgers," which implies the need for monitoring him in all
aspects of financial transactions.
Clients Occupational History
Life experiences. The client began attending the OV in 1998. At this time, the client was
able to participate in the work program that OV had to offer. He attended the work program five
days a week for six hours each day. It was reported that he was a satisfactory worker, and
although he needed many verbal cues throughout the workday, he was very pleasant to the
majority of his co-workers. While working at OV he was able to earn an income that gave him
the sense of some independence. In 2002, he became very ill and required surgery of the nervous
system, as stated in his medical chart. After the surgery, he endured a whirlwind of
complications. These complications ranged from bed sores to pneumonia. When he was finally
discharged from the hospital, he was no longer able to do many of the occupations he once
enjoyed. The client has yet to return to his prior health status since this surgery.
Roles. The clients major role in his life right now is that of being a son. He was once an
employee, however, due to decline in his health status he is not currently employed at this time.
The days he attends the Enable program he plays the role of a student. He participates in some
play activities and shows some interaction between peers. In his charts, it is said that he is rather
close with an uncle of his, in which he would then take on the role of a nephew, and possibly a
companion.
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Values. The client shares the values instilled upon him by his mother and father. They
value religion and more specifically the Catholic Church. They attend church weekly and his
mother brings him to all of the church functions. He is reminded to say his prayers nightly before
he goes to sleep and to be thankful for all of his blessings in his life.
Interests. The client has several major interests. These interests include card games,
trains, fire engines, listening to air traffic control on the radio with his father, receiving attention
from others, planes, bowling, and spending time with family and friends. The client enjoys being
quizzed on identifying different states within the United States as well as specific movies that he
has seen in the past. He also acts engaged when participating in arts and crafts in the day
program at OV, fitness activities, playing on the iPad, and practicing sign language. The client
has also been reported to enjoy counting numbers with his mother.
Dislikes. In contrast to the clients interest, it was noted in his charts that there are many
things that the client does not like or appreciate. These include lots of noises, being told what to
do, crowdedness, and people invading his personal space. It was also observed that the client
seemed very agitated whenever a new person would enter the room.
Previous patterns of occupational engagement. The client can express himself with
some small words and simple gestures. He has a tendency to repeat others when they speak to
him. The client knows his mothers routes that she takes to go to familiar places. If his mother
deviates from these regular routes, he becomes quite upset and will begin hitting, cursing,
grabbing, and yelling. He also has a habit of knocking over small furniture when he gets upset.
The client is able to stand with moderate assistant while using a brace on his right foot
during his physical therapy treatment sessions. However, the client uses a wheelchair as his
primary mode of transportation. The wheelchair that the client uses is a manual wheelchair that
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he is completely dependent in mobility with this device. Because the client struggles with any
visual motor tasks, the family is concerned about transferring to a powered wheelchair in fear
that he may injure himself or others.
Clients Priorities and Outcomes
The client has stated that he would like to be as independent as possible. He would like to
attend more days in the program at OV, and he would like to be able to walk again. Currently,
none of these priorities seem to be a focus of his therapeutic interventions within the OV
program; however these are all realistic goals, that if properly addressed, they could have
positive outcomes.
Occupational Analysis
Context of OT Services
The client was seen at OV. OV is a day program for developmentally disabled adults. OV
offers programs that take place Monday through Friday from 8 a.m. to 3 p.m. OV offers a variety
of services for their members. Unfortunately, OV currently does not have an occupational
therapist (OT) on staff; however they do have three full time nurses. The services that OV has to
offer include art and music programs, a work program, as well as two specialty programs.
The two specialty programs are entitled Pride and Enable. These two programs are
designed for those individuals that may need more structure or may not be ready to join the art,
music, or work programs. The Pride program is the most inclusive program that OV has to offer,
and the Enable program is a step up from this. These programs are directed by the social
coordinator at OV. The Enable program is the program in which the client attends.
It was observed that the facility would benefit extremely if they had an OT on staff.
Instead of the social coordinator deciding on the activities of the programs, the OT would be able
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to facilitate more functional and client-centered activities, particularly within the Enable and
Pride programs.
Within the Enable program, there were three separate rooms. The first room appeared to
be more focused with the occupation of play. There were board games and toys that the
individuals were given throughout the day to occupy their time. There was also a portable
basketball hoop that was taken out for a portion of the day, and there was a karaoke machine that
played during the day as well. The second room was designed for electronics. There were two
televisions, many iPads, and a Wii set hooked up to one television. The third room was the
transition into the work program offered at OV. In this room, there were many tables. The tables
were set up as stations in an assembly line. The purpose of this room was to shred paper to then
recycle it and use it to make paper, as well as holiday cards. The first table was used to take a
stack of mail and separate it between the envelopes and its contents. The members of the
program were instructed to separate the mail into these two groups. The next table was used to
set the two groups of paper into the shredder machines. The last table was used to take the
contents out of the shredder and place it into a cabinet in which it would later be taken out and
placed into a pressing machine to make the paper. At any given time, there were approximately
two to three individuals at each table.
Within each Enable room at OV, there was a designated number of staff assigned to a
specific number of program attendees. The staff to program attendee ratio varied from 1:3 to 1:1,
depending on their diagnosis.
In addition to the activities conducted in each of the three rooms, some of the Enable
program members have the opportunity to go out into the community on field trips to various
locations. OV has contracts with many businesses that allow the members of Enable to visit and
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volunteer services. The members of the Enable program also have gone on field trips to places
such as Red Rock Canyon as well as Ethel M's. These types of field trips allow the members of
the program to experience what Las Vegas has to offer, a luxury that the majority of the
individuals may not have been able to participate in if not for OV.
Activity
Clients performance. The client has been observed participating in many different
activities with his mother as well as select staff members. The client was able to complete a six
piece puzzle with verbal cueing from his mother. Although the client has shown signs of
frustration in the past, he has demonstrated a decrease in negative behavior at the Enable
program. When asked, his mother reported that she has noticed a decrease in this negative
behavior at home as well. It has also been reported that the client has shown an increase in trust
with his mother and has stopped resisting her when she helps assists him during transportation
and transfers. Within the Enable program, it was observed that the client has been able to learn
new tasks with one-on-one instruction from the staff and his mother.
Outside of the facility, the client has been reported to be able to recognize some signs
throughout the community, for instance, a stop sign. The client's mother said that he has
demonstrated to the ability to understand the concept of before and after with her as well.
Observations
Clients diagnosis. The client has been diagnosed with an Intellectual Disability (ID).
The clients medical charts classified him as "Avis 2" on the ID scale used by OV. An Avis 2
score is equivalent to the category of severe on an ID scale of mild, moderate, severe, and
profound. Clients with a diagnosis of severe ID have many profound characteristics. These
characteristics include physical, social, emotional, and mental characteristics. The physical
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characteristics include delay in growth, physical deformation, and unusual movements or
balance. The social characteristics include inappropriate or delayed social adjustment, aloofness,
irresponsible, aggression, and low self-esteem. The emotional characteristics include excessive
movements, inappropriate reactions, or primitive reactions. The mental characteristics include
less than average I.Q., delayed speech skills, poor attention and imagination (Schalock, 2011).
Individuals with ID tend to have a below average Intelligence Quotient (I.Q.). To be
classified as ID the individual must have an I.Q. under 75. Reported in the client's medical
charts, it is said that he has an I.Q. of 28 on the Slosson Intelligence Test and an I.Q. of 45 on the
Wechsler Adult Intelligence Scale (WAIS). These two types of assessments consist of different
cognitive areas that are tested, which may be the reason for the difference in the two scores.
In addition to being diagnosed with ID, the client also has seizures on a regular basis. He
is currently taking anti-seizure medication in hopes to manage this illness. The client also has
hypertension, diabetes, and constipation (with a history of fecal impactions). The client also has
numerous physical contractures in his upper and lower extremities, he is unable to protect
himself; therefore he is a fall risk.
Domains of OTPF impacted. There are many domains of the Occupational Therapy
Practice Framework (OTPF) that are impacted in the client by his diagnosis. The areas within the
domain of areas of occupations that impact the client have been previously addressed in the
above sections.
In regards to the client factors, his diagnosis mainly impacts his body functions and body
structures. The clients body functions that are impacted are mental functions, specific mental
functions, global mental functions, sensory functions, neuromusculoskeletal and movement-
related functions, muscles functions, movement functions, cardiovascular, hematological,
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immunological, and respiratory system functions, and voice and speech function; digestive,
metabolic, and endocrine system functions; genitourinary and reproductive functions.
The clients body structures that are impacted are the structure of the nervous system (i.e.
his past nervous system surgery), structures involved in voice and speech, structures of the
cardiovascular, immunological, and respiratory systems, structures related to the digestive,
metabolic, and endocrine systems, structures related to the genitourinary and reproductive
systems, and structures related to movement.
The performance skills that are impacted by the client's diagnosis are motor skills,
process skills, and social interaction skills. The performance patterns that are impacted by the
client's diagnosis are habits, routines, rituals, and roles. Lastly, the contexts and environments
section of the domain that impacts the client have been previously addressed in the above
sections.
Problem List
Problem Statements
1. Client is dependent in functional mobility due to his multiple contractures in both upper
and lower extremities as well as his overall muscle weakness and lack of endurance.
This problem statement was prioritized first because this involves the ADL of functional
mobility. Typically, ADLs are prioritized before IADLs, however, this was also placed at
number one because in the client's charts he had listed walking as a personal goal.
2. Client is dependent in financial management due to his inability to recognize or
comprehend dominations of money.
This problem statement was listed as the second priority. Although this is not an ADL,
earning and managing money was listed as a personal goal for the client as well.
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3. Client is moderate assistance in meal preparation and cleanup due to his inability to read
and follow directions.
This problem statement was listed as third priority. This was prioritized in this placement in
response to his mothers concern for the clients inability to prepare meals for himself. She is
getting older and she is concerned that she may not be able to take on this role for the client
much longer.
4. Client is moderate assistance in social participation due to his inappropriate behavior and
language.
This problem statement was listed forth. This was prioritized in this order in response to the
OV staff's concern in the client's interaction with his peers. The staff emphasized that if the client
were to behave more appropriate in social situations, he would be able to get more benefit out of
the Enable program and what it has to offer.
5. Client requires maximal assistance in home establishment and management due to his
inability to obtain and maintain personal possessions such as food, medications, and
personal property.
This problem statement was prioritized last. Although, the client is currently living with his
parents and these needs are currently being taken care of for him, his parents are getting older
and there is going to be a time in the near future when they are not going to be able to do this for
him. If he increases this skill now, it may be an easier transition on him for when this occupation
is left to him to manage independently.
Intervention Plan & Outcomes
Primary Framework
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The primary framework when determining this intervention plan was the Person
Environment Occupational Performance Model (PEOP). The PEOP model is ideal for this client
because it is imperative that the client's personal characteristics be taken into consideration as
well as his environment and how well he performs in these occupations in relation to both of
these factors. For this particular client, this model would allow for the intervention to be the most
client-centered and effective as possible.
Frequency and Duration
The frequency and duration of the intervention plan would be one hour sessions, three
times a week for six weeks.
Long-term Goal #1
Client will complete functional mobility with moderate assistance using a four-wheeled
walker (FWW) by end of six therapy sessions.
Short-term goal #1. Client will safely transfer from sit to stand with contact guard
assistance using a FWW by the end of two therapy sessions.
I ntervention #1. Client will be educated on and familiarized with the durable
medical equipment (DME) required to reach the goal of safe transfers. This involves the
therapist introducing equipment such as the FWW and the gait belt. The therapist will
inform the client on the safety precautions to complete a safe sit to stand transfer. After
the client has been informed of the safety precautions, the therapist will then quiz the
client on his comprehension and understanding using a variety of different scenarios to
make sure he understands before beginning the transfer.
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The intervention approach for this intervention is establish, restore. This approach
is most appropriate due to clients need for restoring his functional ambulation that he
once had.
Literature review. Willgoss, Yohannes, & Mitchell (2010) discussed fall risk
factors as well as preventative strategies when working with clients with intellectual
disabilities by conducting a systematic review. The article states "Falling is a common
cause of physical injury and impaired quality of life in people with intellectual
disability. (Willgoss, Yohannes, & Mitchell, 2010, p. 2100) The article points out the
importance of the topic when stating that approximately 57% of people with ID may
experience a fall. In relation to the above intervention plan, the article emphasizes the
importance of "environmental safety, careful medical management and exercise
interventions" (Willgoss, Yohannes, & Mitchell, 2010, p. 2100) and the roles these play
in limiting fall-related injuries. The article encourages healthcare professionals to be
aware of the individuals that are a fall risk as well as educating the patient on how to limit
these numbers of falls.
Precautions and/or contraindications. This particular intervention has no
precautions. This intervention is primarily focused on educating the client.
Client/caregiver training and education. The training required for the client
during this intervention is the focus and desired outcome of this intervention. The entire
intervention would be centered around educating the client on the desired transfer and
assuring his understanding of the safety precautions.
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Grading up and grading down. This intervention could be graded up by giving
more information and quizzing the client on more information. This intervention could be
graded down by starting the client off with less information and less quizzing.
Monitoring and assessment. The client would not necessarily need to be
monitored during this intervention. However, the therapist would be able to assess the
clients understanding and retention of the intervention by incorporating what he learned
into every therapeutic session held after this educational intervention.
Short-term goal #2. Client will ambulate 20 feet with minimal assistance using a FWW
by then end of four therapy sessions.
I ntervention #2. Client will begin ambulating using a sit-to-stand device such
as the Sara 300 Lift. This intervention will provide the client with the ability to perform
sit to stand transfers with more support than the FWW. The client will use this device to
practice ambulating the 20 feet in order to increase his muscle strength, balance, and
overall lower extremity endurance required to complete the short term goal.
This intervention would be most effective when utilized in conjunction with the
modify approach. This approach would be useful because this intervention is teaching the
client to compensate and adapt with the DME.
Literature review. Wagemans and Cluitmans (2006) reiterates the importance of
fall prevention by stating that falls and fractures are a major health problem, especially
among people with intellectual disabilities (Wagemans and Cluitmans, 2006, p.136). As
mentioned in the previous article of Willgoss, Yohannes, & Mitchell (2010), the risk
factors are highlighted in Wagemans and Cluitmans (2006), stating that impaired
mobility is a major factor. In relation to the above intervention, Wagemans and
OCCUPATIONAL PROFILE AND INTERVENTION PLAN 16
Cluitmans (2006) support the need to increase the clients functional mobility as much as
possible by use of proper DME. Although the long-term goal is to use the FWW, this
article supports fall prevention by using the safest equipment to start the patient on
functional mobility.
Precautions and/or contraindications. There are general safety precautions in
this intervention. As with any client, because the client is used to being seated in his
wheelchair, he may experience dizziness and lightheadedness when brought to a standing
position. The client is going to be unbalanced, especially at first, causing him to be a fall
risk as well.
Client/caregiver training and education. The training for the client would be
given prior to beginning the intervention. The client would be familiarized with the DME
and given repeated instructions throughout the intervention.
Grading up and grading down. This intervention could be graded down by
having the client walk shorter distances, or with more assistance from a therapist. The
intervention could be graded up by having the client walk farther distances or with less
assistance from a therapist.
Monitoring and assessment. The client would need to be monitored closely
during this intervention. The therapist would need to look for signs of dizziness or
fatigue. The therapist would be able to easily assess the clients progress by simply
measuring the distance in which he was able to ambulate.
Long-term Goal #2
Client will recognize and comprehend various monetary denominations with verbal cues
using pictures of money by the end of a six week period.
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Short-term goal #1. Client will be able to independently visually recognize and identify
different variations of money with supervision using picture cards by then end of a two week
period.
I ntervention 3. The client will play a type of Go Fish game with cards. Instead of
the cards having pictures of fish on them, the cards will have different denominations of
money. The game will require the client to recognize the money visually as well as find
another that matches it. The client will be encouraged by the therapist to say the name of
the denomination out loud, however if the client is unable to do so then the therapist will
say it out loud to the client.
This intervention would be most useful in combination with the create/promote
approach. This intervention provides the client the opportunity to visually see all the
denominations of money in a fun way, creating an educational way for the client to learn.
Literature review. Suto, Clare, & Watson (2005a) stresses the importance of
encouraging individuals with ID to become more directly involved in their personal
finances. The article also discusses that the most challenging part of financial
management for the individuals with ID was understanding and comprehending the
information relevant to making the decisions.
Precautions and/or contraindications. This intervention does not have any
precautions or contraindications, because this is a simple card game.
Client/caregiver training and education. The client training for this intervention
would be the directions for the Go Fish game.
Grading up and grading down. This intervention could be graded up by giving
the client more of a variety of monetary denominations to choose from. This intervention
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could be graded down by only including a few variations of money in a pile to choose
from.
Monitoring and assessment. The client would need to be monitored in terms of
his frustration level with the cognitive challenge of the game. The therapist would be able
to assess the client in terms of how many pairs of monetary denominations he is able to
successfully put together. The therapist would then be able to document this and compare
to other sessions on which this intervention would be implemented.
Short-term goal #2. Client will be able to comprehend and functionally understand the
value of money every three out of five trials using pretend money by the end of a four week time
period.
I ntervention 4. The client will participate in a game of Junior Monopoly with the
therapist. This game is geared towards ages five an up. From the results of the client's last
I.Q. test, he scored around the age range of an average five year old. Within this game,
the client will be able to see a variety of denominations of money and will be able to
practice which denominations are worth more and what can be purchased with each
denomination.
This intervention would also be useful with the create/promote approach. This
intervention in promoting the clients ability to become familiar with the value of money
as well as the comprehension of what is a realistic item to purchase with the money.
Literature review. Suto, Clare, & Watson (2005b) discusses the need for
individuals with ID to understand the financial decision-making capacity to the fullest.
The article states it is essential that individuals decision-making abilities are
sufficient (Suto, Clare, & Watson, 2005b, p.210). This study found that there is a direct
OCCUPATIONAL PROFILE AND INTERVENTION PLAN 19
correlation between individuals with ID and their basic understanding of financials. This
study directly correlates to the purpose and desired outcome of this particular
intervention. This is necessary to the overall quality of life of the client because weak
financial understanding could limit an individuals decision making opportunities in
everyday life (Suto, Clare, & Watson, 2005b, p.211). This study pertains to this
intervention because it is pointing out the importance for individuals with ID to recognize
and comprehend money in order for them to have some financial management
independence.
Precautions and/or contraindications. The precaution with this intervention is
the possibility of a choking hazard with the small game pieces.
Client/caregiver training and education. The training given to the client prior to
this intervention would be the instructions included in the Junior Monopoly game.
Grading up and grading down. This intervention could be graded up by having
the client play the game with multiple people. This intervention could be graded down by
having the client play with just the therapist.
Monitoring and assessment. The client would again have to be closely monitored
with this intervention, due to the small game pieces that would be a choking hazard. The
therapist could assess the client on how whether or not they come close to winning the
game.
Conclusion
When dealing with a client with ID, there are numerous areas of occupations to work on.
When devising a proper intervention plan, it is crucial to ensure that the plan is as client centered
and meaningful to your specific client. This will in turn lead to a therapeutic and beneficial plan.
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References
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S1-S48. http://dx.doi.org/10.5014/ajot.2014.682006
Kim, H., Choi, M., Kim, H., Yeon, H., Yoon, H., Lee, I., & Chug, S. (2013). Changes in
simple visual matching task performance and physiological signals in intellectually and
developmentally disables people due to administration of highly concentrated oxygen.
Neurorehabilitation, 32(3), 687-692. doi:10.3233/NRE-130892
Schalock, R. L. (2011). The evolving understanding of the construct of intellectual disability.
Journal Of Intellectual & Developmental Disability, 36(4), 223-233. doi:
10.3109/13668250. 2011.624087
Suto, W. I., Clare, I. H., Holland, A. J., & Watson, P. C. (2005a). The relationships among three
factors affecting the financial decision-making abilities of adults with mild intellectual
disabilities. Journal Of Intellectual Disability Research, 49(3), 210-217.doi:
10.1111/j.1365-2788.2005.00647.x
Suto, W. I., Clare, I. H., Holland, A. J., & Watson, P. C. (2005b). Capacity to Make Financial
Decisions Among People with Mild Intellectual Disabilities. Journal Of Intellectual
Disability Research, 49(3), 190-209. doi: 10.1111/j.1365-2788.2005.00647.x
Wagemans, A. A., & Cluitmans, J. M. (2006). Falls and Fractures: A Major Health Risk for
Adults with Intellectual Disabilities in Residential Settings. Journal Of Policy & Practice
in Intellectual Disabilities, 3(2), 136-138. doi: 10.1111/j.1741-1130.2006.00066.x
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Willgoss, T. G., Yohannes, A. M., & Mitchell, D. (2010). Review of risk factors and
preventative strategies for fall-related injuries in people with intellectual disabilities.
Journal Of Clinical Nursing, 19(15/16), 2100-2109. doi:10. 1111/j. 1365-
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