Lindsay Sally, Varahra Azar
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Disabil Rehabil. 2022 Sep;44(19):5341-5362. doi: 10.1080/09638288.2021.1928776. Epub 2021 May 30.
Developing self-determination skills is an important component of youth's maturation. However, many youths with disabilities lack opportunities to engage in activities that can promote these skills. The purpose of this study was to conduct a systematic review of self-determination interventions for children and youth with disabilities.
A systematic review was performed on seven international databases that identified 28 studies meeting our inclusion criteria.
Among the 28 studies, 5184 youth with disabilities (aged 9-29, mean age 16.8 years) were represented across three countries. The interventions varied in duration, length, number of sessions, and delivery format, which included curriculum-based, workshops, experiential or residential learning, peer coaching and mentoring, self-directed individual learning, computer games, and multi-component designs. 19/28 studies reported a significant improvement in self-determination. Of these 13/18 studies showed improvements as measured by Arc's self-determination scale, while 8/13 studies reported a significant improvement as measured by AIR self-determination scale. Other significant differences were reported in vocational skills self-efficacy and self-determination inventory.
Our findings highlight that there are several types of interventions that have the potential to improve self-determination for youth with disabilities. Further research is needed to understand what program components could help youth to obtain optimal outcomes.Implications for RehabilitationSeveral types of interventions (school-based, community, online) have potential to influence self-determination for youth with disabilities.Clinicians and educators should consider having multiple components including workshops, one-to-one and group-based learning, mentoring and coaching for optimal program outcomes.Interventions that are targeted to enhance self-determination for youth with disabilities should be theoretically informed and use a validated measure to assess their effectiveness.
培养自主能力是青少年成熟过程中的一个重要组成部分。然而，许多残疾青少年缺乏参与能够促进这些技能的活动的机会。本研究的目的是对针对残疾儿童和青少年的自主能力干预措施进行系统综述。
对七个国际数据库进行了系统综述，确定了28项符合我们纳入标准的研究。
在这28项研究中，来自三个国家的5184名残疾青少年（年龄在9至29岁之间，平均年龄16.8岁）参与其中。干预措施在持续时间、长度、课程节数和实施形式上各不相同，包括基于课程的、工作坊、体验式或寄宿式学习、同伴辅导和指导、自主个体学习、电脑游戏以及多成分设计。28项研究中有19项报告自主能力有显著改善。在这些研究中，18项中有13项显示通过Arc自主能力量表测量有改善，而13项中有8项报告通过AIR自主能力量表测量有显著改善。在职业技能自我效能感和自主能力量表方面也报告了其他显著差异。
我们的研究结果表明，有几种类型的干预措施有可能改善残疾青少年的自主能力。需要进一步研究以了解哪些项目组成部分可以帮助青少年获得最佳结果。
康复启示
几种类型的干预措施（基于学校的、社区的、在线的）有可能影响残疾青少年的自主能力。
临床医生和教育工作者应考虑采用包括工作坊、一对一和小组学习、指导和辅导在内的多种组成部分，以实现最佳的项目效果。
针对增强残疾青少年自主能力的干预措施应基于理论，并使用经过验证的测量方法来评估其有效性。
