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Thinking on your feet: understanding the immediate responses of staff to adults who challenge intellectual disability services
- Authors:
- RAVOUX Peggy, BAKER Peter, BROWN Hilary
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(3), May 2012, pp.189-202.
- Publisher:
- Wiley
Previous research suggests that there is a significant gap between the conceptualisation of good practice in challenging behaviour management strategies and current practice in intellectual disability services in the UK. This study investigated staff members’ perspectives of managing clients with challenging behaviours. Semi-structured interviews were conducted with eleven staff (ranging from managers to support workers) in two residential services in the independent sector. Both provided 24 hour support to four individuals. One service used a specific training package referred to as Non-Abusive Psychological and Physical interventions, the other used a positive behaviour support framework to inform their behavioural management policy. Service documents on challenging behaviour management were also examined. Analysis of the responses focussed on staff members’ immediate responses to clients’ difficult behaviours and their decision-making processes. The immediate responses of staff were the result of complex appraisals shaped by their service context involving the core processes of making the right choice and prioritising the best interests of all involved. The authors conclude that staff members’ responses can be understood as a dynamic and retroactive process, where their past and current challenging behaviour management influence their responses to clients in the future.
Outcome measurement for people with intellectual disability who present challenging behaviour
- Authors:
- BAKER Peter, DAYNES Shona
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 4(2), June 2010, pp.13-19.
- Publisher:
- Emerald
People with challenging behaviour are commonly referred to the National Health Service for assistance and support. Good clinical practice would indicate that such interventions should be routinely monitored and evaluated in order to be maximally effective. It is imperative that the outcomes chosen are both valid, in that they reflect the true nature of the phenomenon of challenging behaviour, and reliable, in that they reflect accurately the true nature of any change. Frequency, duration and severity of behavioural episodes are important outcome indicators, but they should not be considered in isolation, and the wider impact of the individual’s challenging behaviour, in particular the quality of life of the person and those with whom they share their environments, needs to be made clear. The article argues that it is unlikely that a single measure will ever capture the full impact of challenging behaviour, and that a battery of measures currently holds most promise in relation to representation of what would be considered valid acceptable outcomes.
An examination of the addition of video informed reflective practice to the active support toolkit
- Authors:
- BAKER Peter, APPLETON Philippa, WILLIAMS Rosie
- Journal article citation:
- British Journal of Learning Disabilities, 45(3), 2017, pp.180-189.
- Publisher:
- Wiley
Background: This study evaluated a package of Active Support (AS), which included standard training with additional video informed reflective practice. Materials and Methods: The training package was implemented as part of a service improvement initiative in four residential intellectual disability homes, using a concurrent multiple baseline across environments design. Training consisted of a 1-day workshop, and follow-up coaching. Momentary time sampling was used to measure engagement levels and staff assistance. A new observational tool was piloted to code the presence of positive and negative interactions between staff and the people with intellectual disabilities. Results: Results showed that service user engagement levels and staff assistance increased significantly following the training. There was also a significant increase in positive interactions and a significant decrease in negative interactions between staff and service users. Conclusion: The implications of these results are discussed. (Publisher abstract)