Search results for ‘Subject term:"learning disabilities"’ Sort:
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Factors impacting on the capacity to consent in people with learning disabilities
- Authors:
- DYE Linda, HARE Dougal Julian, HENDY Steve
- Journal article citation:
- Tizard Learning Disability Review, 8(3), July 2003, pp.11-20.
- Publisher:
- Emerald
Much discussion of capacity to consent has focused on how capacity can be assessed. In focusing on the assessment of capacity of people with learning disabilities, information from studies of human judgement and decision -making in the general population had been ignored. This article reviews recent literature, highlights the main factors that affect an individual's capacity to consent and examines the integration of research into these factors in the general population with that of people with learning disabilities. A person's capacity to consent is considered to be affected by three main processes: comprehension, decision making, and communication. Discusses the difficulties people with learning disabilities may have in these processes and possible ways of overcoming these limitations.
The health of people with learning disabilities in the UK: evidence and implications for the NHS
- Authors:
- ELLIOT Johan, HATTON Chris, EMERSON Eric
- Journal article citation:
- Journal of Integrated Care, 11(3), June 2003, pp.9-17.
- Publisher:
- Emerald
Presents a comprehensive review of the UK research literature on the health needs of people with learning disabilities, and the response of mainstream health services to those health needs. Searches were conducted on computerised databases Medline and PsycInfo; hand searches of publications; and consultation with UK researches in the field of health and people with learning difficulties. Publications written in English, focusing on matters relating to health among people with learning difficulties in the UK, published in peer-reviewed journals from 1990 onwards were included in the review. Evidence from the review demonstrated that people with learning difficulties in the UK have significantly poorer health than the UK population generally. Despite these health needs, people with learning difficulties receive poorer support from mainstream health services, across primary care, hospital services and screening programmes.
A systematic review of cognitive decline in the general elderly population
- Authors:
- PARK Helen L., O'CONNELL Janice O., THOMSON Richard G.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1121-1134.
- Publisher:
- Wiley
The aim was to establish the rate of age-related cognitive decline in the general elderly population. Systematic review of studies of cognitive decline in the general elderly population. Medline, Embase and PsycINFO databases were searched using an adapted version of McMaster's aetiology, causation and harm strategies and the Cochrane Dementia and Cognitive Impairment Group strategy. Grey literature was explored and experts contacted. A second observer was involved at all stages and quality appraisal of included studies was performed. Included studies were representative, community-based, cohort studies of people aged over 60, incorporating individuals with dementia. Identification of 5990 abstracts and retrieval of 163 full texts led to inclusion of 19 papers. Heterogeneity made narrative review the appropriate method of data synthesis. Some degree of cognitive impairment with increasing age was found in all studies, although the extent varied. The prevalence of cognitive impairment and the rate of decline increased with age. Studies were of variable quality. Cognitive decline is almost universal in the general elderly population and increases with age. Improved communication between researchers and between clinicians to identify a core minimum data set of neuropsychological tests that could be used in different populations would support consistent study design and meta-analysis, helping to quantify the true rate of cognitive decline in the elderly and assisting diagnosis in clinical practice.
Diagnostic instruments for dementia in older people with intellectual disability in clinical practice
- Authors:
- STRYDOM A., HASSIOTIS A.
- Journal article citation:
- Aging and Mental Health, 7(6), November 2003, pp.431-437.
- Publisher:
- Taylor and Francis
There is a need for simple and reliable screening instruments for dementia in the intellectual disability (ID) population that can also be used to follow their progress, particularly if they are being treated with anti-dementia drugs. Commonly used tests for the general population such as the Mini Mental State Examination (MMSE) are not appropriate for many people with ID. This paper is a literature review of alternative instruments that have been used in research or recommended by experts since 1991 and have the potential to be used as screening instruments. Two types of tests have been identified: those administered to informants, and those that rely on direct assessment of the individual. The most promising informant rated screening tool in most adults with ID including Down syndrome (DS) diagnosis is the Dementia Questionnaire for Persons with Mental Retardation (DMR). However, sensitivity in single assessments is variable and cut-off scores need further optimisation. In those with DS, the Dementia Scale for Down Syndrome (DSDS) has good specificity but mediocre sensitivity. The Test for Severe Impairment and Severe Impairment Battery are two direct assessment tools that show promise as screening instruments, but need further evaluation.
Responding to the challenges of ageing and dementia in intellectual disability in Ireland
- Authors:
- McCARRON M., LAWLOR B. A.
- Journal article citation:
- Aging and Mental Health, 7(6), November 2003, pp.413-417.
- Publisher:
- Taylor and Francis
The intellectual disability (ID) population in Ireland is ageing and the number of older persons with the dual disability of ID and dementia is increasing. In spite of these demographic trends, as in other countries adequate policy and service provision for this population are lacking. This paper draws upon data available on the population with ID and dementia, reviews both generic and ID specific literature, considers the policy context and argues for a specific model of service provision. A service model is proposed for the development of multidisciplinary specialist teams within ID, delivered through mobile regional ID dementia clinics.
Passive activities: the effectiveness of multisensory environments on the level of activity of individuals with profound multiple disabilities
- Authors:
- VLASKAMP Carla, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 16(2), June 2003, pp.135-143.
- Publisher:
- Wiley
The use of multisensory environments (MSEs) is perceived to be important for individuals with profound and multiple disabilities, although there is limited research on the efficacy of the procedures. After a search of the literature, numerous positive outcomes of MSEs were described. Our research aimed to determine whether the use of an MSE, when applied to increase the level of alertness and interaction, actually leads to this effect. A total of 15 facilities in the Netherlands and Belgium agreed to participate in the investigation. Information was gathered on the use of MSE by 177 individuals. For 62 persons, an increase of level of activity was the only stated goal. We randomly selected 20 persons out of this group for observation, using momentary time sampling as a means to relate multisensory experiences to the level of alertness and interaction. The results of our study show that in general there is little evidence for an increase in activity levels as a result of MSE. There is, however, a relation between the level of activity and contextual variables. In particular, people with profound multiple disabilities have strong responses towards stimuli provided by members of staff (touching, talking to the person). In general, the living unit is as good a place as the MSE for promoting alertness and interactions. The influence of materials on the level of activity is limited.
The intellectually disabled offender: methodological problems in identification
- Author:
- MCBRIEN Judith
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 16(2), June 2003, pp.95-105.
- Publisher:
- Wiley
Reliable evidence concerning the prevalence of intellectually disabled offenders that would inform the clinician's approach to the assessment and management of risk is in short supply. This paper aims to assist the clinician in interpreting the available evidence. A literature search was conducted for all years up to January 2003. Each study was first examined for the methods employed to define and measure intellectual disability. Then, the effect of this on prevalence estimates was considered. A wide range of methods has been used to ascertain the presence of intellectual disability - administrative definitions, psychiatric diagnosis, educational background, self-report and direct measurement of IQ and adaptive behaviour. Most studies reviewed used less than adequate ascertainment methods. Reliable answers to two key questions which offenders have intellectual disabilities and which people with intellectual disabilities offend, therefore remain elusive.
Clinical effects of sexual abuse on people with learning disability: critical literature review
- Authors:
- SEQUEIRA Heather, HOLLINS Sheila
- Journal article citation:
- British Journal of Psychiatry, 182(1), January 2003, pp.13-19.
- Publisher:
- Cambridge University Press
There are few publications concerning the psychological reactions of people with learning disabilities to sexual abuse. Most significantly, there are no controlled studies and few which demonstrate a systematic approach to documenting the sequelae of trauma. literature search in peer-reviewed psychiatry, psychology, nursing and social care journals for the years 1974 to 2001 was conducted and 25 studies were reviewed. Several studies suggest that, following sexual abuse, people with learning disabilities may experience a range of psychopathology similar to that experienced by adults and children in the general population. However, because of methodological limitations, these results are not conclusive. Whether people with learning disabilities experience reactions to sexual abuse similar to the general population has yet to be explored by systematic research.
Post-traumatic stress disorder and people with learning disabilities: a literature based discussion
- Authors:
- DOYLE Colin, MITCHELL Duncan
- Journal article citation:
- Journal of Learning Disabilities, 7(1), March 2003, pp.23-33.
- Publisher:
- Sage
People with learning disabilities may experience emotional traumas that impact upon their ability to enjoy life. Much of this trauma mnaifests itself in challenging behaviour. The authors discuss key points from the literature and suggest that post-traumatic stress disorder in people with learning disabilities often goes unrecognised.
The emotional lives of people with learning disability
- Author:
- ARTHUR Andrew R.
- Journal article citation:
- British Journal of Learning Disabilities, 31(1), 2003, pp.25-30.
- Publisher:
- Wiley
This paper reviews accounts of research and therapy and makes an assessment of the current state of knowledge. Very little research actually exists when compared to the non-learning disabled, and so, studies of psychotherapy, child development, parent-infant bonding, psychological assessment and emotional disturbance in people with learning disability are examined. The review finds that there is evidence to suggest the presence of a significantly higher level of emotional developmental problems and disturbance in people with learning disability. This problem requires multidisciplinary attention if progress in improving quality of life is to be maintained.