Searching for a dynamic equilibrium in decision making: the voices of adults with mild intellectual disability and their significant others in Hong Kong.

Abstract

The self-determination of people with intellectual disability (ID) is influenced by their interpersonal environment. This study set out to understand better the experience of Hong Kong adults with mild ID in exercising self-determination and to explore the relational and contextual dynamics of how they make decisions in conjunction with parents and paid carers. A qualitative study was conducted using focus groups for data collection. In total, 32 participants including people with mild ID, parents and rehabilitation personnel were recruited using purposive sampling. Five focus group discussions took place and the data were analysed using a thematic approach. Our findings highlight a continuum of autonomy in decision making in which participants with mild ID exercise different levels of autonomy in different contexts. In the triangular relationship with parents and rehabilitation personnel, all three parties are simultaneously looking to establish a dynamic equilibrium in decision making. The study enriches our understanding of the relational and contextual considerations for people with ID in decision making. They may have their own priorities for all the decisions they make, but these involve a dynamic interaction between all three parties.Implications for RehabilitationThe search for dynamic equilibrium in decision-making is a new finding in studies of the self-determination of people with intellectual disability (ID).The findings embed the considerations of the roles of autonomy and relatedness in the self-determination of people with ID at the intrapersonal level.The findings highlight the importance of understanding the relational concerns people with ID have about those they respect while fostering their self-determination.It is also important to address the dynamic interactions among adults with ID, parents and rehabilitation personnel, and the efforts others make in facilitating the self-determination of people with ID.