Search results for ‘Subject term:"learning disabilities"’ Sort:
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The "forensicisation" of challenging behaviour: the perils of people with learning disabilities and severe challenging behaviours being viewed as "forensic" patients
- Authors:
- DOUDS Fergus, BANTWAL Ashwin
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(3), 2011, pp.110-113.
- Publisher:
- Emerald
Since the closure of long stay learning disability hospitals in 2005, focus in Scotland has shifted on to developing robust community services to cater for the healthcare needs of people with learning disabilities. A small number of individuals with learning disabilities and associated severe challenging behaviours do inappropriately get referred and sometimes admitted to forensic learning disability services. This study investigated this area of clinical practice in the context of referrals to the high secure forensic setting of The State Hospital, Carstairs, Scotland. Five referrals made to the State Hospital's forensic learning disability service between 2005 and 2010 were reviewed. Findings revealed that the identified determinants leading to the making of these referrals were classifiable into psychiatric, environmental and staffing themes. In conclusion, there is a requirement for a specialist in-patient service to meet the needs of this complex group of patients, which demonstrates ‘gaps’ within current services.
Massage as therapy for persons with intellectual disabilities: a review of the literature
- Authors:
- CHAN Jenny Sau-Lai, TSE Sonny Hing-Min
- Journal article citation:
- Journal of Intellectual Disabilities, 15(1), March 2011, pp.47-62.
- Publisher:
- Sage
- Place of publication:
- London
People with intellectual disabilities are vulnerable to psychological stress and anxiety. When these cannot be vented adequately, behavioural problems may arise. To address this, massage therapy has frequently been applied to induce relaxation. This review investigated the efficacy of massage therapy on relaxation and reduction of challenging behaviours. A database search was conducted which uncovered a total of 64 articles, of which 7 met all inclusion criteria. These studies were evaluated in terms of: number of participants; study setting; methodology; intervention pattern; outcome measure of the intervention; and major results. Findings revealed that evidence-based research demonstrating the effectiveness of massage therapy in supporting clinical practice is extremely limited. Case study designs, large amounts of qualitative data and small sample sizes meant that the therapeutic effect of massage therapy could not be substantiated. The authors concluded that future studies with randomised clinical trials or of experimental design are developed.
Solution-focused brief therapy with people with mild intellectual disabilities: a case series
- Authors:
- ROEDEN John M., et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 8(4), December 2011, pp.247-255.
- Publisher:
- Wiley
People with intellectual disabilities often present with additional psychological problems. Solution-focused brief therapy (SFBT) is a form of behaviour therapy that focuses on desired behaviour rather than on the existing problem behaviour. This case study explored 10 applications of SFBT with people with a mild intellectual disability (MID) from a service provider of children and adults with ID in the Netherlands. SFBT sessions varied between 2 and 14 hours per week. Measurements taken before, after, and during a 6-week follow up included an assessment of quality of life and assessment of maladaptive behaviour as well as goal attainment according to people with MID and their carers. Findings revealed that SFBT treatments contributed to improvements in psychological functioning and decreases in maladaptive behaviour. The positive changes evident after SFBT proved sustainable during follow-up. Treatment strategies and therapeutic alliances employed were usually assessed as positive by the participants. The authors concluded that the study indicated the effectiveness of SFBT for people with MID.
Teaching a child with challenging behaviour to use the toilet: a clinical case study
- Authors:
- BROWN Freddy Jackson, PEACE Natalie
- Journal article citation:
- British Journal of Learning Disabilities, 39(4), December 2011, pp.321-326.
- Publisher:
- Wiley
In recent years there has been a trend toward using nappies for disabled children to manage incontinence rather than teaching children to use the toilet. However, learning to use the toilet is an important developmental step for a child’s independence, health and dignity. It can be particularly difficult to teach continence skills to disabled children with aggressive or challenging behaviour. This study showed how a basic toilet training procedure could be modified to teach a 13-year-old child with learning disabilities with aggressive behaviour to use the toilet in school. Continence was achieved within 2 weeks and maintained at 6-week follow-up. Long-term data showed continence was maintained at 6, 12 and 24 month follow-up. The programme was subsequently successfully transferred into the home. The authors concluded that the findings should be disseminated and ensured that they are systematically used in similar situations.
A preliminary investigation of the utility of the "Behavior Support Plan Quality Evaluation Guide II" for use in Australia
- Authors:
- WEBBER Lynne S., et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 36(4), December 2011, pp.273-277.
- Publisher:
- Taylor and Francis
In Victoria, Australia, the Disability Act 2006 specifies that all people receiving a government-funded disability service and who are subject to a restrictive intervention (such as a chemical or mechanical restraint) must have a behaviour support plan. The quality of behaviour support plans can be an important influence on the quality of the support provided to people with disability who show challenging behaviours. The Behavior Support Plan Quality Evaluation Guide II has been used to assess behaviour support plans to support children in schools in the United States. This study examined its usefulness for assessing behaviour support plans designed for adults with an intellectual disability in community support services in Australia. The researchers surveyed experienced practitioners about the relevance of the evaluation guide components, and an audit was conducted of randomly selected behaviour support plans submitted as a statutory requirement. The findings showed evidence of acceptable validity and reliability, and evidence of the need for substantial improvement in the quality of behaviour support plans. The authors conclude that the findings support the utility of the Behavior Support Plan Quality Evaluation Guide II to inform and evaluate service planning in supporting adults with intellectual disability who show challenging behaviour.
There is an alternative
- Author:
- ASSOCIATION FOR SUPPORTED LIVING
- Publisher:
- Association for Supported Living
- Publication year:
- 2011
- Pagination:
- 12p.
- Place of publication:
- Loughton
This report tells the stories of ten people with learning disabilities, each living happily in ordinary homes around the country. Every story is different, but a common thread runs through them. All tell of people who were at one time contained in institutions because their behaviour was deemed to be challenging, people who have gone on to better lives in community services, which actually cost less than institutional care. These institutions, which cost the taxpayer huge sums every year, were supposed to be caring and supportive environments, yet life inside them was restricted, impoverished and uncomfortable. Difficult behaviour was often managed using aversive physical restraint. This report analyses these stories from the perspective of years of experience supporting people with learning disabilities, and identifies seven key features of successful community supported living services.
The relationship between challenging behaviour, burnout and cognitive variables in staff working with people who have intellectual disabilities
- Authors:
- MILLS S., ROSE J.
- Journal article citation:
- Journal of Intellectual Disability Research, 55(9), September 2011, pp.844-857.
- Publisher:
- Wiley
Previous research leads to the hypothesis that negative emotions and the way in which staff perceive challenging behaviour may mediate the relationship between burnout in those working with people with intellectual disabilities (ID) and clients’ challenging behaviour. The aim of this study was to confirm the nature of this relationship. Seventy-eight staff working in variety of service settings in England completed measures of burnout, challenging behaviour and perceptions about challenging behaviour. The perceptions explored included beliefs about the timeline of behaviour, staff's perception of whether they have control over the behaviour, beliefs about clients' ability to control the behaviour and staff's negative emotional responses. Significant positive correlations were found between challenging behaviour and burnout, challenging behaviour and cognitive variables, and cognitive variables and burnout. Regression analyses demonstrated that negative emotions did indeed mediate the relationship between challenging behaviour and burnout. The results also show that higher levels of challenging behaviour were correlated with higher levels of fear of assault.
Attachment style and mental health in adults with intellectual disability: self-reports and reports by carers
- Authors:
- LARSON Felicity V., ALIM Nadja, TSAKANIKOS Elias
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(3), 2011, pp.15-23.
- Publisher:
- Emerald
For this research, participants were recruited from organisations providing services for people with intellectual disabilities in East Anglia, London and South East England. The study aimed to investigate whether adults with mild/moderate intellectual disabilities could accurately self-report their attachment style, and to explore the association between attachment style, challenging behaviour and mental health problems. 60 adults with intellectual disabilities completed an adapted attachment style questionnaire. They were also asked to select a supporting person to complete a questionnaire about them. 39 supporters completed questionnaires, which also provided information about challenging behaviour. The article describes the study and its results. The researchers found that people with mild/moderate intellectual disabilities show the same range of attachment styles as the general population. Insecure attachment was significantly associated with a reported diagnosis of depression but not anxiety, and a link was found between insecure attachment and the presence of challenging behaviour (specifically refusal of medication), but attachment style was not linked to any other kind of challenging behaviour explored in the study. The authors discuss their findings and the implications.
Intellectual disabilities, challenging behaviour and referral texts: a critical discourse analysis
- Authors:
- NUNKOOSING Karl, HAYDON-LAURELUT Mark
- Journal article citation:
- Disability and Society, 26(4), June 2011, pp.405-417.
- Publisher:
- Taylor and Francis
This paper examined the texts of referrals written by care workers in residential services for people with learning difficulties. It used Critical Discourse Analysis to examine referrals made to a Community Learning Disability Team (CLDT). The paper starts with a description of CLDTs and then examines the construction of ‘challenging behaviour’ and ‘intellectual disability’. All 59 referrals about challenging behaviour made to a CLDT for a period of 18 months were reviewed. The study found that referral forms position the person with intellectual disabilities as a problem to be solved, as in need of surveillance, and showed evidence of the routinisation of daily life, surveillance, and mortification of the self. In other words, the study found evidence of institutional ways of life in the referrals. The study was important in highlighting the writing of derogating documents about people with learning disabilities, and raised questions about power in the relationships of these people. The paper concludes with suggestions for further action.
Training emotional intelligence related to treatment skills of staff working with clients with intellectual disabilities and challenging behaviour
- Authors:
- ZIJLMANS L. J. M., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 55(2), February 2011, pp.219-230.
- Publisher:
- Wiley
It has been suggested that staff working with clients with intellectual disabilities (ID) who display challenging behaviour may contribute to the continuation of this behaviour, because it causes emotional reactions such as anxiety, anger and annoyance, which can inhibit an adequate response. This study assessed whether a training aimed at improving emotional intelligence (EQ) in combination with a video-feedback training programme improved the emotional intelligence of 60 staff members working with clients with ID and challenging behaviour. Thirty-four staff members participated in the 4-month programme and 26 constituted the control group. All were working in residential settings in the Netherlands for people with mild to moderate ID. A pretest–posttest control group design was used and effectiveness assessed by using the Bar-On EQ-i and the judgements of experts on emotional intelligence. The emotional intelligence of the experimental group changed significantly compared to the control group. Judgments of the experts also indicated that the change in emotional intelligence of the experimental group was positive. The positive effect of the training programme on emotional intelligence is consistent with previous research. It suggests that the emotional intelligence of staff working with clients with ID and challenging behaviour can be influenced by training.