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Premature deaths of people with learning disabilities: progress update
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2014
- Pagination:
- 22
- Place of publication:
- London
This report updates progress made on recommendations of the 'Confidential Inquiry into premature deaths of people with learning disabilities' (2013). The progress update summarises action taken or underway against each of the main themes themes from the Inquiry, including: improving assessment to identify people with learning disabilities; better integration of services; access to healthcare and interventions; and end-of-life care. Examples of local good practice and national initiatives are included. The report notes that progress has been made, but that more needs to be done. Three specific actions for local areas are highlighted: participating fully in the Self-Assessment Framework and acting on its results; securing the provision of named care co-ordinators; ensuring reasonable adjustments are made and audited. (Edited publisher abstract)
Impact of care pathway-based approach on outcomes in a specialist intellectual disability inpatient unit
- Authors:
- DEVAPRIAM John, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 18(3), 2014, pp.211-220.
- Publisher:
- Sage
- Place of publication:
- London
Specialist intellectual disability inpatient units have come under increased scrutiny, leading to questions about the quality of service provision in this sector. A care pathway-based approach was implemented in such a unit and its impact on outcome variables was measured. The care pathway-based approach resulted in the turnover of more patients, increased capacity for admissions to the unit, reduced lengths of stay in hospital, timely assessments and treatments, which resulted in better outcomes in patients. Care pathway-based approach to service provision provides not only better outcomes in patients but also a reliable way of ensuring true multi-agency working and accountability. If used widely, it can reduce the variability in the quality of current service provision. (Publisher abstract)
Early intervention for children with learning disabilities whose behaviours challenge
- Authors:
- COOPER Vivien, et al
- Publisher:
- Challenging Behaviour Foundation
- Publication year:
- 2014
- Pagination:
- 15
- Place of publication:
- Chatham
Drawing on evidence from systematic reviews, meta analyses, narrative reviews, primary research and national data collections, this narrative review sets out the available evidence around early intervention approaches for children with learning disabilities whose behaviours challenge. It identifies the following early interventions: early behavioural interventions; training and support for families; early identification and rapid response; and positive behavioural support. It also recommends key areas of action to help commissioners proactively target resources to deliver good outcomes. The report from part of the Early Intervention Project, delivered in partnership by the Challenging Behaviour Foundation and the Council for Disabled Children. Key messages (Edited publisher abstract)
The Health Equalities Framework: embedding good practice: report from two workshops to support implementation
- Author:
- NATIONAL DEVELOPMENT TEAM FOR INCLUSION
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2014
- Pagination:
- 11
- Place of publication:
- Bath
Summarises the findings from two workshops for organisations and family carers who are using the Health Equalities Framework (HEF). The report examines how the HEF is being implemented, sets out the lessons learnt, and outlines current initiatives and potential developments. (Edited publisher abstract)
Complex Behaviour Service: enhanced model for challenging behaviour
- Authors:
- INCHLEY-MORT Sophie, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(4), 2014, pp.219-227.
- Publisher:
- Emerald
Purpose: Positive Behaviour Support (PBS) is thought to be an important model for working with people with intellectual disabilities who display behaviours challenging to service. The purpose of this paper is to explore clinical and service user outcomes associated with the delivery of PBS by a Complex Behaviour Service (CBS). Design/methodology/approach: Clinical outcomes of 24 service users treated by the CBS team were assessed at baseline, six and 12 months and compared with those of 22 peers who received usual care. The main outcome was reduction in challenging behaviour measured by the Aberrant Behaviour Checklist (ABC). Secondary outcomes included measures of mental health needs, risk and social care supports. Findings: At six months improvements were seen across all ABC domains in both groups, with greater improvement in the CBS group, compared to usual care in irritability and stereotypy. Between group differences were maintained only for stereotypy at 12 months. No other differences were found. Originality/value: This paper suggests that PBS delivered by trained and dedicated staff may provide clinical benefits to individuals with challenging behaviours. However, there are issues around integration into existing services that need to be addressed in order to maximise efficiency. (Publisher abstract)
Measuring the effectiveness of interventions when occupational performance is severely impaired
- Authors:
- PARKINSON Sue, et al
- Journal article citation:
- British Journal of Occupational Therapy, 77(2), 2014, pp.78-81.
- Publisher:
- Sage
There has been a call for conceptually valid assessments to measure occupational performance with greater sensitivity. This opinion piece reasons that a broad-based tool is required to relate subtle shifts in occupational participation to changes in the therapeutic environment. It includes case vignettes from learning disability and dementia services to illustrate the progress that can be made in occupational participation. Improvements in participation were matched to indicators of change in existing assessment and intervention manuals, leading to the development of a new assessment. Future research will investigate the assessment’s potential to measure progress when a person’s occupational performance is severely impaired. (Publisher abstract)
Addressing health inequities: coronary heart disease training within learning disabilities services
- Authors:
- HOLLY Deirdre, SHARP John
- Journal article citation:
- British Journal of Learning Disabilities, 42(2), 2014, pp.110-116.
- Publisher:
- Wiley
People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed CHD educational resource was piloted within residential community support organisations working closely with adults with complex learning disabilities. Following the training, improvements in knowledge of CHD-related topics were noted. Improvements were also seen in skills and confidence relating to working with others. Participant satisfaction with the training was demonstrated in terms of the acceptability and effectiveness of the training. Systematic training of this nature could lead to increased awareness of and attention to the cardiac health requirements of individuals, thereby improving the health outcomes, health literacy and ultimately self-management of people with learning disabilities. (Publisher abstract)
Assessment and treatment of challenging behaviour for individuals with intellectual disability: a research review
- Authors:
- LLOYD Blair P., KENNEDY Craig H.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 27(3), 2014, pp.187-199.
- Publisher:
- Wiley
Background: Challenging behaviour is frequently associated with the presence of intellectual disability. If not effectively treated, chronic challenging behaviour can negatively impact a variety of quality of life outcomes for individuals with intellectual disability. Methods and Results: The authors review the current status of research relating to the assessment and treatment of challenging behaviour for people with intellectual disability. The history of interventions for challenging behaviour that led to the development of function-based approaches widely in use today are briefly reviewed. The authors then discuss the various operant functions of challenging behaviour, functional behaviour assessment technologies and reinforcement-based interventions. Conclusions: The authors conclude with a discussion of future directions that include models of prevention, ecological validity of assessment procedures and the widespread use of comprehensive behavioural support programmes. (Edited publisher abstract)
Community dialectical behaviour therapy for emotionally dysregulated adults with intellectual disabilities
- Authors:
- BAILLIE Aubrey, SLATER Sean
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(3), 2014, pp.165-173.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to reflexively examine the challenges of implementing a community dialectical behaviour therapy (DBT) service for adults with intellectual disabilities (ID) and describes the practical lessons learned about how to maximise the effectiveness of DBT with this client group. Design/methodology/approach: A brief overview of DBT is provided and reference is made to literature which highlights the potential benefits of providing a DBT service to clients with an ID. This is followed by a discussion of the clinical presentation of the clients receiving DBT in the service that is the focus of this case study. Using a reflexive approach, a detailed discussion follows of the challenges faced in implementing a community DBT service for the clients served. Findings: Solutions to a variety of challenges faced in four years of service delivery are described, key lessons learned are highlighted, together with issues meriting further research. Research limitations/implications: This case study and its implications are limited to community DBT services. Another limitation is that, although outcome data have been collected over the past two years, the dataset is not yet large enough to draw statistical conclusions. Practical implications: The paper describes adaptations to treatment structure and strategy which the authors believe are necessary to improve treatment outcomes in community DBT services for adults with ID. In particular, the practical experience suggests that a didactic approach to teaching DBT skills is not effective and should be replaced by the “community of learners” approach that involves the trainer contingently responding to client input. Pre-set lesson plans inhibit the trainers’ ability to respond contingently. Originality/value: The existing literature on providing a DBT service for people with an ID has principally focused on providing a rationale for providing this type of intervention, and on assessing outcomes. Given that this is still a relatively new type of provision for this client group, a detailed examination of process issues is called for. (Publisher abstract)
Evaluation toolkit for providers: an assessment tool and action plan for organisations to improve the quality of life for people with learning disabilities as they grow older
- Author:
- TOWERS Christine
- Publisher:
- Foundation for People with Learning Disabilities
- Publication year:
- 2014
- Pagination:
- 34
- Place of publication:
- London
This evaluation toolkit is to help provider organisations to improve the quality of support for people with learning disabilities as they grow older. It aims to enable providers to understand the values, knowledge and skills that need to be in place to support people as they grow older so that their lives are as happy, healthy and fulfilling as possible and draw up and deliver an action plan to improve the support provided to people as they grow older. It uses the 8 outcomes from the Association for Real Change 'Real Change Challenge on Older People'. It provides indicators for each of the eight outcome that providers can use to assess themselves against using a traffic light system (red, amber and green). The toolkit suggests resources to help achieve each outcome. There is also a template for developing an action plan to help organisations implement the necessary changes. (Edited publisher abstract)