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The efficacy of positive behavioural support with the most challenging behaviour: the evidence and its implications
- Authors:
- LAVIGNA Gary W., WILLIS Thomas J.
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 37(3), September 2012, pp.185-195.
- Publisher:
- Taylor and Francis
Positive behaviour support (PBS) is behaviour analysis applied in support of people with challenging behaviour. However, questions have been raised as to PBS effectiveness, costs, and accessibility. This review examined the efficacy of 12 outcome studies encompassing 423 cases. Findings indicated that PBS was effective with both severe and high-rate behaviour problems, was cost-effective, used a methodology that was easily trained and widely disseminated, and worked in institutional settings in which the most difficult problems are thought to be, as well as in the community. The major implication of this review is that practitioners may be obligated to use PBS when faced with the need to develop a plan of support given the ethical principle of using the least restrictive method consistent with the right to effective treatment. Implications for practice are discussed.
The PAS-ADD assessments and their continuing conceptual development
- Author:
- MOSS Steve
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(1), 2012, pp.5-16.
- Publisher:
- Emerald
The PAS-ADD assessments (Psychiatric Assessment Schedules for Adults with Developmental Disabilities) have been in continuous development since the mid-1980s. Although originally developed through work on the health status of older people with intellectual disability they now encompass children as well as adults. The author discusses the theoretical and practical issues that have shaped the development of the assessments. The fundamental aim of the modern PAS-ADD system is to improve case detection and assessment by supporting and enhancing the skills of clinical staff, rather than attempting to replace the need for those skills. The assessor makes the final judgement about diagnosis. The PAS-ADD assessments are based on existing psychiatric classification and diagnostic rules for the general population and are conceptually different from instruments derived from psychometric principles. It is suggested that these factors have major implications, both for instrument design and for the evaluation of effectiveness.
Functional vision assessment for people with learning disabilities
- Author:
- SEE ABILITY
- Publisher:
- SeeABILITY
- Publication year:
- 2012
- Pagination:
- 39
- Place of publication:
- Epsom
Around 1 in 3 people with a learning disability have a sight problem. Unidentified sight problems can seriously undermine people’s quality of life and lead to avoidable sight loss and increased dependency. Many people with learning disabilities may not be able to tell others if they have a sight problem. This Functional Vision Assessment was created by SeeAbility. It is intended to be used by supporters of people with learning disabilities who know that person well, such as family carers and support staff. This Functional Vision Assessment is an observational tool that can be used to recognise how a person with learning disabilities might be using their sight, and can help give an indication of what a person might not see or have difficulty seeing. The resources in the pack aim to: enable carers to find out more about what a person can see; enable carers to effectively monitor a person’s vision between eye tests; identify questions to ask the optometrist during the person’s next eye test; identify questions to ask rehabilitation workers for people who have a visual impairment; and provide strategies to support the individual make the best use of their vision.
The need for cognitive profiles based on neuropsychological assessments to drive individual education plans (IEPs) in forensic settings
- Authors:
- LOWINGS Graham, WICKS Beth
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 7(4), 2012, pp.180-188.
- Publisher:
- Emerald
Many people in secure forensic settings are expected to take part in psycho-educational programmes as part of their treatment and rehabilitation. However many are hampered in this because of cognitive difficulties. These difficulties may result from acquired brain injury, deficits associated with substance misuse, childhood trauma, mental health problems and occasionally prescribed medication, or intellectual disability. This paper outlines the scale of the problem and offers potential solutions. The use of individual education plans based on neuropsychological profiles is proposed together with guidance on the preparation and delivery of educational materials that could improve the efficacy of psycho-educational programmes. The authors believe that understanding neuropsychological difficulties would mean that best use is made of the psycho-educational materials presented, thus speeding up and improving the efficacy of the rehabilitation process and potentially reducing the risk that the person poses to themselves and others. Currently there are resources, which offer guidance to teachers of children with neuropsychological difficulties but not for the adolescent and adult forensic population. This paper aims to address this gap.
Relationship between self-report and proxy ratings on assessed personal quality of life-related outcomes
- Authors:
- CLAES Claudia, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 9(3), September 2012, pp.159-165.
- Publisher:
- Wiley
Assessing the quality of life (QoL) of a person with intellectual disabilities is often complicated by their limited verbal abilities. Assessment processes often have to rely on informants such as a family member or support worker. This article reports on 2 studies which aimed to evaluate the impact of self-report vs. proxy ratings in the assessment of QoL scores. Study 1 aimed to evaluate the consistency between self-report and direct observation data by support staff. The participants were 161 individuals with mild or moderate levels of intellectual functioning. Study 2 aimed to evaluate the difference between self-report and proxy ratings using direct observation interviews with family and support staff. The participants were 42 individuals with a mild level of intellectual disability. Both studies involved the use of the self-report and the direct observation forms of the Personal Outcomes Scale. Study 1 found significant differences between the 2 respondent groups in 3 QoL domains and an acceptable level of internal consistency for both self-report and direct observation strategies. Study 2 found some differences between client and staff ratings but no significant differences between client and family ratings. The article concludes with noting the need for methodological pluralism in QoL assessment, the importance of self-report by persons with intellectual disability, and the need to develop better strategies to evaluate QoL outcomes for those individuals who cannot respond for themselves.
Eligibility for statutory learning disability services in the north-west of England. Right or luxury? Findings from a pilot study
- Authors:
- MCINNIS Erica E., HILLS Alan, CHAPMAN Melanie J.
- Journal article citation:
- British Journal of Learning Disabilities, 40(3), September 2012, pp.177-186.
- Publisher:
- Wiley
Community learning disability teams are facing increasing demands for their services. Access to these services in England is often governed by eligibility criteria. Eligibility criteria can both define the intended client group for a specialised service and also provide a means of managing demand. This study arose from ongoing discussion around eligibility for services amongst the North West Regional Learning Disability Special Interest Group of clinical psychologists. A semi-structured questionnaire was developed about service eligibility criteria and psychologists’ role within the referral process to learning disability services. The questionnaire was distributed to a clinical psychologist in each community learning disability service in the region. A total of 16 completed questionnaires were returned. The survey findings highlighted both variations and similarities across the region in terms of definitions of learning disabilities, eligibility for accessing local services and the psychometric measures used to assess functioning. Differences in how services assess eligibility can lead to difficulties, for example when people move area. The use of standard eligibility criteria could be one means of overcoming this.
Evaluating the ability of and enabling a blind adult with learning disability to sign a tenancy agreement
- Authors:
- WAIGHT Mary Philomena, OLDREIVE Warren James
- Journal article citation:
- British Journal of Learning Disabilities, 40(1), March 2012, pp.55-61.
- Publisher:
- Wiley
The Mental Capacity Act 2005 requires professionals to evaluate and, where appropriate, promote capacity to enable adults with learning disability to engage in complex decisions that affect their lives. This paper describes a case study in which a man with learning disabilities and visual impairment was supported by Speech and Language Therapy and Occupational Therapy to sign a tenancy agreement in order to transfer living arrangements from residential care to a private tenancy. A screening assessment evaluating memory and verbal reasoning skills was used to assess the man’s mental capacity. A software system involving the Clicker 5 software and switches was used to provide information about tenancy. A format was derived which evaluated his ability to both retain and use this tenancy-specific information in a range of scenarios. This process resulted in evidence that enabled him to sign the tenancy agreement. The article provides an outline of the assessment pathway, and all assessments and information used are included for reference.
Mental health needs in adolescents with intellectual disabilities: cross-sectional survey of a service sample
- Authors:
- HASSIOTIS A., TURK J.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(3), May 2012, pp.252-261.
- Publisher:
- Wiley
Despite mental health needs and service use being relatively high across the lifespan of those with intellectual disability, relatively little is known about these needs during adolescence. This study investigated the prevalence and predictors of mental health needs and service use in adolescents (n=75) with intellectual disabilities in one area of Southern England. Individual assessments were carried out, the main outcome of which was the presence of mental health needs measured by the Developmental Behaviour Checklist. Prevalence of mental health needs increased from 51% as reported by parents to 67% as judged by clinical interviews. Having a need was associated with low adaptive functioning, diagnosis of autism and family history of mental illness. High scores on parent reports of participant mental ill-health showed negative correlations with adaptive functioning scores. Most individuals were in receipt of social and health care. Half of the participants had sought help for mental health problems. Almost half of those receiving medication were on psychiatric medication. It is concluded that adolescents with intellectual disabilities may have considerable mental health problems that are functionally impairing but often unidentified and hence untreated. The authors believe that identification of those at risk and comprehensive needs assessment are essential to maximise potential and quality of life and to reduce further deficits and social exclusion.
Supporting aspirations - or not? Recent reforms on equality, the green paper on Special Educational Needs and the potential of a neurodiversity spectrum statement
- Authors:
- MACKENZIE Robin, WATTS John, HOWE Lati
- Journal article citation:
- Tizard Learning Disability Review, 17(1), 2012, pp.36-48.
- Publisher:
- Emerald
The purpose of this paper is to review current legal and policy initiatives focused on special educational needs and equality in England. It discusses issues concerning inclusion of children with special educational needs into mainstream education, and includes contributions from parents about their experience concerning inclusion and statements of special educational needs. It then comments on plans for reform set out in the 2011 Department of Education green paper on special educational needs, covering changes directly affecting schools and pupils with special educational needs, quality of education, and responses to the proposals. It also discusses the potential contribution of a neurodiversity spectrum statement to assess a wide range of characteristics, arguing that this would lead to a holistic approach to assessing differences in learning styles, thinking, communication and behaviour, and adapting teaching to suit these differences.