Participation in Everyday Leisure and Its Influencing Factors for People with Intellectual Disabilities: A Scoping Review of the Empirical Findings

Round 1

Reviewer 1 Report

Thank you for this exciting article. However, considerable weaknesses in the structuring are identified. The contribution should be restructured.

Lines 155 to 168 are placed in a chapter. However, this section seems to summarize the entire introduction and provide information about the intention of the article. This should be emphasized more.
Furthermore, Opaschowski is mentioned and described. Why this is important for the article is not obvious. Please restructure the Introduction.

Line 175 makes no sense. Because only English articles are included, it is not yet a rapid (scoping) review. Please check the criteria.

A review makes it possible to search for definitions. However, it needs definitions of what are considered leisure activities to determine inclusion criteria for the review. Please explain how leisure activities were used as inclusion or exclusion criteria in the review. Or was the use of the term itself sufficient? If so, please name.

Please control the use of abbreviations in the text in general. Abbreviations are used in places and then indicated further down in the text e.g. PCC or PMID.

In the results section, the link to the questions (here c and d) should be made or it should be mentioned that these are discussed in the discussion. Especially d) does not appear to be a question of the scoping review per se, but a guiding research question.

What criteria were used to determine that studies before 2000 were old, from 2000 were new, and had no bias?

Searched 4 databases, all in English. Then, instead of Psyndex, a database named FIS Bildung (German) appears in the graph. This does not seem to be a primary database in English.

The results section should be restructured or the methods section adapted. Thus, it is started with question b). From 4.4 there is no more comparison between the grades. Please refer to each other better.

The first section of the discussion is confusing. The description of the division belongs in the methods section.

In the limitation: The mentioned strength is not convincing and should be reconsidered. This sentence "Additionally, only English language studies that were open access were included in this scoping review" does not match above, as it is mentioned above that library access was used.

Author Response

Dear Reviewer 1,

we thank you for your valuable suggestions and comments and hope that we were able to increase the quality of our review through the adjustments.

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Stated purpose of this manuscript was to provide a scoping review of research in the area of leisure activity among individuals with intellectual disabilities.  Although the manuscript does not offer any real new insights, the manuscript does provide a valuable overview of some of the available literature and therefore warrants consideration for publication.  There are several recommended changes prior to such consideration, however:

1. Both in the abstract and in the introduction, the authors mentioned that research regarding leisure activity among individuals with an intellectual disability is minimal.  This is simply not true.  There is an extensive amount of that literature.  In fact, they then go on to cite quite a few of the studies.  In addition, their limiting of studies they used for this review to only those with full text articles available is something they need to consider in making this statement.  Also, the first paragraph of the discussion continues along this vein.  That needs eliminated from the discussion or significantly modified.

2. There are a few typographical errors that the authors need to fix and some sentences/phrases that are unclear or confusing (e.g., in the abstract, “leisure time as a time frame of participation in leisure activities reflects the quality of life”).  Another example is the sentence “In addition, participation can also be operationalized and measured qualitatively as a level of performance.” appears to leave readers hanging without an explanation.  A review of the manuscript by a colleague of the author whose attention is to clarity of writing would help identify some of these sentence and phrases.  The authors then need to modify those.

3. It’s unclear how the authors went from 6584 hits in the literature down to only 179 hits.  Identification of which criteria excluded over 97% of initial hits is essential.  Also, the authors indicated that they “excluded 152 publications for different reasons” but do not completely elaborate on those reasons.  This information needs provided.

4. In Figure 1, the authors use the term PIMD, but they do not describe what they mean by this term until three pages after that.  They need to ensure that they provide the meaning for any abbreviations prior to any use.

5. Of most concern is that the authors make some sweeping generalization statements, sometimes based on just one or two articles.  This is of concern because (a) of the importance of replication in science, (b) their exclusion of the vast majority of publications from their review, and (c) some articles they did not cite are contradictory to some of their conclusions.  Of additional concern is that they make statements that are not necessarily within the scope of their review.  For instance, they make the statement that “People with ID are generally less engaged in social and recreational activities than typically developed children are.” and they make that sweeping statement based on one study from over 10 years ago.  In addition, this study had too small a number of participants to make such a large generalization.  There are other studies (not cited by the authors) that also support this statement, but the authors need to be careful when making such sweeping generalizations based on one relatively old study.  As such, they need to temper their statements instead of citing them as definitive statements of fact.

6. The authors do a nice job of reporting high level implications, but the paper may benefit from discussion of some specific detailed comments they make.  For example, explaining how adaptive behavior might be a predictor of activity participation (line 517) would be helpful.  In addition, on line 572, elaboration of what attributes of support persons (e.g., skill level, schedule, attitudes) contribute to dependency would help clarify their comments.

7. The discussion would also benefit from additional hypotheses about possible explanations and implications for differences in leisure activity between individuals with a mild or moderate intellectual disability versus those with a severe or profound intellectual disability, especially given exploration of this differentiation was a key purpose of the study.

8. The last paragraph of the discussion needs revised.  Although the authors generally do a nice job of highlighting the importance of self-determination and its value for people with an intellectual disability, this last paragraph begins to argue against the concept of self-determination.  The concepts highlighted in this paragraph are appropriate, but the wording needs changed to indicate that such resources would be helpful (instead of necessary) to support individuals with an intellectual disability.  It’s clear the authors are advocating for supports; they just need to do it in a way that does not diminish the self-determination advances that people with an intellectual disability have already made.

9. Having uniform headings and consistent style of those headings would facilitate reading and comprehension.

10. There are some relatively minor but important clarifications needed in the Appendix:

a.       Ages for participants in article #6 in the Appendix appears listed as “>58-18.”  This appears to be a typo that needs fixed.

b.       Article #10 in the Appendix appears to be the same article cited in the literature as #63.  The Appendix lists the date of publication as 2009, but the reference list indicates 2010.  This inconsistency needs checked and corrected.  Also, it is not clear what the P references in the second column.   

Overall, although this paper does not add anything new to the literature, its value as a review could warrant publication pending some relatively minor changes. 

There are a few typographical errors that the authors need to fix and some sentences/phrases that are unclear or confusing (e.g., in the abstract, “leisure time as a time frame of participation in leisure activities reflects the quality of life”).  Another example is the sentence “In addition, participation can also be operationalized and measured qualitatively as a level of performance.” appears to leave readers hanging without an explanation.  A review of the manuscript by a colleague of the author whose attention is to clarity of writing would help identify some of these sentence and phrases.  The authors then need to modify those.

Author Response

Dear Reviewer 2, 

We thank you for your valuable suggestions and comments and hope that we were able to increase the quality of our review through the adjustments.

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Thank you for editing your article. It is a very interesting topic with a good description of the current state of art.