Search results for ‘Subject term:"learning disabilities"’ Sort:
Results 1 - 10 of 24
Aggression in intellectual disability - a new approach
- Authors:
- TURNER Katie, CLARKE David
- Journal article citation:
- Mental Health Review Journal, 14(2), June 2009, pp.28-36.
- Publisher:
- Emerald
Aggressive behaviour is a problem for services providing care for people with intellectual disabilities, affecting the quality of life of the individual and the quality of care provided. Current research trends, which focus on risk factors and mental health problems, are discussed. Other factors that could contribute to aggression in people with intellectual disability (PWID), such as lifestyle and environmental issues are examined. A methodology that would allow for the integration of all these factors, Behavioural Sequence Analysis, is a suitable investigative approach to this problem.
Perpetrators of domestic violence abuse within Intellectual Disability services: a hidden population?
- Authors:
- SWIFT Charlotte, WAITES Erin, GOODMAN Wendy
- Journal article citation:
- British Journal of Learning Disabilities, 46(2), 2018, pp.74-81.
- Publisher:
- Wiley
Background: Domestic violence abuse (DVA) has been identified by the UK Government as a priority to address. Whilst there is a growing body of research into perpetrators of DVA from the mainstream population, there is scant research into perpetrators of DVA who have an intellectual disability. This lack of an evidence base suggests there may be a group of individuals for whom there is no suitable treatment approach. A Forensic Community Learning Disabilities Team (FCLDT) completed a multiservice evaluation of their service and sector CLDTs to obtain a measure of local unmet need. Materials and methods: A retrospective review was completed for referrals to the FCLDT and four of their sector CLDTs for 2014 and 2015. A record sheet was designed for the process of data collection and the analysis of referrals. Results: In regard to the FCLDT, 14% of the total referrals made to the FCLDT in 2014 referenced DVA perpetration and the figure rose to 26% in 2015. For CLDTs, 1.9% of the total referrals made to the CLDT in 2014 and 3.18% in 2015 referenced DVA perpetration. Conclusions: A significant proportion of referrals to the Forensic CLDT relate to the perpetration of domestic violence abuse. A proportion of Sector CLDT referrals made reference to behaviours that, according to the Home Office definition, would be classified as domestic violence abuse, but was infrequently referred to as such. The paper considers these findings in the light of the Home Office definition and its application to people with intellectual disabilities. (Edited publisher abstract)
Management of aggression care plans in a forensic intellectual disability service: a ten-year progress update
- Authors:
- KITCHEN David, THOMAS Cathy, CHESTER Verity
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(2), 2014, pp.88-96.
- Publisher:
- Emerald
Purpose: Standardised approaches to the management of aggression and violence are critical for all stakeholders of intellectual disability services. The purpose of this paper is to describe the Management of Aggression Care Plan (MoACP). The care plan aims to reduce levels of restrictive interventions, to ensure any interventions relative to aggression and violence are the least restrictive possible, and to promote adaptive behaviours and support life enriching opportunities, in a manner which is personalised to the unique profiles of every patient. Design/methodology/approach: The MoACP was first described by Thomas et al. (2005). This paper describes the rationale, theoretical basis, structure and benefits of the care plan, and provides details of revisions made to the plan in response to evidence-based practice recommendations. Findings: The value of implementing a structured approach to the care planning of management of aggression and violence, in reducing the frequency and impact of restrictive practices, and promoting life enriching opportunities is described. Practical implications: The paper describes a number of practical features of the care plan which most support its continued effectiveness, including patient involvement, individual patient focused training, and audit. Originality/value: Although many services undertake localised approaches to the care planning of management of violence and aggression in forensic intellectual disability services, few have been described in the published literature. (Publisher abstract)
Care staff perceptions of challenging behaviour and fear of assault
- Authors:
- ROSE John L., CLEARY Adam
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 32(2), June 2007, pp.153-161.
- Publisher:
- Taylor and Francis
This study investigates fear of assault in relation to exposure to challenging behaviour. The extent to which a social psychological model of fear of assault can be generalised to care staff working with individuals with intellectual disability (ID) was tested and the validity of the instruments used was assessed. A total of 87 care staff took part in a questionnaire-based study carried out in two separate and distinct organisations providing residential services to individuals with ID. In one service, staff exposure to challenging behaviour was high, with many clients having a forensic history, and in the other, staff exposure to challenging behaviour was low. According to one measure, care staff exposed to high levels of challenging behaviour were more fearful about work-related violence. However, no difference was found between the groups on the second measure. Regression analyses indicated some support for the generalisability of dimensions of the model of fear of assault in explaining feelings of unsafety. This study suggests that fear of assault may be an important factor when trying to understand care staff responses to challenging behaviour. However, the equivocal nature of the results raises questions about the validity of existing methods of assessing this fear.
Secure care and treatment needs of individuals with learning disability and severe challenging behaviour
- Author:
- VAUGHAN Phillip
- Journal article citation:
- British Journal of Learning Disabilities, 31(3), September 2003, pp.113-117.
- Publisher:
- Wiley
Reports on a survey undertaken within the catchment area of the Wessex Consortium (population 1.8 million) to identify the number of individuals with learning disabilities and challenging behaviour who were placed in or needed to be placed in secure care. Twenty-nine men and six women were identified, the majority of whom were in out-of-area placements. Argues that there is a need to develop a local long-stay secure service offering a range of security measures and focusing on individuals who exhibit problems of violence and sexually inappropriate behaviour. Consideration should be given to providing small domestic style functional units as the preferred model of provision with a separate facility for a small number of women. The service should also be closely integrated with local community learning disability services.
Violent incidents and the use of antipsychotic medication within a specialist challenging behaviour unit: an evaluation of the Poole approach to challenging behaviour
- Authors:
- ROWLAND George, et al
- Journal article citation:
- British Journal of Learning Disabilities, 28(3), September 2000, pp.91-101.
- Publisher:
- Wiley
This paper documents a retrospective evaluation of a specialist challenging behaviour unit for individuals with severe learning disabilities according to two criteria: (1) its efficacy at reducing the frequency and severity of violent incidents; and (2) the level of reliance upon antipsychotic medication for behavioural purposes. The results demonstrate a 92% reduction in incidents of violence towards others over the 6 years since the unit opened, alongside a 95% reduction in violence towards property. During the same period, the levels of antipsychotic medication used for behavioural purposes fell in the cases of three out of the four clients under examination. An attempt is made to highlight the predominant factors underlying this success as potential indicators for the development of services for those who exhibit challenging and violent behaviours.
Recent research on physical aggression in persons with intellectual disability: an overview
- Author:
- ALLEN David
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 25(1), March 2000, pp.41-57.
- Publisher:
- Taylor and Francis
Physically aggressive behaviours pose major problems to carers supporting people with intellectual disability. This review considers the prevalence and nature of this form of challenging behaviour within this population and describes possible causal factors. Discusses the present status of both behavioural and pharmacological interventions for aggression and outlines the importance of devising reactive management plans for aggressive behaviours.
Guiding force
- Author:
- VALIOS Natalie
- Journal article citation:
- Community Care, 13.1.00, 2000, pp.26-27.
- Publisher:
- Reed Business Information
The government intends to act on the use of physical restraint for people with learning difficulties. Ask how this notoriously fraught subject for care homes will be tackled.
Trauma and institutional risk in a secure developmental disorder service: does the SAVRY inflate risk in adolescents exposed to ACEs?
- Authors:
- WEBB Elanor Lucy, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 13(1), 2022, pp.32-44.
- Publisher:
- Emerald
Purpose: Adverse childhood experiences (ACEs) are highly prevalent in people with developmental disorders who engage in offending behaviour. Many violence-based risk assessment tools include items pertaining to ACEs, and may inflate risk scores in trauma-exposed groups. This paper aims to explore the relationships between ACEs, risk assessment scores, incidents of risk and restrictive practices, in adolescents with developmental disorders in a forensic inpatient setting. Design/methodology/approach: Secondary analysis was conducted on clinical data for 34 adolescents detained to a developmental disorder service. Data were extracted for Structured Assessment of Violence Risk in Youth (SAVRY) risk scores and risk behaviours and restrictive practices, as measures of observed risk. Findings: Participants exposed to more ACEs had higher SAVRY risk scores (p < 0.001, two-tailed), with elevations specifically on the historical subscale (p < 0.001, two-tailed). Neither ACEs nor risk scores were associated with the frequency of risk behaviours. Nevertheless, participants exposed to four or more ACEs were secluded more frequently (p = 0.015, two-tailed), indicating a potential association between trauma and risk severity. Those with more complex developmental disorders experienced fewer ACEs (p = 0.02, two-tailed) and engaged in self-harm behaviours less frequently (p = 0.04, two-tailed). Research limitations/implications: The inclusion of ACEs in risk assessment tools may lead to the inadvertent stigmatization of trauma-exposed individuals. Further investigation is necessary to offer clarity on the impact of early adversity on risk assessment accuracy and levels of institutional risk, and the role of developmental disorders in this relationship. Originality/value: To the best of the authors’ knowledge, this study is the first to explore the relative associations between ACEs, risk assessment scores and observed institutional risk and does so in a highly marginalized population. (Edited publisher abstract)
What kind of support and training do junior qualified nurses working with women with learning disabilities in a secure setting require when dealing with violence and aggression
- Authors:
- GOULDING Helen, RIORDAN Sharon Alicia
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 7(3), 2016, pp.140-150.
- Publisher:
- Emerald
Purpose: The paper aims to explore the perceived needs of junior nurses working with women with learning disabilities in a secure setting who display violence and aggression. The study aims to contribute to this specialised area of research and to identify potential areas for further post registration education. Design/methodology/approach: The study adopted a qualitative design using thematic analysis. Initial questionnaires were distributed and the results analysed in order to form initial themes. These initial themes were then used to carry out a one off focus group and this was transcribed verbatim and then analysed using Braun & Clarke (2006) thematic analysis to develop final themes. Findings: The findings identified a need for staff to be able to access effective immediate support following incidents of violence and aggression and support be offered within a clear structured environment. Staff indicated that peer supervision be made available and that they also receive adequate education relating to gender specific issues and the use of seclusion. Research limitations/implications: The research had several limitations. These included a small sample size which was also largely self-selected. Bias may have to be acknowledged in respect of completion of questionnaires depending on their view of participation and what they might be contributing to. Despite this the results do raise further questions such as staff decision making around the use of seclusion. Practical implications: Implications centred around the organisation's delivery of education to staff in relation to the clinical decision making skills they require in order to effectively support women with learning disabilities who display violent and / or aggressive behaviour. The study also has implications for potential supervision structures currently offered within these services. Originality/value: This paper fulfils a need to explore services for women with a learning disability further and how services can be shaped using current perspective and up to date research in line with recent policy, e.g Corston Report 2007. (Edited publisher abstract)