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A functional assessment of handmouthing among persons with severe and profound intellectual disability
- Authors:
- SWENDER Stephen L., et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 31(2), June 2006, pp.95-100.
- Publisher:
- Taylor and Francis
The behavioural function of handmouthing has been assessed across various studies utilising analogue functional analyses. The aim of the current study was to expand upon research on this relatively understudied behaviour by examining the relationship between handmouthing and Gastro Esophageal Reflux Disorder (GERD), and the potential variables maintaining this challenging behaviour in 30 individuals with intellectual disability. First, the relationship of GERD to handmouthing was examined. Second, the behavioural function of handmouthing was assessed with an indirect functional assessment, the Questions About Behavioral Function (QABF). The authors found that a diagnosis of GERD was present with greater frequency among individuals with handmouthing than among matched peers who did not engage in handmouthing. Non-social reinforcement was most frequently endorsed as a behavioural function of this challenging behaviour. Although individuals with handmouthing exhibited more GERD than those who did not handmouth, the findings suggest that handmouthing was most often maintained by non‐social reinforcement. The importance of utilising functional assessment methodology for the assessment and treatment of handmouthing is discussed.
How to help your autistic spectrum child: practical ways to make family life run more smoothly
More than half a million people in Britain are somewhere on the autistic spectrum. Jackie Brealy writes with understanding gained from the both a parent's and a teacher's perspective. Her focus is entirely on the practical as she looks at ways to cope with family life. She acknowledges the wealth of books that discuss the latest theories about what causes ASD, but suggests that what parents really want to know is how to get a decent night's sleep, stop their child flapping their arms, or find some time for your other children. Concerned at this lack of down-to-earth, practical help for parents, she has worked with Beverly Davies, a journalist, and with input from other parents has produced a practical guide to help parents with all the day-to-day problems that make life difficult for them and their ASD child. The book is written with reference to services available in the UK.
Oh dear, what can the matter be?
- Authors:
- UNIVERSITY OF STIRLING. Dementia Services Development Centre, (Producer)
- Publisher:
- University of Stirling. Dementia Services Development Centre
- Publication year:
- 2004
- Pagination:
- (18 mins.), DVD
- Place of publication:
- Stirling
This short film explains why it is important for people with dementia to stay active. It looks at why walking is important for people with dementia and shows how to help them get on their feet. It can be used as part of a moving and handling course or to stimulate discussion on understanding challenging behaviour and planning meaningful activities.
Bathing in residential care: understanding the experiences of residents and their care providers
- Authors:
- HOLROYD Ann, HOLROYD Heather
- Journal article citation:
- Quality in Ageing and Older Adults, 16(2), 2015, pp.106-117.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to understand how changes in an older adult’s physical capacity alter their bathing preferences, how the care environment incorporates residents’ values and beliefs around bathing to fulfil these changing care needs, and how institutional factors, such as staff scheduling and communication processes, influence Resident Care Aides’ (RCAs) bathing practices. Design/methodology/approach: A multiple methods approach involving surveys and interviews with residents and RCAs in a Canadian residential care facility. This paper draws mostly from the semi-structured, qualitative interviews with older adult residents (n=9; Mini Mental Status Exam (MMSE) scores > 15) and RCAs (n=10) on two nursing units offering different bathing options. Findings: Decreasing energy levels and physical decline were commonly cited reasons for residents’ changing bathing preferences. Residents were overall very appreciative of the bathing care they received in residential care, and identified the weekly tub bath as an anticipated encounter where they experienced a valued social interaction with their assigned RCA. While identifying bathing as an occasionally stressful aspect of their work, RCAs also described the bathing experience as an intimate bonding activity. The study identified bathing as an important activity in residential care. Originality/value: Previous studies have focused on moderate to severely cognitively impaired older adults’ and their demonstration of agitated behaviours during bathing. Most participants in this study had only minor cognitive impairment, as measured by MMSE scores (average score=20.6); therefore, this study provides insight into the experiences and needs of older adults whose perspective is not generally reflected in the literature. (Publisher abstract)
Effect of music on mealtime disruptions
- Authors:
- HOOPER Jeff, CARSON Derek, LINDSAY Bill
- Journal article citation:
- Nursing Times, 27.11.12, 2012, pp.22-24.
- Publisher:
- Nursing Times
People with learning disabilities may display anxiety-driven behaviours that disrupt mealtimes. This study examined how delivering calming background music through headphones affected anxiety-driven behaviours that disrupted mealtimes of people with learning disabilities. A convenience sample of 30 adults with mild, moderate or severe learning disabilities was videotaped during mealtimes on two consecutive days. On the first day, half the group age without any calming music, while the other half sat opposite wearing earphones. On the second day, the non-music and music groups were swapped around. The final sample size was 24, as some would not tolerate the headphones. Of these 24 only three showed disruptive behaviour. There were signs that calming music has a positive effect on disruptive mealtime behaviours, though the sample was too small to conduct meaningful analysis.
Caring for people with dementia
- Author:
- EMBRACE-LEARNING
- Publisher:
- Embrace-Learning
- Publication year:
- 2011
- Place of publication:
- Altrincham
An e-learning training course developed for those caring for someone with dementia, whether within the family or as a professional. The six study units cover: What is dementia?; Improving communication; Helping people with dementia with everyday tasks; Responding to challenging behaviour; Using activities and exercise as part of a care plan; and Support in the later stages of the condition. The online materials include quizzes and activities to reinforce learning. A workbook accompanies each study unit, which includes questions relating to the course and your work experience. This can be completed online or printed out and filled in manually.
Stress and burden among caregivers of patients with Lewy Body Dementia
- Authors:
- LEGGETT Amanda N., et al
- Journal article citation:
- Gerontologist, 51(1), February 2011, pp.76-85.
- Publisher:
- Oxford University Press
Lewy Body Dementia (LBD) is the second most prevalent dementia type in the USA. The authors describe its symptoms, list its distinguishing features and advise on its possible misdiagnosis as Alzheimers disease. This study looks at stress, and the burden and appraisal of emotional, physical and social challenges faced by 611 family carers. Participants were recruited via a Lewy Body Dementia Association survey online between December 2007 and January 2008. A modified 12-item Zarit Burden Interview and factor analysis revealed 3 types of burden: role strain; personal strain; and worry about performance. Multiple regressions identified the following as predictors of these burdens: behavioural and emotional problems (BEPs); deficiencies in the activities of daily living (ADL); isolation; carer age; and patient gender. Other hallmark stressors commonly associated with LBD include: motor and movement disabilities, which add to difficulties with ADL; and a lack of formal awareness of the condition, which can lead to feelings of isolation and BEPs. The authors note that the following were not linked to burden: formal service use; falls; difficulties in finding a physician; and subsequent evaluation of that physician.
Quality of life for the Camberwell cohort
- Authors:
- BEADLE-BROWN J., MURPHY G., DiTERLIZZI M.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(4), July 2009, pp.380-390.
- Publisher:
- Wiley
Despite the acknowledged difficulties of measuring satisfaction for people with intellectual disabilities, the current study examined the quality of life (QoL) of the Camberwell Cohort, a total population sample of people with severe intellectual disability and/or autism. The Lifestyle Satisfaction Scale (LSS) was combined with selected questions from the Quality of Life Questionnaire and conducted with 12 people with intellectual disabilities and 72 proxy respondents. Inter-rater reliability on overall score was available for 10 participants and was acceptable with a Spearman's Rank order correlation co-efficient over 0.8. There were no significant differences between the scores of proxies and service users on the domains of the LSS. The sample of service users who completed the interviews was too small to allow further detailed analysis of their responses. However, responses from the proxy interviews indicated that there were no differences in life satisfaction between those socially impaired and socially able. However those with autism were reported to be less satisfied on Community Satisfaction while those with challenging behaviour had lower scores overall and specifically on Community Satisfaction. Those with an IQ below 50 had lower scores overall, than those with an IQ above 50 and specifically on Recreation Satisfaction. Linear regression analysis on total QoL score indicated that only three variables seemed to be important in predicting proxy QoL scores: challenging behaviour at Time 3, IQ at Time 3 and independent living skills at Time 1. The authors conclude that despite the difficulties encountered, this study provided some support for the widely held belief that QoL is lower for those with intellectual disability and for those with challenging behaviour.
Improving the quality of life of adults with more severe learning disabilities by increasing their interactions with their immediate environment
- Authors:
- BRENNAN Andrew, et al
- Journal article citation:
- Tizard Learning Disability Review, 8(2), April 2003, pp.23-31.
- Publisher:
- Emerald
Reports on a research project to measure the engagement levels of adults with severe learning disabilities living in staffed houses. 51 adults with moderate and severe learning disabilities living in 13 staffed houses in Solihul were included in the study. The project identifies individuals with the lowest levels of engagement; examines individual and environmental characteristics which contribute to these low levels; and to highlights 'good practice' and identifies service characteristics that encourage good practice.
Commentary on “Positive Behavioural Support as an alternative to medication”
- Author:
- ROBINSON Dave
- Journal article citation:
- Tizard Learning Disability Review, 24(1), 2019, pp.9-12.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provide a commentary on the article by Lee and colleagues, entitled “Positive Behavioural Support as an alternative to medication”, from the perspective of Dimensions, a national provider of social care support to people with learning disabilities and/or autism. As a supporter of the NHS England STOMP campaign, Dimensions recognises that people with learning disabilities and/or autism who have displayed “challenging behaviours” are at risk of being wrongly or over prescribed psychotropic medications intended to control that behaviour, and encourages the use of non-medical support strategies as an effective alternative to psychotropic medications. Design/methodology/approach: Dimensions surveyed the approximately 1,400 people with learning disabilities and/or autism for whom they provide 24-h support. The survey was intended to assess the extent of use of psychotropic medications and the level of adherence to NICE “best practice” guidelines. The survey was the precursor to an awareness raising campaign and development of an operational toolkit intended to inform and empower people supported, families and colleagues to take a more proactive role in the prescription and review of psychotropic medications. Findings: In total, 54 per cent of people surveyed were being prescribed psychotropic medication, of whom 97 per cent had been prescribed one or more medications for at least six months. Around 51 per cent were having six monthly multi-disciplinary reviews and around 31 per cent had not had a multi-disciplinary review within the preceding 12 months. Only 13 per cent of people taking psychotropic medication had a plan in place that was specifically aimed at reducing or stopping the medication. Originality/value: Empowering people to participate in and challenge clinical decision making can have a transformative effect on the lives of a group of people who have experienced a significant negative impact from prolonged use of psychotropic medications. (Edited publisher abstract)