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Context influences the motivation for stereotypic and repetitive behaviour in children diagnosed with intellectual disability with and without autism
- Authors:
- JOOSTEN Annette V., BUNDY Anita C., EINFELD Stewart L.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(3), May 2012, pp.262-270.
- Publisher:
- Wiley
Stereotypical and repetitive behaviours are part of normal child development. However while they diminish during the second year in typically developing children they often continue in those with intellectual disability and autism. Motivation seems to change with context, but there is little empirical evidence to support this. Data describing stereotypic behaviours from 279 Revised Motivation Assessment Scales (MAS:R) was evaluated using Rasch analysis. Data were gathered from two groups of Australian children (mean age 9.7 years): Group 1 with intellectual disability (n = 37) and Group 2 with both intellectual disability and autism (n = 37). Behaviour was examined in three contexts: free time, transition and while engaged in tasks. MAS:R distinguishes two intrinsic motivators: enhanced sensation and decreased anxiety and three extrinsic motivators: seeking attention or objects or escape. Significant differences in motivators were observed during free time and transition. No one motivator predominated while children were engaged in tasks. For both groups, sensory enhancement was a more likely motivator in free time and anxiety reduction was a more likely motivator during transition. Transition was the context most likely to influence extrinsic motivators, but there were significant differences between the groups. The authors conclude that context influences the motivation for stereotyped and repetitive behaviours; transition appears to have a particularly powerful effect.
Estimating the prevalence of autism spectrum conditions in adults: extending the 2007 adult psychiatric morbidity survey
- Authors:
- BRUGHA T., et al
- Publisher:
- NHS Information Centre
- Publication year:
- 2012
- Pagination:
- 31p.
- Place of publication:
- London
This report extends the 2007 Adult Psychiatric Morbidity Survey. The original data has been combined with data from a new study of the prevalence of autism among adults with learning disabilities living in private households and communal care establishments in Leicestershire, Lambeth and Sheffield. For this latter study, 290 adults were recruited resulting in 83 interviews with those living in private households. Sixty four per cent of communal care establishments approached took part in the study leading to 207 interviews. The overall prevalence of autism from the combined data was 1.1 per cent. The prevalence of autism was higher in men (2.0 per cent) than women (0.3 per cent). The learning disability study demonstrated that the prevalence of autism increased with greater severity of learning disability/lower verbal IQ. Sex differences were less marked in adults with learning disabilities compared with the general population. The estimated prevalence of autism changed very little when the data were re-analysed to take into account that the prevalence of autism might be higher or lower in other settings, such as prisons. This study has demonstrated that autism is common among people with a learning disability. Taking this into account gives an estimated overall prevalence of autism in England of 1.1 per cent; compared with a previous estimate of 1.0 per cent in the APMS (2007).
Reasonably adjusted? Mental health services and support for people with autism and people with learning disabilities
- Authors:
- BATES Peter, TURNER Sue, NATIONAL DEVELOPMENT TEAM FOR INCLUSION
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2012
- Pagination:
- 65
- Place of publication:
- Bath
The law requires mental health services to make reasonable adjustments so that they stop discriminating against people with autism or learning disabilities. ‘Reasonably adjusted?’ describes the reasonable adjustments mental health services have put in place for people with learning disabilities and people with autism. It is organised in three sections, starting with a summary of the context. The second section follows a care pathway from first contact with primary care services through referral to specialist help and on to discharge, reporting on the adjustments made by individuals and organisations that are trying to provide high quality services to people and their families The third section: ‘Effective services in a flourishing community’ begins with a broad view of active citizenship and follows an organisational pathway. ‘Reasonably adjusted?’ offers practical examples and includes an easy ready summary. Its content forms the basis of a subsequent NDTi publication, ‘The green light toolkit’ (2013). (Edited publisher abstract)
Promoting positive behaviour when supporting people with a learning disability and people with autism
- Author:
- PALLEY Sharon
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2012
- Pagination:
- 144p.
- Place of publication:
- Kidderminster
This book is primarily aimed at those working with people whose behaviour challenges services and who are studying for the level 2 or 3 diplomas in health and social care; in particular level 3- promoting positive behaviour. It puts the person at the centre of the support offered and uses real life stories, activities and thinking points to address the required learning outcomes. Practical examples offer guidance in applying the ideas in practice. The book explores how to promote positive behaviour and the use of proactive and reactive strategies. The author explains how to respond to incidents of challenging behaviour and support people following an incident. She also explains how to review and revise support plans and the legislative framework for providing support to people whose behaviour challenges services.
The effect of person-centred staff training on the incidents of challenging behaviour in adults with autism
- Authors:
- JACKSON Sarah, DUPEROUZEL Helen
- Journal article citation:
- Good Autism Practice, 13(1), May 2012, pp.64-68.
- Publisher:
- British Institute of Learning Disabilities
Many adults with autism are not receiving enough support to meet their needs. This lack of effective support often leads to frustration, deterioration in their behaviour, and a label of challenging behaviour. This article describes a pilot staff training programme designed to increase awareness of autism-specific interventions. The training was designed for 26 core staff members (5 registered nurses and 21 support workers) working in 2 low-security flats within a hospital ward in Lancashire. These staff supported 7 service users diagnosed with autism and learning disabilities who also displayed extremes of challenging behaviour. Meetings with key stakeholders highlighted 4 themes that were pertinent to the 7 service users: environmental support; communication strategies; behavioural approaches; and person-centred approaches. These themes formed the basis of the training package. The training was delivered in 8 sessions over a 2 month period. The training was evaluated using questionnaires administered to all the staff pre- and post-training, and qualitative staff interviews conducted with 17 staff. The findings showed that the training led to a marked decrease in challenging behaviour as well as to a significant increase in staff knowledge.
What is the effect on children with autism who witness incidents of challenging behaviour at school?
- Author:
- CHOUDRY Benazir
- Journal article citation:
- Good Autism Practice, 13(1), May 2012, pp.31-39.
- Publisher:
- British Institute of Learning Disabilities
The aim of this study was to explore the effects on children with autism who witness episodes of challenging behaviour at school. The study took place in an independent special school for children with autism from the ages of 4-16 years. All of the pupils have autism together with learning and behavioural difficulties. The majority of pupils in this setting regularly witness incidents of challenging behaviour from their peers. The study participants were 34 members of staff and 8 children. Data were gathered from questionnaires, interviews and structured observations. The staff reported that there were often changes in behaviour or appearance in children who had witnessed an incident of challenging behaviour. These changes ranged from pupils displaying anxious behaviours, challenging behaviours, and appearing withdrawn. The majority of staff said that the offered debriefing (usually involving talking) to these children. Difficulties that children with autism face in communication were the most common reasons for staff not offering to debrief them. Pupils themselves reported a negative effect after witnessing challenging behaviour and suggested doing activities they liked to help them feel better.
Prevalence of anxiety disorder in children and young people with intellectual disabilities and autism
- Authors:
- GOBRIAL Ereny, RAGHAVAN Raghu
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(3), 2012, pp.130-140.
- Publisher:
- Emerald
Anxiety disorder has frequently been reported in association with intellectual disabilities and autism in children and young people; comorbidity may increase this susceptibility further. However this belief that children and young people with intellectual disabilities and autism may experience symptoms of anxiety at a greater level than the general population is not supported with research evidence. This study was designed to further investigate the observations about prevalence. A total of 150 children and young people (age range of 5-18 years) with intellectual disabilities and autism from a metropolitan district in the North of England were screened for mental health problems using the Reiss Scales for Children's Dual Diagnosis and the Glasgow Anxiety Scale. Overall 61.3 per cent tested positive for mental health problems. The prevalence of anxiety was 32.6 per cent on the Glasgow Anxiety Scale. This group consisted of 47 males and seven females with mean age of 11.85 years. The study raises the issue of risk factors for the high prevalence of anxiety in children and adolescents with autism.
Clinical psychology and people with intellectual disabilities
- Authors:
- EMERSON Eric, et al
- Publisher:
- Wiley-Blackwell
- Publication year:
- 2012
- Pagination:
- 408p.
- Place of publication:
- Chichester
- Edition:
- 2nd ed
The editors’ aim when compiling this book was to provide a resource that will support the training of clinical psychologists and other professionals in their work with people with intellectual disabilities. It is pitched to cover the “middle ground” between a "how to" manual and an academic review of the literature. In depth coverage is provided on all aspects of clinical practice, from key basic concepts and assessment to evidence–based intervention techniques. The book is in three main sections: the first sets the scene looking at issues that underpin services for people with intellectual disabilities. The second part addresses a wide range of clinical issues, while the third focuses more specifically on issues related to clinical practice with specific client groups such as people with challenging behaviour, older people and parents with learning disabilities themselves. All chapters in this new edition have been fully updated with the latest evidence. New chapters cover working professionally, working with people with autism and addressing aspects of the wider social context within which people with learning disabilities live.
Disability and difference in higher education: be prepared for what you can't know
- Author:
- GEE Nick
- Journal article citation:
- Diversity and Equality in Health and Care, 9(2), 2012, pp.151-155.
- Publisher:
- Insight Medical Publishing
The last decade has seen a growing emphasis on addressing disability in main stream society through legislation to improve access to everyday living and working environments. This has resulted in a significant increase in the number of disabled students undertaking health and social care programmes at higher education institutions in the UK. Some disabilities are highly noticeable and easy to identify. Hidden disabilities such as intellectual impairment, Asperger’s syndrome and dyslexia are more difficult to recognise. This can lead to misinterpretations and misunderstandings when expectations are not met resulting in people with hidden disabilities, being ignored, excluded, or even becoming the target of hostility. This paper aims to explain some of these hidden disabilities and some of the responsibilities that higher education providers have towards students affected by these types of differences. The disabilities covered are; dyslexia; Asperger’s syndrome, autism, mental health difficulties, dyscalculia, dyspraxia; and attention deficit hyperactivity disorder.
Choosing staff members reduces time in mechanical restraint due to self-injurious behaviour and requesting restraint
- Authors:
- JENSEN Craig C., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(3), May 2012, pp.282-287.
- Publisher:
- Wiley
This brief report describes an attempt to reduce self-injurious behaviour and associated mechanical restraint of a women who had a history of biting herself to the point of causing nerve damage. The use mechanical restraints to protect her from dangerous self-injury was decreased by the client choosing the staff person who would work with her. The client was a 28-year-old woman diagnosed with autism, bipolar disorder, static cerebral encephalopathy, moderate intellectual disabilities, hypotonia and musculoskeletal deformities. Mechanical restraints were applied when she bit, tried to bite herself or asked for them. When she was allowed to choose staff members, the use of mechanical restraint decreased. The authors conclude that reducing the time spent in mechanical restraint by giving the client a choice of staff members who would work with her demonstrates that such a choice may be an establishing operation. The value of cumulative records and scatterplots to evaluate changes in the occurrence of self-injurious behaviour and associated mechanical restraint is demonstrated as are the advantages of using alternating treatment designs to assess the effectiveness of treatment conditions for someone who exhibits long-term cyclic behaviour.