Search results for ‘Subject term:"learning disabilities"’ Sort:
Results 1 - 10 of 24
An evaluation of a community living initiative in Ireland
- Authors:
- SHEERIN Fintan, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 19(3), 2015, pp.266-281.
- Publisher:
- Sage
- Place of publication:
- London
One of the central principles underpinning Irish intellectual disability policy is that of decongregation. Allied to this is the belief that life in community settings offers greater opportunities and richer experiences than does life in institutional settings. This study explores the experiences of a group of adults with intellectual disabilities who moved from residential settings to living units in the community. Using a qualitative descriptive approach, it considers the significance of that move for them and seeks to understand the extent to which their lives have changed. Whereas it emerges that this was a positive period in their lives, it is clear that a number of issues remain to be addressed and these provide useful information for similar developments in the future. (Publisher abstract)
Outcomes from a community‐based Positive Behavioural Support team for children and adults with developmental disabilities
- Authors:
- BOWRING Darren L., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 33(2), 2020, pp.193-203.
- Publisher:
- Wiley
Background: Previous evaluations of community PBS teams have not investigated whether behaviour change is both statistically reliable and clinically significant. Few previous studies have reported quality of life (QoL) and social validity outcomes. Method: The present authors collected data on 85 people referred to a specialist PBS team. The present authors used a unique set of multiple measures and statistical change metrics to evaluate outcome. Results: Statistically significant improvements in QoL and health‐related QoL (HRQoL), with medium to large effect sizes, were demonstrated following PBS input. Mean Behaviour Problems Inventory‐Short Form scores reduced from 37.74 (SD = 30.54) at baseline to 12.12 (SD = 12.24) at follow‐up, with a large effect size (d = 0.84). Stakeholders reported valuing the process and outcomes of PBS, findings which support the social validity of PBS for people with developmental disabilities. Conclusion: This study demonstrates successful PBS outcomes in QoL, HRQoL, challenging behaviour and social validity in a community setting. (Edited publisher abstract)
Outcomes of an inner city forensic intellectual disability service
- Authors:
- WOOSTER Leah, McCARTHY Jane, CHAPLIN Eddie
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 9(1), 2018, pp.1-8.
- Publisher:
- Emerald
Purpose: National policy in England is now directed towards keeping patients with intellectual disability (ID) presenting with forensic problems for time-limited treatment. The result is that secure hospital services are expected to work much more proactively to discharge patients to community-based services. However, there is little evidence in recent years on the outcome of discharged patients with ID from secure hospitals. The purpose of this paper is to describe the outcomes of a patient group discharged from a specialist forensic ID service in London, England. Design/methodology/approach: This is a descriptive retrospective case note study of patients with ID admitted to and discharged from a secure service with both low and medium secure wards, over a six-year period from 2009 to 2016. The study examined patient demographic, clinical and outcome variables, including length of stay, pharmacological treatment on admission and discharge, offending history and readmissions to hospital and reoffending following discharge. Findings: The study identified 40 male patients, 29 of which were admitted to the medium secure ward. In all, 27 patients (67.5 per cent) were discharged into the community with 14 patients having sole support from the community ID services and 4 from the community forensic services. In total, 20 per cent of patients were readmitted within the study period and 22.2 per cent of patients received further convictions via the Criminal Justice System following discharge. Originality/value: This was a complex group of patients with ID discharged into the community with a number at risk of requiring readmission and of reoffending. Community-based services providing for offenders with ID must have sufficient expertise and resourcing to manage the needs of such a patient group including the ongoing management of risks. The national drive is significantly to reduce the availability of specialist inpatient services for this group of patients but this must occur alongside an increase in both resources and expertise within community services. (Edited publisher abstract)
Deinstitutionalization and community living: outcomes and costs: report of a European study: volume 3: country reports
- Editors:
- BEADLE-BROWN Julie, KOZMA Agnes, (eds.)
- Publisher:
- University of Kent. Tizard Centre
- Publication year:
- 2007
- Pagination:
- 599p.
- Place of publication:
- Canterbury
These country reports form the third volume of the final report from the European Union Project Deinstitutionalisation and community living – outcomes and costs: report of a European Study. There are 28 country reports included. The aim of each report is three-fold: to summarise the data collated for the template for each of the service types identified for that country; to comment on the completeness and adequacy of the data collated; to provide a commentary on the context and current situation for people with disabilities in each country. In order to analyse, summarise and compare data across countries, information received on each template was recorded into categories. It is these categories which are included in the data summaries at the beginning of each of the country reports.
Deinstitutionalization and community living: outcomes and costs: report of a European study: volume 1: executive summary
- Authors:
- MANSELL Jim, et al
- Publisher:
- University of Kent. Tizard Centre
- Publication year:
- 2007
- Pagination:
- 14p.
- Place of publication:
- Canterbury
This project aimed to bring together the available information on the number of disabled people living in residential institutions in 28 European countries, and to identify successful strategies for replacing institutions with community-based services, paying particular attention to economic issues in the transition. The goal was seen as the provision of a flexible range of help and resources which can be assembled and adjusted as needed to enable all people with disabilities to live their lives in the way that they want but with the support and protection that they need. This is characterised by several features: separation of buildings and support; access to the same options as everyone else; choice and control for the disabled person and their representatives. Recommendations included: The European Commission should promote joint work between Member States and Eurostat to define a minimum data set for residential services for people with disabilities. The data set needs to be workable both for countries which still have services largely based in institutions, where the distinction between institutional care and care at home is very clear, and for countries which are in the advanced stages of replacing institutions with community-based services and independent living.
Deinstitutionalization and community living: outcomes and costs: report of a European study: volume 2: main report
- Authors:
- MANSELL Jim, et al
- Publisher:
- University of Kent. Tizard Centre
- Publication year:
- 2007
- Pagination:
- 134p.
- Place of publication:
- Canterbury
This detailed project aimed to bring together the available information on the number of disabled people living in residential institutions in 28 European countries, and to identify successful strategies for replacing institutions with community-based services, paying particular attention to economic issues in the transition. The overall aim of the project was to provide scientific evidence to inform and stimulate policy development in the reallocation of financial resources to best meet the needs of people with disabilities, through a transition from large institutions to a system of community-based services and independent living. The reports includes: the identification and collation of existing national data sources; description of the sequence and process of service development; comparison of the costs of community-based vs. institutional services; identification of transitional costs; and the analysis of political and economic strategies used to manage costs. Major recommendations included the harmonised data set at a European level, the publication of statistics demonstrating progress in each country, and the cost- effectiveness of community versus institutional models of residential care and change over time.
An evaluation of positive behavioural support for children with challenging behaviour in community settings
- Authors:
- GREY Ian, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 22(4), 2018, pp.394-411.
- Publisher:
- Sage
- Place of publication:
- London
This study employs a multiple baseline across individual design to describe the implementation of positive behavioural supports for seven children and adolescents in residential community settings over a period of 24 months. These individuals with intellectual disability are residing in one county with long-standing challenging behaviour resulting in home breakdown and serious physical injury. Four types of outcome are presented: rates of behaviour, rates of medication, psychiatric symptomatology and quality of life (QoL). Behaviours reduced to lower levels for the majority of participants following the implementation of positive behavioural supports, and improvements were largely sustained. The use of psychotropic medications reduced or stabilized for the majority of individuals over the same period. QoL Questionnaire scores improved substantially for four participants. The results are discussed in the context of a framework for supporting children with severe challenging behaviours in the community. (Edited publisher abstract)
Making a difference? Ten years of managing people with intellectual disability and forensic needs in the community
- Authors:
- DE VILLIERS Jana, DOYLE Michael
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 6(3/4), 2015, pp.165-174.
- Publisher:
- Emerald
Purpose: Nationally community services for patients with intellectual disability and forensic needs are limited, and research to guide service development for this patient group with highly complex needs is sparse. The purpose of this paper is to provide an overview of referrals to and case management by the multi-agency Fife Forensic Learning Disability Service (FFLDS), including demographic data, treatment, risk assessments and outcomes. Design/methodology/approach: All referrals received between 2004 and 2014 were reviewed to identify key demographic factors and to clarify the outcome of the referrals. Risks levels and presence of factors related to ongoing risk management were identified. For those accepted, final outcomes were noted. Findings: In total, 145 referrals were received by FFLDS between 1 January 2004 and 31 December 2014. Of these 117 were accepted for ongoing case management. In total 106 patients were discharged from FFLDS over the review period, with the vast majority remaining in community settings. Patients were overwhelmingly male, with an age range of 16-79 (mean age of 30). Approximately half of referrals were from criminal justice agencies, and sexual and violent offences predominated. Alcohol and/or illicit substance use was problematic in 49 per cent of patients. Research limitations/implications: FFLDS needs to consider building links with Drug and Alcohol Services, for assistance in developing expertise in managing problematic alcohol and/or illicit substance use. Links with professionals working with female offenders may increase the rate of referral of female patients. Originality/value: Policy and legal frameworks emphasise the need to manage people with learning disabilities and forensic needs in the least restrictive environment possible. This paper provides information on a cohort of forensic patients over a ten-year period, including characteristics and outcomes, to inform the evaluation of these frameworks and the planning of both community and in-patient services for this patient group. (Publisher abstract)
Sex offenders with learning disabilities: three responses to the challenge of service provision
- Authors:
- HINGSBURGER Dave, et al
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(1), January 2011, pp.42-54.
- Publisher:
- Emerald
This article sets out to explore three differing approaches from three agencies to supporting and treating people with a learning disability who have sexually offended. The three agencies are: Waymarks in the United Kingdom, York Central Hospital Behaviour Management Services and Vita Community Living Services both in Ontario, Canada. Each agency provides services to a similar population of offenders with disabilities. It can be argued that there was a very limited range of theoretical models available when each organisation developed. Consequently each agency developed their service according to the needs and ‘best fit’ of the people they were supporting with the available resources at that time. As a result, different models of service arose, all of which have had real success with meeting the needs of people with learning disabilities who have sexually offended, while providing support and treatment in differing ways. This article examines: the treatment approaches of the three agencies; how success is measured in those participating in treatment; and the style of leadership in the agencies. Some case study examples are provided which demonstrate the success of these agencies.
Deconstructing normalisation: clearing the way for inclusion
- Authors:
- CULHAM Andrew, NIND Melanie
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 28(1), March 2003, pp.65-78.
- Publisher:
- Taylor and Francis
This paper considers two major movements affecting the lives of people with an intellectual disability: normalisation and inclusion. The authors look back at the normalisation movement, reviewing its aims, processes and outcomes, and explore its relationship and compatibility with inclusion. In looking forward to the realisation of the inclusion agenda they ask whether normalisation is a suitable platform on which to build inclusion, or whether a process of deconstruction is needed. They discuss what lessons can be learnt from normalisation for the inclusion movement.