Using mobile technology to support relationship development, well-being and social participation of adults with a visual and intellectual disability.

All messages sent by the client and the caregivers will be registered on a

webbased computerized data collection system. The kind of emotional message

sent and the frequency of these in the different phases of the research will be

used to examine the increasing quality of client-caregiver interaction and

differentiation among caregivers.

Outcome variables: Instruments



First it is important to note that although quite a variety of instruments are

mentioned, caregivers will only be asked to fill out the items that are of

concern to this study. Secondly, the care organizations which employ caregivers

will receive compensatory funding for the time they need for completing the

questionnaires. The client*s mentor will be asked to answer the questionnaires.

An independent caregiver will support the client in completing some of the

questionnaires.



Outcome variables: Separation distress, loneliness & challenging behaviour

- The Psychopathology Inventory for Mentally Retarded Adults (PIMRA) (Matson,

Van Minnen & Hoogduin, 1994): It is one of the most widely administered and

researched instruments in assessing psychopathology in individuals with

developmental disabilities. This scale consists of 56 true/false items within

eight subscales: Schizophrenia, Affective Disorder, Psychosexual Disorder,

Adjustment Disorder, Anxiety Disorder, Somatoform Disorder, Personality

Disorder, and Inappropriate Adjustment. The psychometric properties have been

widely studied and suggest that overall it is a reliable and valid screening

measure of psychopathology in persons with ID. Only the 7 items on *anxiety

disorder* will be used with a scoring time of approximately 3 minutes.

- The health of the nation outcome scales learning disabilities (Honos-LD)

(Roy, Matthews, Clifford,

Fowler & Martin, 2002) will be used to measure risk and vulnerability of mental

health problems

that suits the needs of people with learning disabilities. Only item 3D

(Anxiety, phobias, obsessive

or compulsive behavior) will be used with a scoring time of approximately 1

minute.

- Sociale redzaamheidschalen verstandelijk gehandicapten (SRZ/SRZi). SRZ/SRZi

Social ability scales for people with ID (Kraijer, Kema, & Bildt, 2004): The

SRZ has a Cohen*s kappa for reliability of between r = .66 and .89 and adequate

validity. Only the 5 items on *social functioning* will be used with a scoring

time of approximately 2 minutes.

- The Dutch version of the Adult Behavior Checklist (ABCL) for the ages 18 to

59 (Achenbach & Rescorla, 2003): scales for adaptive functioning, empirically

based syndromes, substance use, internalising, externalising, and total

problems. There are six scales to gain characteristics consistent with DSM-IV

categories: Depressive Problems, Anxiety Problems, Somatic Problems, Avoidant

Personality Problems, Attention Deficit/Hyperactivity Problems, and Antisocial

Personality Problems. The ABCL was found to be a reliable and valid measure to

assess psychopathology in persons with mild intellectual disabilities or low

IQ, admitted for treatment in facilities for adults with mild intellectual

disability and severe challenging behaviour (Tenneij & Koot,2007). The observer

rating scale will be used with a scoring time between 5 and 20 minutes.

-Residential observation: The professional caregivers in the participants'

residential homes will be instructed to record the frequency of the challenging

behaviours (e.g. distress, behavioural problems, clamping behaviour). An online

web-based computerized data collection system *Thesis Tools*, will be used for

the daily reporting of challenging behaviour. A computerized reminder for

filling out the lists will be added and will be visible on the computer on

which caregivers daily check their e-mail. The daily scoring time will take

around 5 minutes. An earlier study with a paper and pencil version achieved

responses rates of 100% over periods of 9 to 12 months of daily scoring

(Sterkenburg et al., 2008).

-The Symptom Checklist-90-R SCL-90-R is a questionnaire frequently used as an

instrument to determine the experienced degree of psychopathology and for the

evaluation of treatment. The reliability and validity of the instrument is

described as good (COTAN evaluation) (Arrindell & Ettema, 2003). The items are

divided in eight scales: Fear, Agoraphobia, Depression, Somatic complaints,

Insufficient way of thinking and reacting, Suspicion and interpersonal

sensitivity, Anger-hostility, and Sleeping problems. The shortened version, the

Brief Symptom Index (BSI) (De Beurs & Zitman, 2005) often used to measure

therapy effect, will be used. The 53 item list will be scored by the client

assisted by an independent researcher. The BSI is a easy to score list with a

duration of approximately 15 minutes.



Outcome variable: feeling of well-being

- The IDQOL Intellectual Disability Quality of Life (Hoekman et al. 2001) is a

short questionnaire (quickscan) to examine the quality of life of persons with

a moderate to mild intellectual disability. The 16-item questionnaire with its

5-point scale (using smileys) has a Cronbach*s Alpha for internal consistency

of between .72 and .86. The items cover the range from personal well-being,

social well-being and well-being in the caregiving situation. It will take

between 5 and 20 minutes to complete the questionnaire. An independent

caregiver will support the client.