British Journal of Learning Disabilities, 35(4), December 2007, pp.205-213.
Publisher:
Wiley
This article draws on existing theory and research findings in the field of quality of life (QoL) and those with learning/intellectual disability and extrapolates current thinking in terms of measurable domains of QoL. The condition of autism spectrum disorders (ASD) is becoming increasingly prevalent in the sector of supported living and adult residential care. The author examines the core features of ASD and applies known characteristics to ways in which QoL domains and assessment tools can be adapted to people with ASD.
This article draws on existing theory and research findings in the field of quality of life (QoL) and those with learning/intellectual disability and extrapolates current thinking in terms of measurable domains of QoL. The condition of autism spectrum disorders (ASD) is becoming increasingly prevalent in the sector of supported living and adult residential care. The author examines the core features of ASD and applies known characteristics to ways in which QoL domains and assessment tools can be adapted to people with ASD.
Subject terms:
instruments, learning disabilities, quality of life, assessment, autistic spectrum conditions;
This guide is designed to help with establishing a framework to support individuals with learning disabilities or autistic spectrum disorders whose behaviour challenges services and presents a risk to themselves or others. It sets out in clear and simple terms a structured and systematic approach to the identification, assessment and management of risks associated with challenging behaviours.
This guide is designed to help with establishing a framework to support individuals with learning disabilities or autistic spectrum disorders whose behaviour challenges services and presents a risk to themselves or others. It sets out in clear and simple terms a structured and systematic approach to the identification, assessment and management of risks associated with challenging behaviours.
Extended abstract:
Author
POWELL Sharon.
Title
Risk in challenging behaviour: a good practice guide for professionals.
Publisher
British Institute of Learning Disabilities, 2005
Summary
This guide is designed to help with establishing a framework to support individuals with learning disabilities or autistic spectrum disorders whose behaviour challenges services and presents a risk to themselves or others. It sets out in clear and simple terms a structured and systematic approach to the identification, assessment and management of risks associated with challenging behaviours.
Context
Risk is an evolving concept; it is changing and rarely stays the same from one day to the next. Individuals are prepared to take calculated risks in their daily lives for a variety of reasons. Professionals are expected to identify and manage risk objectively. Reactive strategies for risk management when behaviour challenges should form part of an overall framework. This should include approaches that support positive behaviour. Physical interventions should be used only as a last resort.
Contents
A foreword explains recent developments and an introduction outlines the problem and the intentions of the guide. The first section, on philosophical and organisational issues, discusses organisational foundations, the nature of risk, taking risks, procedures for working with risk, why risk should be assessed, and the elements of risk. The second, on assessing risk, covers risk scoring, identifying hazards and risks, the risk assessment process, describing the challenging behaviour, articulating risk, managed and unmanaged risk, the assessment process, what might go wrong, and physical interventions in the context of risk assessment. Two sets of checklists are given, on procedures for working with risk, consisting of three lists, for developing risk policies, service user vulnerability, and breaking confidentiality; and on risk assessment process, with four lists, for information gathering, planning and consultation, implementation and monitoring, and evaluation and review. Three pro formas are also given, for behaviour description, articulating risk and assessment of service user vulnerability.
Advances in Mental Health and Intellectual Disabilities, 9(5), 2015, pp.222-229.
Publisher:
Emerald
Purpose: Adults with autism spectrum disorder (ASD) present with a range of psychiatric disorders. However, making an accurate diagnosis is challenging. It is important to follow a robust and informed process in the assessment of psychopathology that is centred on the individual and their neurodevelopmental difficulties. The purpose of this paper is to provide clinicians with an evidence-based approach to the assessment process for adults with ASD presenting with a possible co-occurrent psychiatric disorder.
Design/methodology/approach: A review of the recent literature was undertaken focusing on key papers that describe the assessment of mental health problems in adults with ASD.
Findings: The presentation of psychiatric symptoms is influenced by the underlying developmental disorder and it is often quite different from the one of the general population. Thus, it is essential to undertake a comprehensive psychopathological assessment including a diagnostic assessment of ASD. There is a very small evidence base on the use of diagnostic tools in the assessment of adults with ASD.
Originality/value: This is a practice review paper applying recent evidence from the literature.
(Publisher abstract)
Purpose: Adults with autism spectrum disorder (ASD) present with a range of psychiatric disorders. However, making an accurate diagnosis is challenging. It is important to follow a robust and informed process in the assessment of psychopathology that is centred on the individual and their neurodevelopmental difficulties. The purpose of this paper is to provide clinicians with an evidence-based approach to the assessment process for adults with ASD presenting with a possible co-occurrent psychiatric disorder.
Design/methodology/approach: A review of the recent literature was undertaken focusing on key papers that describe the assessment of mental health problems in adults with ASD.
Findings: The presentation of psychiatric symptoms is influenced by the underlying developmental disorder and it is often quite different from the one of the general population. Thus, it is essential to undertake a comprehensive psychopathological assessment including a diagnostic assessment of ASD. There is a very small evidence base on the use of diagnostic tools in the assessment of adults with ASD.
Originality/value: This is a practice review paper applying recent evidence from the literature.
(Publisher abstract)
Subject terms:
assessment, diagnosis, autistic spectrum conditions, learning disabilities, literature reviews, evidence-based practice, mental health problems;
Advances in Mental Health and Intellectual Disabilities, 13(5), 2019, pp.173-181.
Publisher:
Emerald
Purpose: Children and young people with comorbid intellectual disabilities (ID) and autism spectrum disorders (ASD) are more likely to exhibit comorbid mental health disorders (MHD) and other significant behaviours (SB) in addition to the core symptoms of ASD. The purpose of this paper is to identify the prevalence of comorbid MHD and behaviours in children and young people with ID and ASD in Egypt. Design/methodology/approach: The Reiss scale for children’s dual diagnosis was administered by parents and teachers of 222 Egyptian children and young people with mild/moderate ID and ASD to screen for MHD and SB. The mean age of children and young people was 12.3 years (SD = 3.64), with 75.6 per cent male. Findings: The results revealed that 62.2 per cent of children and young people with ID and ASD had high rates of comorbid MHD and behaviour disorders were shown in 64.4 per cent of the participated children and young people. The results identified anger, anxiety and psychosis being the most frequently diagnosed disorders while crying spells and pica were the most SB. No differences were found between the male and female with ID and ASD in the current study. Research limitations/implications: Mental health assessment of children and young people with ID and ASD will help to highlight the needs of these vulnerable children and develop the appropriate services. Originality/value: The findings highlight the prevalence of MHD in children and young people with ID and ASD in Egypt. This has implications on the assessment of comorbid disorders and services needed for children with ID and ASD in Egypt.
(Edited publisher abstract)
Purpose: Children and young people with comorbid intellectual disabilities (ID) and autism spectrum disorders (ASD) are more likely to exhibit comorbid mental health disorders (MHD) and other significant behaviours (SB) in addition to the core symptoms of ASD. The purpose of this paper is to identify the prevalence of comorbid MHD and behaviours in children and young people with ID and ASD in Egypt. Design/methodology/approach: The Reiss scale for children’s dual diagnosis was administered by parents and teachers of 222 Egyptian children and young people with mild/moderate ID and ASD to screen for MHD and SB. The mean age of children and young people was 12.3 years (SD = 3.64), with 75.6 per cent male. Findings: The results revealed that 62.2 per cent of children and young people with ID and ASD had high rates of comorbid MHD and behaviour disorders were shown in 64.4 per cent of the participated children and young people. The results identified anger, anxiety and psychosis being the most frequently diagnosed disorders while crying spells and pica were the most SB. No differences were found between the male and female with ID and ASD in the current study. Research limitations/implications: Mental health assessment of children and young people with ID and ASD will help to highlight the needs of these vulnerable children and develop the appropriate services. Originality/value: The findings highlight the prevalence of MHD in children and young people with ID and ASD in Egypt. This has implications on the assessment of comorbid disorders and services needed for children with ID and ASD in Egypt.
(Edited publisher abstract)
Subject terms:
comorbidity, mental health problems, young people, learning disabilities, children, autism, autistic spectrum conditions, mental health, assessment;
Journal of Intellectual Disabilities and Offending Behaviour, 8(4), 2017, pp.176--87.
Publisher:
Emerald
Purpose: The purpose of this paper is to assess the training forensic mental health professionals in the USA receive on intellectual and developmental disabilities (I/DD). Given the difficulties obtaining accurate prevalence rates of these disabilities in criminal justice settings, it is important to understand how these disabilities are being evaluated and the level of understanding about these disabilities evaluators hold.
Design/methodology/approach: An online survey was distributed to forensic mental health professionals in the USA that included questions on training opportunities in graduate education, post-graduate forensic training, and professional training opportunities. Participants were also asked about their current work, how they assess I/DD, and their estimates on the percentage of cases they see with I/DD.
Findings: Respondents reported some training that focused heavily on assessment methods. Most respondents estimated between 5 and 25 percent of their cases involving I/DD and reported using a wide range of assessment methods. Finally, many respondents reporting more training needed in this area.
Practical implications: More training is needed for forensic mental health professionals on identifying I/DD. Additionally, professional guidelines on what tools and methods to rely on to identify these disabilities is paramount to ensure homogeneity of methods and, thus, better estimates of overall prevalence in criminal justice settings.
Originality/value: This is the first assessment focused on how forensic mental health professionals are trained to identify I/DD and can be used to improve identification of I/DD in forensic settings.
(Publisher abstract)
Purpose: The purpose of this paper is to assess the training forensic mental health professionals in the USA receive on intellectual and developmental disabilities (I/DD). Given the difficulties obtaining accurate prevalence rates of these disabilities in criminal justice settings, it is important to understand how these disabilities are being evaluated and the level of understanding about these disabilities evaluators hold.
Design/methodology/approach: An online survey was distributed to forensic mental health professionals in the USA that included questions on training opportunities in graduate education, post-graduate forensic training, and professional training opportunities. Participants were also asked about their current work, how they assess I/DD, and their estimates on the percentage of cases they see with I/DD.
Findings: Respondents reported some training that focused heavily on assessment methods. Most respondents estimated between 5 and 25 percent of their cases involving I/DD and reported using a wide range of assessment methods. Finally, many respondents reporting more training needed in this area.
Practical implications: More training is needed for forensic mental health professionals on identifying I/DD. Additionally, professional guidelines on what tools and methods to rely on to identify these disabilities is paramount to ensure homogeneity of methods and, thus, better estimates of overall prevalence in criminal justice settings.
Originality/value: This is the first assessment focused on how forensic mental health professionals are trained to identify I/DD and can be used to improve identification of I/DD in forensic settings.
(Publisher abstract)
Subject terms:
assessment, learning disabilities, autistic spectrum conditions, training, mental health professionals, surveys, forensic psychiatry, criminal justice, professional role;
This book provides practical advice and knowledge to help professionals understand common intellectual disabilities and how they might affect parenting capability. It provides guidance on how to carry out effective assessments and explains how interventions might differ when working with parents who have a learning disability. It includes chapters on: mild learning disabilities and parenting; borderline learning disability; autistic spectrum conditions; parenting, emotions and attachment; and working with families. It also explores emotional and mental health issues that can occur alongside learning disabilities, such as anxiety, depression, and attachment disorders, to show how they should be understood in the context of cognitive abilities and the parenting role.
(Edited publisher abstract)
This book provides practical advice and knowledge to help professionals understand common intellectual disabilities and how they might affect parenting capability. It provides guidance on how to carry out effective assessments and explains how interventions might differ when working with parents who have a learning disability. It includes chapters on: mild learning disabilities and parenting; borderline learning disability; autistic spectrum conditions; parenting, emotions and attachment; and working with families. It also explores emotional and mental health issues that can occur alongside learning disabilities, such as anxiety, depression, and attachment disorders, to show how they should be understood in the context of cognitive abilities and the parenting role.
(Edited publisher abstract)
Subject terms:
parents with learning disabilities, child protection, learning disabilities, parenting, assessment, social work, autistic spectrum conditions, mental health problems;
Journal of Intellectual Disabilities and Offending Behaviour, 6(2), 2015, pp.102-111.
Publisher:
Emerald
Purpose: The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID).
Design/methodology/approach: The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test.
Findings: Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study.
Originality/value: The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD.
(Publisher abstract)
Purpose: The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID).
Design/methodology/approach: The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test.
Findings: Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study.
Originality/value: The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD.
(Publisher abstract)
Advances in Mental Health and Intellectual Disabilities, 9(3), 2015, pp.108-115.
Publisher:
Emerald
Purpose: The purpose of this paper is to examine the trend of admissions and inpatient characteristics in a NHS intellectual disability hospital from 1975 to 2013, in particular looking at the effect following the Winterbourne View scandal.
Design/methodology/approach: A retrospective review of all admissions over a three-year period (January 2011-January 2013) was completed. This information was compared with admissions to the same hospital in three-year period over the last four decades (1975-1977, 1985-1987, 1995-1997, and 2003-2006). Number of admissions, gender, age, source of admission, length of stay, reasons for admission, type of admission, and diagnosis of psychiatric illnesses were included.
Findings: There were 87 admissions (including 29 from out of area) in the study period of 2011-2013. The number of admissions had varied over the years but male admissions were consistently higher than female. A majority of people stayed over six months. For the first time in five decades, there were more formal inpatients than informal ones. The diagnosis of Autism Spectrum Disorder (ASD) and of Attention Deficit Hyperactivity Disorder had increased.
Originality/value: This study has examined admission trends over five decades. It has highlighted that the Mental Health Act legislation is being used more frequently and that co-morbid mental disorders, such as ASD are commonly associated with those admitted to hospital. A well planned-out community health care system, as well as adequate social provision are keys to maintain people with intellectual disability in the community. Furthermore, a better understanding of the symptomology of challenging behaviours, and appropriate use of mental health legislation are crucial in providing a high-quality service that has clear treatment goals and values. Some of these issues have contributed to the failure of the recent initiative to reduce the size of the inpatient intellectual disability following Winterbourne View scandal.
(Publisher abstract)
Purpose: The purpose of this paper is to examine the trend of admissions and inpatient characteristics in a NHS intellectual disability hospital from 1975 to 2013, in particular looking at the effect following the Winterbourne View scandal.
Design/methodology/approach: A retrospective review of all admissions over a three-year period (January 2011-January 2013) was completed. This information was compared with admissions to the same hospital in three-year period over the last four decades (1975-1977, 1985-1987, 1995-1997, and 2003-2006). Number of admissions, gender, age, source of admission, length of stay, reasons for admission, type of admission, and diagnosis of psychiatric illnesses were included.
Findings: There were 87 admissions (including 29 from out of area) in the study period of 2011-2013. The number of admissions had varied over the years but male admissions were consistently higher than female. A majority of people stayed over six months. For the first time in five decades, there were more formal inpatients than informal ones. The diagnosis of Autism Spectrum Disorder (ASD) and of Attention Deficit Hyperactivity Disorder had increased.
Originality/value: This study has examined admission trends over five decades. It has highlighted that the Mental Health Act legislation is being used more frequently and that co-morbid mental disorders, such as ASD are commonly associated with those admitted to hospital. A well planned-out community health care system, as well as adequate social provision are keys to maintain people with intellectual disability in the community. Furthermore, a better understanding of the symptomology of challenging behaviours, and appropriate use of mental health legislation are crucial in providing a high-quality service that has clear treatment goals and values. Some of these issues have contributed to the failure of the recent initiative to reduce the size of the inpatient intellectual disability following Winterbourne View scandal.
(Publisher abstract)
It is well established that high numbers of children who come to the attention of youth justice services have complex support needs, low levels of educational attainment, and far more unmet health needs than other children. An online survey was undertaken between October and December 2009 to investigate how staff from youth offending teams (YOTs) identify and support children with particular impairments and difficulties, and what support they in turn receive. Responses were received from over half of YOTs in England and Wales; there were 208 responses from 89 YOTs. The impairments and difficulties included were: mental health problems, IQs of less than 70, communication difficulties, ADHD, autistic spectrum disorder, low levels of literacy, special educational needs, and specific learning difficulties such as dyslexia. The research identified a lack of routine screening and assessment to identify children’s support needs. Although YOT staff spoke highly of specialist services and support, many reported gaps in provision. The survey found that: only around half of YOT staff said they received any training to help identify when children might have particular impairments and difficulties; most YOTs did not use screening or assessment tools or procedures to identify children with learning disabilities; fewer than 1 in 10 staff said their YOT kept statistics on the number of children with disabilities serving court orders; and more than 1 in 5 staff said their YOT did not have a mental health worker. Most YOT staff reported that children with these impairments were more likely to receive a custodial sentence. This report also includes the findings of 3 focus groups, which took place in July 2010, looking specifically at the issue of custodial sentences.
It is well established that high numbers of children who come to the attention of youth justice services have complex support needs, low levels of educational attainment, and far more unmet health needs than other children. An online survey was undertaken between October and December 2009 to investigate how staff from youth offending teams (YOTs) identify and support children with particular impairments and difficulties, and what support they in turn receive. Responses were received from over half of YOTs in England and Wales; there were 208 responses from 89 YOTs. The impairments and difficulties included were: mental health problems, IQs of less than 70, communication difficulties, ADHD, autistic spectrum disorder, low levels of literacy, special educational needs, and specific learning difficulties such as dyslexia. The research identified a lack of routine screening and assessment to identify children’s support needs. Although YOT staff spoke highly of specialist services and support, many reported gaps in provision. The survey found that: only around half of YOT staff said they received any training to help identify when children might have particular impairments and difficulties; most YOTs did not use screening or assessment tools or procedures to identify children with learning disabilities; fewer than 1 in 10 staff said their YOT kept statistics on the number of children with disabilities serving court orders; and more than 1 in 5 staff said their YOT did not have a mental health worker. Most YOT staff reported that children with these impairments were more likely to receive a custodial sentence. This report also includes the findings of 3 focus groups, which took place in July 2010, looking specifically at the issue of custodial sentences.
Subject terms:
learning disabilities, mental health problems, screening, special educational needs, vulnerable children, young offenders, youth justice, youth offending teams, assessment, autistic spectrum conditions;
HASSIOTIS Angela, BARRON Diana Andrea, HALL Ian, (eds.)
Publisher:
Wiley-Blackwell
Publication year:
2009
Pagination:
276p.
Place of publication:
Chichester
This guide to the management of mental health problems in people with learning disabilities has been written by nearly 30 contributors from the United Kingdom, United States, Canada, Ireland and Australia. Sixteen chapters cover topics including effective communication, clinical assessment, assessing mental capacity, decision making, depression, anxiety, obsessive compulsive disorders (OCDs), post traumatic stress disorder (PTSD), psychoses, autistic spectrum disorders (ASDs), substance misuse, challenging behaviour, interaction of physical with mental health, older people, mentally disordered offenders, mental health crises, community care and pharmacological and psychological interventions. Two appendices entitled ‘Critique of the ICD 10 and DSM IV based classification of mental disorders in intellectual disability’ and ‘A to Z of disciplines that may contribute to the multi-and interdisciplinary work as applied to mood and anxiety disorders’ are also included. The publication is aimed at health professionals to develop their understanding of mental health issues of people with learning disabilities.
This guide to the management of mental health problems in people with learning disabilities has been written by nearly 30 contributors from the United Kingdom, United States, Canada, Ireland and Australia. Sixteen chapters cover topics including effective communication, clinical assessment, assessing mental capacity, decision making, depression, anxiety, obsessive compulsive disorders (OCDs), post traumatic stress disorder (PTSD), psychoses, autistic spectrum disorders (ASDs), substance misuse, challenging behaviour, interaction of physical with mental health, older people, mentally disordered offenders, mental health crises, community care and pharmacological and psychological interventions. Two appendices entitled ‘Critique of the ICD 10 and DSM IV based classification of mental disorders in intellectual disability’ and ‘A to Z of disciplines that may contribute to the multi-and interdisciplinary work as applied to mood and anxiety disorders’ are also included. The publication is aimed at health professionals to develop their understanding of mental health issues of people with learning disabilities.
Subject terms:
intervention, learning disabilities, mental health problems, person-centred care, psychiatry, assessment, autistic spectrum conditions, diagnosis;