Search results for ‘Subject term:"learning disabilities"’ Sort:
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Epilepsy and challenging behaviour in adults with intellectual disability: a systematic review
- Authors:
- BLICKWEDEL Jessica, ALI Afia, HASSIOTIS Angela
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 44(2), 2019, pp.219-231.
- Publisher:
- Taylor and Francis
Background: Epilepsy and challenging behaviour are both highly prevalent in the intellectual disability (ID) population and it is thus crucial to understand any possible associations between the two. Method: PsycINFO, MEDLINE, Embase, CINAHL and Web of Science were searched for quantitative data about epilepsy and any forms of challenging behaviour in adults with ID. Results: A total of 25 articles were included in the review. Overall the evidence suggests that while epilepsy is not a good explanatory variable for the presence of challenging behaviour; the relationship is complex. However, for some people with epilepsy and for certain types of challenging behaviour a link may exist. Conclusions: Given the possible link between epilepsy-related factors such as seizure type and specific subgroups of challenging behaviour, investigating these relationships further and particularly exploring how to best measure challenging behaviour in people with epilepsy could be of great clinical benefit. (Edited publisher abstract)
Loneliness in people with intellectual and developmental disorders across the lifespan: a systematic review of prevalence and interventions
- Authors:
- PETROUTSOU Alexandra, HASSIOTIS Angela, AFIA Ali
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 31(5), 2018, pp.643-658.
- Publisher:
- Wiley
Background: The aim of the study was to conduct the first systematic review investigating the prevalence of loneliness in people with intellectual developmental disabilities (IDD) and the interventions targeting loneliness. Method: A search across five databases was conducted (May 2016–June 2016). One reviewer (A. P.) selected the articles for inclusion and assessed their risk of bias using a standardised tool. The second reviewer (A. H.) examined the list of included/excluded articles and the ratings of the studies. Results: Five prevalence studies met the inclusion criteria and provided an average loneliness prevalence of 44.74%. Only one intervention study was included, and it demonstrated that there was not any significant group difference for loneliness outcomes (p = .21). The majority of the studies had a weak quality rating. Conclusion: The systematic review evidenced that loneliness is a common experience in people with IDD and there is a need to extend current research. (Edited publisher abstract)
Applied behaviour analysis and standard treatment in intellectual disability: 2-year outcomes
- Authors:
- HASSIOTIS Angela, et al
- Journal article citation:
- British Journal of Psychiatry, 198(6), June 2011, pp.490-491.
- Publisher:
- Cambridge University Press
The development of multidisciplinary teams to provide specialist care for problem behaviours in people with intellectual disabilities was a key recommendation of the Mansell report in the UK. However, research into its effectiveness is limited. In this study, 63 participants with behavioural problems were recruited form community intellectual disabilities services in England; 31 were administered standard treatments, and 32 were administered standard treatment augmented by a specialist behaviour service. The costs of both groups were estimated from a health and personal services system perspective. Costs were compared between the standard and intervention group. The augmented treatment was reported to be clinically and cost-effective after 6 months. In a 2-year follow-up of the same trial cohort (n=58), participants receiving the specialist intervention had significantly lower total and subdomain Aberrant Behavior Checklist scores than those receiving usual care alone. After adjustment for baseline covariates there was no significant difference in costs between the trial arms. The authors concluded that trained professionals may improve clinical outcomes of individuals with severe and complex needs at no extra cost.
Individual characteristics and service expenditure on challenging behaviour for adults with intellectual disabilities
- Authors:
- HASSIOTIS Angela, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(5), September 2008, pp.438-445.
- Publisher:
- Wiley
English policy argues that people with intellectual disabilities should be supported in their local communities. There is considerable evidence that this aspiration is not being achieved. This paper seeks to look at the subsection of people with intellectual disabilities who have expensive care needs because of challenging behaviour, to identify the decision-making processes that have led to current service provision and expenditure and to suggest improvements. A survey was carried out within five North London boroughs to investigate the characteristics of a cohort of people with intellectual disabilities and challenging behaviour in high-cost accommodation (over £70 000/annum). Postal questionnaires and face-to-face interviews were conducted with stakeholders with intellectual disabilities and patterns of current costs were estimated from existing data provided by the commissioning authorities in the five boroughs. Two hundred and five individuals with intellectual disabilities and challenging behaviour were identified. They were accommodated in placements provided by 97 separate providers, both in and out-of-area. Those more likely to be placed out-of-area were younger, had multiple health problems, significant challenging behaviour and mental health problems including autistic spectrum disorders. The local community intellectual disabilities teams identified a number of difficulties in meeting the needs of those service users. Expenditure on all placements for service users with intellectual disabilities is significant. There is a notable lack of investment in local service development. A coherent approach is required, often across service boundaries. The authors suggest a model for targeted investment aimed at supporting effective local services, and reducing the need for and expense of out-of-area placements.
Mental health, learning disabilities and adolescence: a developmental perspective
- Authors:
- HASSIOTIS Angela, BARRON Diana Andrea
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 1(3), September 2007, pp.32-39.
- Publisher:
- Emerald
This article presents the results of a survey of a community-based sample of adolescents with learning disabilities. The aims were to describe a cohort of adults with learning disabilities in one catchment area and explore the prevalence of mental disorders and their association with socio- demographic and clinical variables. The hypothesis was that adolescents with learning disabilities as a group have high rates of mental health problems when compared with published rates of mental disorders in adolescents without mental health disorders.
Challenges in accessing local services for a person with complex mental health needs: a network approach
- Authors:
- HASSIOTIS Angela, PARKES Charles, HALL Ian
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 1(1), March 2007, pp.42-44.
- Publisher:
- Emerald
This case study of a women with moderate learning disabilities, autistic traits and bipolar affective disorder illustrates the challenges of supporting people with learning disabilities in community settings during and acute episode of mental illness. She was admitted to a generic in-patient psychiatric service, and the way in which her links with her home and community were maintained are described. The difficulty of transferring and maintaining behavioural guidelines form the in-patient to a community setting are discussed. The delay in effecting a discharge necessitated her admission to a specialist unit for people with learning disabilities outside the local areas. The possible reasons and solutions for this scenario are debated.
Mental health and social care needs of older people with intellectual disabilities
- Authors:
- STRYDOM Andre, HASSIOTIS Angela, LIVINGSTON Gill
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 18(3), September 2005, pp.229-235.
- Publisher:
- Wiley
In this study all adults with intellectual disabilities (ID) without Down syndrome (DS) aged 65+ living in the London boroughs of Camden and Islington were identified. The Psychiatric Assessment Schedule for Adults with a Developmental Disability (PASADD) checklist was used to detect psychiatric disorder, the Vineland behaviour scale (maladaptive domain) for problem behaviours and the Dementia Questionnaire for persons with Mental Retardation (DMR) to screen for dementia. Carers reported health problems and disability. Needs were measured with the Camberwell Assessment of Need for adults with Intellectual Disabilities (CANDID-S). A total of 23 older people with ID (13 had mild ID and nine more severe ID) and their carers participated in the survey. In which, 74% had one or more psychiatric symptoms; 30% were previously known with a diagnosis of mental illness. One-third of the older people screened positive for dementia. Three quarters of the group had physical health problems, 74% had poor sight, 22% had hearing loss and 30% had mobility problems. Carers rated unmet needs for accommodation (22%), day activities, and eyesight and hearing. The people with ID rated unmet needs to be social relationships (44%), information and physical health. The authors conclude that older people with ID without DS have considerable prevalence of health problems and psychiatric disorders, including symptoms of functional decline and dementia. Such symptoms are often not recognised and further research into their needs is a priority.
Mental health services for people with learning disabilities
- Authors:
- HASSIOTIS Angela, BARRON Phil, O'HARA Jean
- Journal article citation:
- British Medical Journal, 9.9.00, 2000, pp.583-584.
- Publisher:
- British Medical Association
Mental health services in the United Kingdom are set for dramatic restructuring in the light of recent government initiatives to improve quality of care and equity of provision. National standards for promoting mental health and treating mental illness are designed to reduce the risk of future tragedies and improve the quality of life of people with mental illness. But little thought has been given to the well documented mental health need of people with learning disabilities. A complete overhaul is needed with strong links to mainstream services.
A re-design of undergraduate medical training in intellectual disability: building psychological capital and imparting knowledge to redress health inequalities
- Authors:
- HARWOOD Ian, HASSIOTIS Angela
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(6), 2014, pp.344-361.
- Publisher:
- Emerald
Purpose: Over 1,250 people with intellectual disabilities die unnecessarily every year in NHS care. The purpose of this paper is to develop higher-order learning amongst medical students to increase engagement with this disadvantaged group and redress this injustice in care provision. Design/methodology/approach: The Psychiatry of Intellectual Disability input to University College London's (UCL) undergraduate medicine MBBS curriculum was re-designed. Materials were developed to broaden the students’ understanding of the stigma and health implication of intellectual disability and the affect it has on the care received by these patients. These were delivered in lecture and e-learning formats. The concept of psychological capital was used to frame the development of new materials with direct involvement of service users with intellectual disability. It is a management model designed to promote higher levels of learning, resulting in a deeper understanding of patient issues by UCL medical graduates. Findings: Findings from the online survey that accompanies the e-learning materials suggests that students have overwhelmingly adopted a positive outlook towards patients with intellectual disability and consider training necessary for all doctors. The filmed scenarios with people with intellectual disability appealed to students. Practical implications: The broadening of the educational materials required a re-design of the methods of curriculum delivery, a higher level of self-directed learning and student time commitment. Further assessments of the impact of the module are planned to include formative assessments of learning. Social implications: Medical lack of knowledge, personal attitudes and a reluctance to engage with people with intellectual disability have been identified as barriers to their receiving appropriate care. Originality/value: A blend of organisational change theories has been integrated into the production of a new, multi-media, e-learning package. (Publisher abstract)
Complex behaviour service: content analysis of stakeholder opinions
- Authors:
- INCHLEY-MORT Sophie, HASSIOTIS Angela
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(4), 2014, pp.228-236.
- Publisher:
- Emerald
Purpose: Positive behaviour support has been positioned by current government policy as an important intervention for people with intellectual disabilities who display behaviours that challenge services. However, little is known about service user or carer opinions towards the use of this kind of model. The paper aims to discuss this issue. Design/methodology/approach: Opinions and experiences of 25 carers and six service users were collected through semi-structured interview as part of the evaluation of an enhanced service, Complex Behaviour Service, based on positive behaviour support principles. Findings: Content analysis indicated that the service was seen as acceptable and useful and that positive experiences of the service linked to: frequency and availability of the service; talking about behaviour and being listened to; understanding, and change in, the service user, carer and behaviour. Originality/value: This adds to the small but growing literature on service user and carer opinions towards specific interventions and highlights themes that future services could consider in delivering evidence-based care. (Publisher abstract)