Multidisciplinary Interventions for People with Diverse Needs - A Training Guide for Teachers, Students, and Professionals

In the last few decades, the world has undergone profound demographic changes, reflected in life expectancy. We live for much longer, but we cannot say that these growing years are directly proportional to the quality of life. Dementia, in its different aetiologies, is more and more frequent with a consequent decline in the quality of life. However, cognitive decline and the onset of dementia may be delayed with the adoption of healthy lifestyle habits and therapeutic combinations that use nonpharmacological approaches such as activity and physical exercise. This chapter integrates a thorough review of the literature that characterizes ageing, cognitive decline and dementia, and it summarizes scientific evidence on the effects of physical activity on cognitive functions. Finally, recommendations are presented on the prescription of exercise for older people and elderly people with dementia. It is known that there are direct benefits (action on neurotrophic factors and neurotransmitters, among others), as well as indirect ones such as those resulting from a better vascularization of the brain. However, physical exercise requires precautions related to the conditions inherent to normal and pedagogical ageing. It is possible to perform adapted physical activity resulting from the coordination of sports and health professionals, knowledgeable of the needs and idiosyncrasies of the elderly, with cognitive decline or dementia.

A disorder of consciousness (DoC) is a state where consciousness has been affected by damage to the brain. DoC range in the form of a hierarchy, including coma, vegetative state and minimally conscious state. The most common way to assess consciousness is to observe their responses to stimulation. However, observing these responses and detecting purposeful behaviours is extremely challenging. Several studies have shown that misdiagnosis is common. It is crucial to optimise the way consciousness assessments are performed. Clinical management of DoC patients, from treatment of pain to end-of-life decisions, depends on behavioural observations. In the present chapter, we review the challenges posed by the assessment of consciousness and the importance of combining clinical assessment with complementary methods of assessment, such as positron emission tomography, functional magnetic resonance imaging and electroencephalography. According to the diagnosis established, the patient will follow different care pathways. Although therapeutic options of DoC are still limited, basic therapies include artificial nutrition and hydration, physical and occupational therapies as well as sensory stimulation. Pharmacologic trials, deep brain stimulation and multisensory stimulations are some of the therapeutic options for DoCs. Recently, it was removed the requirement to obtain legal sanction for every decision to withdraw clinically assisted nutrition and hydration from people in DoCs. This has led to an entire paradigm shift, from a focus on the diagnosis to a focus on the patient’s best interest. Although these decisions will spare the courts’ involvement, one should never disregard reaching a correct diagnosis for this vulnerable population.

The international society is involved in an active commercial and labour activity. This activity is based on the elimination of barriers and the dissipation of borders. Everyone wants their part of the European dream, but not everyone has equal opportunities and fair access. People with disabilities or other needs often encounter obstacles, including difficulty or inability to communicate in a non-native language, English. This chapter presents the EN-ABILITIES Project that seeks the inclusion of human diversity through communication in English. Here, we present a survey of English learning needs by people with special needs, as well as a structure for an online accessible learning model. A review of European legislation and the different concepts of universal design applied to learning contexts is presented, as well as the results of a placement test conducted with people people with disabilities and the perspectives of English teachers about the teaching of this language to people with disabilities. It also addresses the particularities to be taken into account when providing online training for people with diverse skills.

The objective of this research is to know the activities, the routes, the places visited and the obstacles identified in daily life routines of children/youth with disabilities, living in urban environments, during the time in which they are off the school period. In methodological terms, we used as instruments of study an anamnesis fact sheet and a routine diary that was completed by the parents together with the child/youth, an Individual Educational Plans (IEP) and a semi-structured narrative interview. Eight subjects between the ages of 9 and 15, all with different pathologies, were part of the study. The study was exploratory, descriptive and analytical. The results demonstrated that the subjects are supported in their routines by their parents and other relatives. Weekly out-of-school routines are primarily focused in the home (meaningful and important place) with activities classified mostly as sedentary ones in which they use little materials and, in the places, where they perform specific activities (Therapies, Tutoring, Music Conservatory and Catechism). The age and pathologies associated with each subject are factors that influence autonomy and independence of mobility. They visited few places and did so mainly in the company of family members. The main obstacles encountered in the routes performed are closely related to their pathology, showing difficulties in interacting with their peers. We conclude that the children/young people who participated in the study engaged in few activities and these were mostly in the home and sedentary. They visit few places, have poor independence of mobility, and interact poorly with others.

Since the disorder was first identified, difficulty in processing, integrating and responding to sensory stimuli has been described as a feature of autism spectrum disorders (ASD). Current estimates show that between 42 and 98% of children with ASD demonstrate these sensory difficulties and sensory features (i.e.: hyper- or hyporeactivity to sensory input or unusual interest in the sensory aspects of the environment) that are now included as one of four possible manifestations of ‘Restricted, Repetitive Patterns of Behavior, Interests, or Activities’ (American Psychiatric Association, 2013). Families report that behaviours associated with difficulties in processing and integrating sensory information create social isolation for them and their child, restrict participation in daily living activities and impact social engagement. Three types of Sensory Processing disorders are distinguished: (1) sensory modulation disorders, which affect the regulation of the level or intensity of the response that occurs in the presence of the sensory information, thus differentiating between over-responsiveness, under-responsiveness and sensory seeking, (2) sensory discrimination disorders, which affect the ability to distinguish and identify sensory inputs, and (3) sensorimotor integration disorders, which involve a difficulty in transforming sensations into motor responses, including postural disorders with a sensory basis and developmental dyspraxia, in which ideation and motor planning are compromised, producing difficulties in learning new motor tasks. Consequently, interventions to address problems associated with difficulty processing sensory information, such as occupational therapy using sensory integration are among the most often requested services by parents of children with ASD.

Eating habits and modern society have made diabetes a global concern and those who suffer from it are a vulnerable population due to adverse health consequences and functioning limitations. However, prevention and disease management help maintaining quality of life. This chapter brings together professionals from different scientific fields who have embarked on extensive bibliographical research, merging scientific evidence with professional experience. It is possible to verify that the interprofessional work benefits the patient with diabetes, articulating nursing care, nutritional education, practise of adjusted physical activity and the adaptation of environments, occupations and activities supervised by an Occupational Therapist. It is intended that the reader seizes the knowledge of different professionals, use it to their own advantage and help those who need it.

Celiac Disease is a serious autoimmune disorder that can emerge in genetically predisposed persons where the ingestion of gluten could damage the small intestine. It can develop at any age and if left untreated, it can lead to severe health problems. Celiac disease has a hereditary component and when a celiac person eats gluten (a protein found in wheat, barley and rye), the body begins an immune response that leads to damage the small fingerlike projections (villous) of the small intestine, avoiding the proper absorption of nutrients into the body. In this chapter, we intend to present a brief review of the literature that has been produced, following the new perspectives on celiac disease approach. We present a brief description of recent advances in the celiac disease diagnosis, treatment and gluten-free diet.

For the last few years, neurosciences has been focusing its research on analysing the structures and processes behind Animal-Assisted Therapies (AAT) and their effects on persons with neurodevelopmental disorders. The aim of this study is to present an overview of the main evidence-based effects of AAT in the promotion of skills, health-related issues, and well-being of persons with neurodevelopmental disorders. For this matter, the main theories of AAT effects will be approached. In conclusion, animal-human interaction characteristics and how this relationship may compensate deficits and promote functional competences will be described.

Even with extensive documentation on the health benefits of physical activity (PA), a part of the population does not practice enough PA to have these benefits, especially people with disabilities. People with motor disabilities tend to be less engaged in PA than their peers, even with the positive outcomes on bodily, social, functional and emotional changes promoted by PA. Therefore, the identification and knowledge of PA’s determinants, either as facilitators or barriers, for people with motor disabilities seems logical and essential. The goal of this chapter is to review the literature about these determinants and examine possible future paths. This information can contribute to conceptual changes and new interventions and policies that increase the levels of PA practice in this population subgroup and, consequently, further advance their social inclusion.

The positive relationship between physical activity (PA) and health, healthy lifestyle and regular PA engagement has been pointed out in the literature. However, a significant proportion of the world's population does not engage in enough PA, and in Portugal, the situation is getting worst in terms of children and adolescents with disabilities. These subgroups tend to be inactive, facing numerous health problems and limitations in their daily lives, with consequences in their functionality and quality of life. Most of the research studies within the framework of disability are based on adults and are not specific to a kind of disability. The goal of this study is to analyse and compare the psychosocial correlates of PA of 91 children and adolescents, between 10 and 17 years, in regular schools. Of all the participants, 30 had intellectual disability (13.43±2.28), 31 (13.4±0.1) had spina bifida and 30 had (12.70±1.15) typical development. A questionnaire was applied to characterize the engagement in PA by these children, to determine their impact factors. There were significant differences in the formal and informal PA engagement of students and their parents and peers. Students with a disability tend to be less engaged both in formal and informal physical activity, however, the attitude towards PA and physical education was identical in all the students, as well as competence and health perception. Scholarly sports seem to be a good strategy for the participation of all the students in physical activities. There should be an emphasis on studying and finding solutions and strategies to enable children to have access to physical activity in and out of school.