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Comparing residential programmes for adults with autism spectrum disorders and intellectual disability: outcomes of challenging behaviour and quality of life
- Authors:
- GERBER F., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 55(9), September 2011, pp.918-932.
- Publisher:
- Wiley
Behavioural challenges have limited research using quality of life (QoL) as a treatment outcome in autism spectrum disorders (ASD) and intellectual disabilities (ID). This study combine QoL measures and objective observations of challenging behaviours (CB) to evaluate changes in adults with ASD and ID treated in different residential programmes in Switzerland. The authors hypothesised that a decrease in CB would be related to an improved QoL. This 45-month study followed 31 adults with ASD and ID who had been integrated into two residential programmes Autism Programme with a Structured Method (PAMS) vs. traditional programme for ID (No-PAMS)] for 2–19 years. QoL [Quality of Life Inventory in a Residential Environment (IQVMR)] and severity of autistic features (Childhood Autism Rating Scales) were evaluated annually. CB, as measured by the Aberrant Behaviour Checklist (ABC), including stereotypic behaviour and inappropriate speech, were repeatedly assessed every 3 months. In the PAMS programme, stereotypic behaviour and inappropriate speech (ABC scores) significantly decreased, and the IQVMR total score increased; in contrast, in the No-PAMS group, ABC scores did not change and the IQVMR total score decreased. Further analysis partially confirmed that the PAMS programme had an effect on CB and that QoL improvement did not directly depend on the type of programme but on reducing CB as measured by the ABC.
Using contact work in interactions with adults with learning disabilities and autistic spectrum disorders
- Authors:
- BROOKS Sharon, PATERSON Gail
- Journal article citation:
- British Journal of Learning Disabilities, 39(2), June 2011, pp.161-166.
- Publisher:
- Wiley
People with learning disabilities and additional autistic spectrum disorder are at risk of becoming socially isolated because of their difficulties in interacting with others. This article describes a project which used contact work with people with learning disabilities and autistic spectrum disorder in a residential setting. Contact work is a form of Pre-Therapy, which is a person-centred approach which focuses on psychological contact. The approach has been developed using the idea of contact reflections for use with people who find it difficult to establish psychological contact because of their emotional, mental health or cognitive problems. The approach was used with 2 clients with learning disabilities and autistic spectrum disorder. Both clients were offered 10 individual sessions using contract reflections with speech and language therapists. The sessions were evaluated using a tool created for the project that was designed to measure different contact behaviours. The impact of the project on both clients and therapists is discussed, and was felt to be useful on a subjective level. In addition, the measurement tool is discussed, and found to be useful in collecting quantitative data but requires additional work to capture the more qualitative aspects of the work.
Science and pseudoscience in developmental disabilities: guidelines for social workers
- Authors:
- THYER Bruce A., PIGNOTTI Monica
- Journal article citation:
- Journal of Social Work in Disability and Rehabilitation, 9(2-3), April 2010, pp.110-129.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Individuals with a developmental disability can now be provided a variety of empirically supported treatments that have been shown to be useful in promoting educational attainments, social and vocational skills, self-care, and in reducing behavioural problems. Unfortunately, a large number of pseudoscientific or bogus therapies continue to be offered to this population and their families. This article reviews the characteristics of pseudoscientific and bogus treatments, and provides several examples of unsupported or harmful interventions offered by contemporary social workers and other human service professionals, to the detriment of people with disabilities. It examines pseudoscientific treatments such as animal-assisted therapies. In conclusion, the authors encourage social workers to identify pseudoscientific interventions and avoid providing these, in favour of using empirically supported treatments.
Seeking to prevent residential care for young people with intellectual disabilities and challenging behaviour: examples and early outcomes from the Ealing ITSBS
- Authors:
- REID Caroline, SHOLL Catherine, GORE Nick
- Journal article citation:
- Tizard Learning Disability Review, 18(4), 2013, pp.171-178.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to present early outcomes and case examples from the Ealing Intensive Therapeutic and Short Break Service. Design/methodology/approach: The service was piloted over a period of 3.5 years during which clinical data were collected for young people at risk of a move to residential care. Findings: here were positive outcomes for young people with intellectual disabilities and challenging behaviour who were seen through the service with residential placements prevented in the vast majority of cases. Originality/value: These early outcomes highlight the importance of providing intensive therapeutic intervention with short breaks in order to prevent family placement breakdown. (Publisher abstract)
The autism matrix: the social origins of the autism epidemic
- Authors:
- EYAL Gil, et al
- Publisher:
- Polity
- Publication year:
- 2010
- Pagination:
- 240p.
- Place of publication:
- Cambridge
Using a combination of historical narrative and international comparison, the authors offer a new interpretation of autism from a sociological perspective. They argue that the recent rise in autism should be understood in the context of the deinstitutionalization of learning disabilities in the mid-1970s. This resulted in a change in the way institutions had to deal with childhood developmental disorders, but also of the cultural lens through which we view them. The authors show that where deinstitutionalization went the furthest, as in Scandinavia, UK and parts of the USA, autism rates are highest. Where it was absent or delayed, as in France, autism rates are low.
From isolation to intimacy: making friends without words
- Authors:
- CALDWELL Phoebe, HORWOOD Jane
- Publisher:
- Jessica Kingsley
- Publication year:
- 2007
- Pagination:
- 188p.
- Place of publication:
- London
If you have no language, how can you make yourself understood, let alone make friends? Caldwell has worked for many years with people with severe intellectual disabilities and/or autistic spectrum disorder who are non-verbal, and whose inability to communicate has led to unhappy and often violent behaviour. In this new book she explores the nature of close relationships, and shows how these are based not so much on words as on the ability to listen, pay attention, and respond in terms that are familiar to the other person. This is the key to Intensive Interaction, which she shows is a straightforward and uncomplicated way, through attending to body language and other non-verbal means of communication, of establishing contact and building a relationship with people who are non-verbal, even those in a state of considerable distress. This simple method is accessible to anyone who lives or works with such people, and is shown to transform lives and to introduce a sense of fun, of participation and of intimacy, as trust and familiarity are established.
Children with developmental coordination disorder
- Editors:
- SUGDEN David, CHAMBERS Mary, (eds.)
- Publisher:
- Whurr
- Publication year:
- 2005
- Pagination:
- 319p., bibliog.
- Place of publication:
- London
The term Developmental Coordination Disorder (DCD) is used to describe a group of children who have difficulty. with tasks involving movement such that it interferes with their daily living or academic progress. As with other developmental disorders such as autistic spectrum disorder, attention deficit disorder and dyslexia, DCD is now a prominent concern of both researchers and practitioners. This text is aimed at both researchers and professionals who work in a practical manner with the condition and includes professionals in health, occupational therapists, physiotherapists, health visitors, paediatricians, and - in the educational field - teachers and others who are in daily contact with the children - their parents. The essence of the text is that work with children should be guided by research evidence driving the clinical practice which in turn raises more questions for research.
Communication issues in autism and Asperger syndrome: do we speak the same language?
- Author:
- BOGDASHINA Olga
- Publisher:
- Jessica Kingsley
- Publication year:
- 2005
- Pagination:
- 288p.,bibliog.
- Place of publication:
- London
Providing a theoretical foundation for understanding communication and language impairments specific to autism, the author explores the effects of different perceptual and cognitive styles on the communication and language development of autistic children. She stresses the importance of identifying each autistic individual's nonverbal language, which can be visual, tactile, kinaesthetic, auditory, olfactory or gustatory – with a view to establish a shared means of verbal communication. She offers an explanation of why certain approaches, might work with some autistic children but not others. The ‘What They Say' sections of the book enable the reader to see through the eyes of autistic individuals and to understand their language differences first hand. ‘What We Can Do to Help' sections throughout the book give practical recommendations on what to do in order to help autistic individuals use their natural mechanisms to learn and develop social and communicative skills. The final chapters are devoted to assessment and intervention issues with practical recommendations for selecting appropriate methods and techniques to enhance communication, based on the specific mode of communication a person uses.
The multi-component model of harmful sexual behaviour for people with autism and co-morbid intellectual disabilities – a theory and practice guide
- Author:
- WORTHINGTON Rachel
- Journal article citation:
- Journal of Forensic Practice, 21(1), 2019, pp.1-13.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore to what extent neuro-typical theories of sexual offending apply to clients with Levels 2 and 3 autism with a co-morbid intellectual disability (ID). The paper develops a model of harmful sexual behaviour (HSB) for this client group and makes suggestions for how these behaviours can be understood and reduced. Design/methodology/approach: The revised Integrated Theory of Sexual Offending (ITSO) (Ward and Beech, 2016) is used as a starting framework to understand HSB in this client group. This attends to specific neuropsychological systems, brain development, motivation and emotional processing. Findings: The revised ITSO has some utility in understanding HSB in this client group. This is improved when neuro-atypical specific state factors are identified. Practical ways of establishing these state factors are made which attend to the function of the behaviour in line with “Good Lives” model of rehabilitation. Research limitations/implications: Recommendations for ways in which the function of HSB in this client group can be identified are made as well as recommendations for how treatment can be tailored dependent on the function of behaviour in this client group. Practical implications: The paper makes practical recommendations for how interventions for people with ID and autism in line with Ward, Clack and Haig’s (2016) Abductive Theory of Method which noted that interventions should be adopted to consider wider explanations for offending thus acknowledging that treatment could extend beyond cognitive behavioural therapy for clinical phenomena. Future treatments for clients with autism and LD are suggested which attend to sensory needs, teaching alternative communication strategies for seeking out “deep pressure” or attention in ways that do not involve sexual offending, using picture communication, information technology or Makaton to communicate needs or using social stories to explain the consequences of behaviour. In addition, neuro-atypical interventions which attend to the neuropsychological functioning of clients could also be included in treatment for neuro-typical clients, thus ensuring that interventions attend to every aspect of the ITSO and not purely clinical phenomena. Social implications: Enhancing treatment interventions for clients with ID and autism could both reduce risk and enhance quality of life for this client group. Originality/value: Much of the work to date exploring HSB in clients with autism has attended to clients with Level 1 autism or those without an additional ID. This paper provides practitioners with a theory upon which to understand HSB in clients with a dual diagnosis of Levels 2/3 autism and an ID as well as practical recommendations for reducing HSB in this client group. (Edited publisher abstract)
Psychiatric and behavioural disorders in intellectual and developmental disabilities
- Editors:
- BOURAS Nick, HOLT Geraldine, (eds.)
- Publisher:
- Cambridge University Press
- Publication year:
- 2007
- Pagination:
- 424p.
- Place of publication:
- Cambridge
- Edition:
- 2nd ed.
The fully revised and updated second edition of this book is aimed at all those involved in the fields of intellectual, developmental and learning disabilities. It draws on both clinical experience and recent research findings to bring together information on the mental health and behavioural problems of people with intellectual, developmental and learning disabilities and mental retardation. Contributions are provided from a multidisciplinary team of experts and cover; assessment and diagnosis, psychopathology, treatment and therapeutic interventions, and policy and service systems. Children are included and a wide range of conditions discussed, such as depression, anxiety, schizophrenia, dementia, personality disorder and self injurious behaviour. New to this edition are chapters on; mental health assessment and monitoring tools for people with intellectual disabilities; interdisciplinary multimodal assessment for mental health problems; the interface between medical and psychiatric disorders; personality disorders; mental health problems in people with autism spectrum disorders; psychosocial interventions; and psychodynamic approaches.