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A systematic review of quality of life measures for people with intellectual disabilities and challenging behaviours
- Authors:
- TOWNSEND-WHITE C., PHAM A.N.T., VASSOS M.V.
- Journal article citation:
- Journal of Intellectual Disability Research, 56(3), March 2012, pp.270-284.
- Publisher:
- Wiley
Six of the twenty-four quality of life instruments identified, were considered to be psychometrically sound and were assessed against 24 criteria developed from the consumer outcome measurement literature. None of the instruments were specifically developed for use with people with intellectual disability. One scale, the Multifaceted Lifestyle Satisfaction Scale, performed well in most respects but suffered from a lack of replication; a criticism applied to all of the instruments studied in detail. The need for further development and validation of quality of life measures for use with people who display challenging behaviour, or have intellectual disabilities, is emphasised.
A healthy dialogue: challenging the 'psycho-medical monologue' in services for people with challenging behaviours
- Author:
- GOBLE Colin
- Journal article citation:
- Changes an International Journal of Psychology and Psychotherapy, 16(4), Winter 1998, pp.287-293.
This paper explores the transformative potential of dialogue-based approaches in services for people with learning difficulties and challenging behaviours, and the necessity of challenging 'psycho-medical' discourses and culture.
The influence of staff training on challenging behaviour in individuals with intellectual disability: a review
- Authors:
- COX Alison D., DUBE Charmayne, TEMPLE Beverley
- Journal article citation:
- Journal of Intellectual Disabilities, 19(1), 2015, pp.69-82.
- Publisher:
- Sage
- Place of publication:
- London
Many individuals with intellectual disability engage in challenging behaviour. This can significantly limit quality of life and also negatively impact caregivers (e.g., direct care staff, family caregivers and teachers). Fortunately, efficacious staff training may alleviate some negative side effects of client challenging behaviour. Currently, a systematic review of studies evaluating whether staff training influences client challenging behaviour has not been conducted. The purpose of this article was to identify emerging patterns, knowledge gaps and make recommendations for future research on this topic. The literature search resulted in a total of 19 studies that met our inclusion criteria. Articles were separated into four staff training categories. Studies varied across sample size, support staff involved in training, study design, training duration and data collection strategy. A small sample size (n = 19) and few replication studies, alongside several other procedural limitations prohibited the identification of a best practice training approach. (Publisher abstract)
Positive goals for positive behavioural support: interventions to improve the quality of life for people with learning disabilities whose behaviour challenges
- Authors:
- FOX Peter, EMERSON Eric
- Publisher:
- Pavilion
- Publication year:
- 2010
- Pagination:
- 80p., CD ROM
- Place of publication:
- Brighton
This resource is written to help with the selection and evaluation of outcomes of intervention for people with learning disabilities whose behaviour presents challenges for services. The authors cover a range of potential outcomes, enabling selection of those which are most relevant in order to evaluate progress towards achieving those outcomes. They look at both the personal and social consequences of the person's challenging behaviour and the effect of interventions on these quality of life factors, rather than simply focusing on attempting to reduce the challenging behaviour itself. The book is designed to act as an addition to existing assessment and intervention processes and documentation, and can be adapted to suit individual circumstances. Sections include: positive goals and positive behavioural support (PBS); development of positive goals; and how to use positive goals. It is aimed at carers, clinical psychologists, psychiatrists, behaviour therapists, community learning disability nurses, social workers, care managers, members of community learning disability teams and members of challenging behaviour teams. The resource is presented in ring-bound format with a CD-rom containing video clips and photo stories.
Moral positioning: service user experiences of challenging behaviour in learning disability services
- Author:
- STEVENS Martin
- Journal article citation:
- British Journal of Social Work, 36(6), September 2006, pp.955-978.
- Publisher:
- Oxford University Press
Several studies have indicated the importance of challenging behaviour as a limiting factor on quality of life. This article presents the findings of research that aimed to investigate adults with learning disabilities’ understanding and experiences of what is perceived by staff and services to be challenging behaviour. This study was the final phase of research involving Interviews, group discussions and observations were carried out with twenty-six people with learning disabilities using social services’ residential and day services. Participants were able to articulate complex responses about challenging behaviour, which is characterized as a ‘moral web’: a complex network of antecedents, behaviours and consequences. Social care staff were seen by participants to play a key role: protecting people and ensuring that appropriate (negative) consequences were suffered by instigators of challenging behaviour. These findings are interpreted within a positioning theory perspective, suggesting the importance of understanding the ways that challenging behaviour is constructed through social interaction. Implications in the following areas are discussed: developing practice; the role of social care staff; and the study of challenging behaviour as a social phenomenon.
Evaluation of a community facility for people with learning disabilities and behaviour disorder (challenging behaviour)
- Authors:
- ROY Meera, et al
- Journal article citation:
- British Journal of Learning Disabilities, 22(1), 1994, pp.11-17.
- Publisher:
- Wiley
As part of a resettlement programme in the West Midlands, three young men with learning disabilities and behaviour disorder moved to a flat in the community providing one-to-one staffing. A fourth man received respite care. A multi-professional team evaluated various aspects of their care and found that they showed an increase in engaged behaviour, a decrease in disturbed behaviour and violent incidents, and required less psychotropic medication.
MIETS: a service option for people with mild mental handicaps and challenging behaviour or psychiatric problems. 2: Assessment, treatment and outcomes for service users and service effectiveness
- Authors:
- MURPHY Glynis, CLARE Isabel
- Journal article citation:
- Mental Handicap Research, 4(2), 1991, pp.180-206.
- Publisher:
- BIMH Publications
Describes the assessment and treatment programmes of two service users to illustrate the Mental Impairment Evaluation and Treatment Service approach, and gives details of the skill profiles which were used to plan their future placements. Data on the behavioural characteristics of MIETS users at pre-admission and discharge are also presented, together with a discussion of the difficulty of using such measures to evaluate service effectiveness.
The informal culture of a direct care staff team supporting people with intellectual disabilities who present with behaviours that challenge: commentary
- Author:
- BEADLE-BROWN Julie
- Journal article citation:
- Tizard Learning Disability Review, 26(3), 2021, pp.169-173.
- Publisher:
- Emerald
Design/methodology/approach: It provides a brief narrative review of the literature on the factors that determine the quality of life of people with intellectual disabilities, including the impact of culture. Findings: Key to ensuring good quality of life outcomes is support that is facilitative, enabling and empowering which can compensate for severity of disability and improve people’s experiences. This approach is called Active Support. Improving quality of life is a key part of preventing and responding to behaviours that challenge. Culture is an important factor in ensuring staff are motivated to work in such ways but is likely to be intertwined with many other factors. Originality/value: This paper summarises the key literature on what is needed to improve outcomes for people with intellectual disabilities. It introduces the importance of exploring how the different dimensions of culture interact and how culture, practice, processes and structures might work in a much more complex and intertwined fashion than previously conceptualised. (Edited publisher abstract)
An evaluation of positive behavioural support implemented within an intensive community support service for people with learning disabilities who present with behaviours that challenge
- Authors:
- LEWIS Nicola, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 25(3), 2021, pp.348-356.
- Publisher:
- Sage
- Place of publication:
- London
This article evaluates the effectiveness of a multidisciplinary intensive community support service, using positive behavioural support (PBS) as a core intervention model to reduce behaviours of concern and to improve the quality of life and occupational involvement of individuals with a learning disability who present with behaviours that challenge. The service used outcome measures to evaluate the effectiveness of the PBS model. The study looks at pre- and post-outcome measures which showed a significant improvement in behaviour, quality of life and occupational outcomes for individuals with a learning disability presenting with complex behaviours of concern. This study contributes to the growing evidence base for PBS being delivered by specialist community learning disability teams. (Edited publisher abstract)
First steps toward positive behavior support in the Netherlands: a pilot study exploring the effectiveness of a training for staff
- Authors:
- KLAVER Marian, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 17(3), 2020, pp.188-194.
- Publisher:
- Wiley
Despite the effectiveness of positive behavior support (PBS) in reducing challenging behaviors, the availability of PBS for individuals with intellectual disabilities is limited in many countries including the Netherlands. Training care staff supporting individuals with intellectual disabilities in PBS may be a way to improve the provision of PBS. The researchers aimed to explore the preliminary effectiveness of a PBS training for staff in reducing challenging behaviors of individuals with intellectual disabilities. Using a one group, double pretest–posttest design, 24 staff members involved in the care of 11 adult individuals with intellectual disabilities and challenging behaviors participated. The researchers assessed changes in challenging behaviors and quality of life of the individuals, in staff self‐efficacy in dealing with challenging behaviors, and in the use of restraints, using staff rated questionnaires, structured interviews, and medical files. At posttest, the researchers found significant reductions in challenging behaviors, improved quality of life, and increased staff self‐efficacy, but no changes in the use of restraints. In contrast, no significant changes on any of the measures appeared between the two pretests. These findings suggest that a staff training in PBS may be effective for reducing challenging behaviors in individuals with intellectual disabilities. (Edited publisher abstract)