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Predictors of challenging behaviour in adults with intellectual disability
- Authors:
- KORITSAS Stella, IACONO Teresa
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(6), 2015, pp.312-326.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to determine the extent to which mental health, physical health, communication, learned function of the behaviour(s), severity of disability, living arrangement, age, and gender, alone or in combination, predicted challenging behaviours in adults with intellectual disability. Design/methodology/approach: In total, 74 adults with intellectual disability and their paid carers were recruited into the study from adult disability services in Victoria, Australia. Paid carers provided information about participants with intellectual disability on a range of measures targeting each variable of interest. Findings: Based on principle components analyses of three challenging behaviour measures, two topographies of challenging behaviour emerged: contact and non-contact behaviours. Multiple regression analysis revealed that contact behaviours were predicted by anxiety scores and severity of disability. In addition to severity of disability and anxiety scores, non-contact behaviours were also predicted by sensory scores. Practical implications: The results of the current study indicate that contact and non-contact behaviours were determined by multiple factors. Clinicians and others who work with people who display challenging behaviour may, therefore, find it helpful to utilise the biopsychosocial model in their formulations of possible reasons that motivate a person to engage in challenging behaviour. Originality/value: These results contribute to the evidence base available to clinicians and researchers to guide future assessment for challenging behaviour. Expansion of functional assessment methods to explore factors not traditionally included, such as mental health and severity of intellectual disability, as causes of challenging behaviour, may prove helpful. (Publisher abstract)
Healthy lifestyles for adults with intellectual disability: Knowledge, barriers, and facilitators
- Authors:
- CATON Sue, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 37(3), September 2012, pp.248-259.
- Publisher:
- Taylor and Francis
People with intellectual disability (ID) are more likely to have health problems than people without. However, little research has investigated health from the perspective of the people with ID themselves. This qualitative study investigated what people with ID understand being healthy to mean, and what their experiences are of healthy lifestyles. Interviews were conducted with 13 adults in Wales to ask them about their health and healthy lifestyles. Findings revealed that interviewees had an understanding of what it meant to be healthy, have a healthy diet, the dangers of substance misuse, and the benefits of exercise. They also demonstrated some knowledge about rationales for engaging in healthy behaviours. Findings suggested that people with ID demonstrate some understanding of the consequences of unhealthy behaviours, and of the need for moderation.
Fit for life
- Author:
- REES Greg
- Journal article citation:
- Learning Disability Today, 15(6), November/December 2015, pp.26-27.
- Publisher:
- Pavilion
- Place of publication:
- Hove
A case study example which describes how a woman with learning disabilities from the West Midlands changed her life by losing nearly six stone and eliminating her dependence on insulin following a complete lifestyle overhaul. The woman was supported by Sandwell Council's Adult Services team based at an Inclusive Fitness Initiative (IFI) centre, which has been accredited as a centre of excellence for people with disabilities. (Edited publisher abstract)
Challenging behaviour: the causes (part II)
- Authors:
- KORITSAS Stella, IACONO Teresa
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(5), 2012, pp.236-248.
- Publisher:
- Emerald
The second in a two-part series, this paper aims to provide an overview of the dominant approaches used to explain the causes of challenging behaviour. It presents the causes of challenging behaviour according to 3 theoretical approaches which have dominated the literature: applied behaviour analysis, biological factors, and psychiatric disorders. The authors argue that the causes of challenging behaviour are likely to be complex and involve multiple factors, but that the 3 main approaches focus on single causes and do not explore possible interactions between various causes. They propose a fourth approach, the biopsychosocial model (which encourages consideration of biological, psychological, and social factors), as an alternative model to explain the causes of challenging behaviour.
Ageing and health status in adults with intellectual disabilities: results of the European Pomona II study
- Authors:
- HAVEMAN Meindert, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 36(1), March 2011, pp.49-60.
- Publisher:
- Taylor and Francis
POMONA II was a European Commission funded public health project collecting information from 14 countries using a set of key health indicators specifically relevant for people with intellectual disabilities. This research focused on age-specific differences relating to environmental and lifestyle factors and the 17 medical conditions measured by the POMONA Checklist of Health Indicators. The article describes how information was collected using the POMONA Health Interview Survey and Evaluation Form from a sample of 1,253 participants in Austria, Belgium, Finland, France, Germany, Ireland, Italy, Lithuania, the Netherlands, Norway, Romania, Slovenia, Spain, and the United Kingdom. It then presents the results of the analysis, with tables showing characteristics of people with intellectual disabilities in the study, frequency of social contacts with relatives or friends according to age, lifestyle risk factors in people with intellectual disabilities according to age, and general and age-specific prevalence rates of health problems. The authors discuss how healthy older adults with intellectual disabilities are with regard to lifestyle factors, and whether there are health disparities between older adults with and without intellectual disabilities. They note that some evidence of health disparities was found for older people with intellectual disabilities, particularly in terms of under diagnosed or inadequately managed preventable health conditions.
Better access to primary healthcare for adults with learning disabilities: evaluation of a group programme to improve knowledge and skills
- Authors:
- WEBB Jenny, STANTON Melanie
- Journal article citation:
- British Journal of Learning Disabilities, 37(2), June 2009, pp.116-122.
- Publisher:
- Wiley
The health of people with learning disabilities is poor when compared with the general population but this difference is not reflected in higher rates of access to primary healthcare. This paper reports on a study undertaken to run and evaluate a 12-week programme to enable people with learning disabilities to better access primary healthcare. The importance of this research lies in the successful outcomes achieved, and in the distinctive properties of the programme, which used practice-based groups, and focussed on the development of health skills as well as health knowledge.
Perspectives of constraining and enabling factors for health-promoting physical activity by adults with intellectual disability
- Authors:
- TEMPLE Viviene A., WALKLEY Jeff W.
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 32(1), March 2007, pp.28-38.
- Publisher:
- Taylor and Francis
Physical activity influences health in individuals and within populations. This study explored factors perceived as enabling or inhibiting participation in physical activity by adults with intellectual disability from a health promotion perspective. Six focus group interviews were conducted: adults with intellectual disability (1 group, n = 9), direct care workers (1 group, n = 5), group home supervisors (2 groups, n = 9 and n = 6), managers (1 group, n = 4), and parents (1 group, n = 7) in the State of Victoria, Australia. Three major themes were identified from the focus group interviews: motivation for participation, social support, and political and financial support. The most critical issue was the lack of clear policies. Both day training centres and accommodation services would benefit from development of policies related to health-promoting physical activity. Flowing on logically from the development of policy would be much needed training and support of staff.
Health screening and developmental disabilities
- Authors:
- IACONO Teresa, SUTHERLAND Georgina
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 3(3), September 2006, pp.155-163.
- Publisher:
- Wiley
Adults with developmental disabilities often experience health disparities when compared with the general population. The aim of this Australian study was to describe health screening activities involving a large group of adults and explore how factors, such as living arrangement, type and severity of disability, and age, influence reported rates of participation. The study involved administering surveys to adults with disabilities and their immediate support persons (parents, carers, and professional support workers) and asking whether adults had visited a general practitioner (GP) and what was their participation in preventive services during the previous 12-month period. Participation in preventive screening services ranged between 3% (screening for sexually transmitted infection) and 58% (screening for elevated blood pressure), and rates for certain services appeared low, particularly in comparison with equivalent screenings in the general population. Results showed a relationship between participation rates and living situation, type of disability, and age, but not severity of disability. The results suggest that higher rates of participation in preventative health activities among those enrolled in formal services may reflect a greater obligation or concern among paid workers and possibly a lack of awareness of health issues by families, and also that screening disparities may be attributed to GPs who may be applying guidelines from the general population but who are not aware of disability-specific issues when examining adults with disabilities.
Specialist community teams for adults with learning disabilities: referrals to a countywide service in England
- Authors:
- CLARE Isabel C.H., et al
- Journal article citation:
- Tizard Learning Disability Review, 24(2), 2019, pp.41-49.
- Publisher:
- Emerald
Purpose: While “generic” community teams for adults with learning disabilities (CTs) are well-established in the UK, very little recent evidence is available about any aspect of their work. As part of a larger project about the role, structure and functioning of CTs, the purpose of this paper is to provide data about referrals. Design/methodology/approach: Over three months, the authors obtained data about 270 consecutive new referrals to five CTs in a countywide integrated health (NHS) and care management (local authority) service. Findings: The 270 referrals related to 255 individuals, mainly already service users, with almost a third (30 per cent, n=204) described as people with severe or profound disabilities. Consistent with the reported living arrangements (residential accommodation or with one or more family members (87 per cent, n=270)), referrals were most often made by social care staff, General Practitioners or carers. The referrals related to a wide range of issues including mental health and/or behavioural needs, physical health and skills, and independence. The major group, however, were requests about a person’s entitlement to specialist learning disability services and/or reviews of an existing social care package. Research limitations/implications: The focus on new referrals and the exclusion of intra-team referrals mean that the data are not representative of a CT’s caseload and cannot be used as a basis for resourcing. Nevertheless, the findings emphasise the heterogeneity of the population, and the long-term and varied nature of their needs, meaning that CTs require access to a range of expertise and, often, an inter-agency approach. The implications for service design are considered. Originality/value: This is the first empirical study of referrals to specialist integrated (health and care management) community learning disabilities teams in England. (Edited publisher abstract)
Exploring the impact of health inequalities on the health of adults with intellectual disability from their perspective
- Authors:
- BOLLARD Martin, McLEOD Eileen, DOLAN Alan
- Journal article citation:
- Disability and Society, 33(6), 2018, pp.831-848.
- Publisher:
- Taylor and Francis
Across every indicator of health inequality, adults with intellectual disability are disadvantaged. However, first-hand accounts from adults with intellectual disability exploring the impact health inequalities have for their health and are absent from the literature. The research was underpinned by a participatory approach, involving Men with intellectual disability as members of a steering group and through 20 interviews. Thematic analysis revealed how low income and reduced employment had a negative impact on the men’s physical and psychological health. New findings show how living in deprived areas exposed men to constant threats to their safety with an adverse effect on their health. (Edited publisher abstract)