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Severe Intellectual Disabilities (severe + intellectual_disabilities)
Selected AbstractsThe Effect of an Attachment-Based Behaviour Therapy for Children with Visual and Severe Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2008P. S. Sterkenburg Background, A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour. Method, Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were treated. Challenging behaviour was recorded continuously in the residential home and during therapy sessions. Alternating treatments were given by two therapists. In phase 1, the experimental therapist attempted to build an attachment relationship in sessions alternating with sessions in which a control therapist provided positive attention only. In phase 2, both therapists applied the same behaviour modification protocol. Results, Across clients, challenging behaviour in the residential home decreased during the attachment therapy phase. The behaviour modification sessions conducted by the experimental therapist resulted in significantly more adaptive target behaviour than the sessions with the control therapist. Conclusion, For these clients with a background of attachment problems, attachment-based behaviour modification treatment may have important advantages over standard behaviour modification. [source] The Disclosure Process and its Impact on South Asian Families with a Child with Severe Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2003Chris Hatton Background, Although several research studies have investigated parental experiences of the disclosure process in White families with a child with severe disabilities, little work has focused on the experiences of South Asian families. Materials and methods, This study aimed to provide a rich picture of the disclosure experiences of South Asian parents of a child with severe intellectual disabilities, using semi-structured qualitative interviews with 26 parents over two time points, and structured quantitative interviews with 136 parents. Results, Parents reported variable experiences of the disclosure process, with many parents experiencing disclosure in the wrong language for them and most parents reporting little post-disclosure support. Parents identified good practice in disclosure as prompt disclosure in the appropriate language, with the partner present (where possible), with emotional support as part of the process, with clear and practical information, and linked to post-disclosure support from a keyworker. Conclusions, Good practice in disclosure was also associated with parental understanding of their child, and parents being more likely to mobilize informal and formal supports. The implications of these findings are discussed. [source] The Cost-Effectiveness of Supported Employment for People with Severe Intellectual Disabilities and High Support Needs: a Pilot StudyJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2000Julia Shearn The costs and outcomes of supporting seven people with severe intellectual disabilities and high support needs in part-time employment were compared with those of a Special Needs Unit (SNU) of a day centre, both within-subject and against an equal-sized comparison group. The income of those employed was described. Direct observation of the employment activities and representative SNU activities were undertaken to assess participant engagement in activity and receipt of assistance, social contact in general and social contact from people other than paid staff. Costs of providing service support were calculated taking account of staff : service user ratios, staff identities and wage rates and service-administrative and management overheads. Employment was associated with greater receipt of assistance, higher task-related engagement in activity and more social contact from people other than paid staff. SNU activities were associated with greater receipt of social contact. Supporting people in employment was more expensive than in the SNU. Cost-effectiveness ratios of producing assistance and engagement in activities were equivalent across the comparative contexts. The SNU was more cost-effective in producing social involvement; employment in producing social contact from people other than paid staff. [source] Challenging Behaviour Analysis and Intervention in People with Severe Intellectual Disabilities, 2nd ednJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 6 2002Cambridge., E. Emerson Cambridge University Press [source] Impact of Mental Health Training for Frontline Staff Working With Children With Severe Intellectual DisabilitiesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008Teresa Whitehurst Abstract, The risk factors for young people with intellectual disabilities developing a mental health disorder are higher than those found in the general population, yet training is very rarely available to frontline staff. A recent study in the United Kingdom cited prevalence rates of mental ill health among adults with intellectual disabilities ranging from 35.2 to 40.9%, depending upon the sensitivity of the diagnostic tool used (Cooper et al., 2007). The ability to identify mental health problems is crucial to early intervention, but is particularly difficult when the symptoms of intellectual disability often mask emerging problems and confound differential diagnosis. The literature relating to mental health training focuses largely on changes in knowledge base and attitude, falling short of considering the primary focus of training,its impact upon practice and how this ultimately benefits people with intellectual disabilities. This study highlights the need for training, considers a training package provided to all frontline (direct care) staff in a residential school in the United Kingdom, catering to young people between the ages of 6 and 19 with severe intellectual disabilities, and investigates the impact of training upon practice and its influence upon the organization. [source] Intellectual disability, challenging behaviour and cost in care accommodation: what are the links?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2005Martin Knapp PhD Abstract The paper examines the links between degree of intellectual disability, challenging behaviour, service utilisation and cost for a group of people with intellectual disabilities living in care accommodation in England. A cross-sectional survey was conducted of people with intellectual disabilities, identified via provider organisations, with supplementary collection of costs data. Multivariate analyses of cost variations were carried out for 930 adults with intellectual disabilities. There were strong, nonlinear, interdependent links between degree of intellectual disability, behaviour, service use and costs. Higher costs were associated with more severe intellectual disabilities and more challenging behaviour. Sector and scale of residence also influenced cost in quite complex ways. Access to and use of services by people with intellectual disabilities were not always appropriately linked to perceived or actual needs. Policy makers and local commissioning agencies need to explore the sources of cost variation between individuals, sectors and types of accommodation in order to achieve national policy objectives on quality, choice, independence and inclusion. [source] The Effect of an Attachment-Based Behaviour Therapy for Children with Visual and Severe Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2008P. S. Sterkenburg Background, A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour. Method, Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were treated. Challenging behaviour was recorded continuously in the residential home and during therapy sessions. Alternating treatments were given by two therapists. In phase 1, the experimental therapist attempted to build an attachment relationship in sessions alternating with sessions in which a control therapist provided positive attention only. In phase 2, both therapists applied the same behaviour modification protocol. Results, Across clients, challenging behaviour in the residential home decreased during the attachment therapy phase. The behaviour modification sessions conducted by the experimental therapist resulted in significantly more adaptive target behaviour than the sessions with the control therapist. Conclusion, For these clients with a background of attachment problems, attachment-based behaviour modification treatment may have important advantages over standard behaviour modification. [source] The Disclosure Process and its Impact on South Asian Families with a Child with Severe Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2003Chris Hatton Background, Although several research studies have investigated parental experiences of the disclosure process in White families with a child with severe disabilities, little work has focused on the experiences of South Asian families. Materials and methods, This study aimed to provide a rich picture of the disclosure experiences of South Asian parents of a child with severe intellectual disabilities, using semi-structured qualitative interviews with 26 parents over two time points, and structured quantitative interviews with 136 parents. Results, Parents reported variable experiences of the disclosure process, with many parents experiencing disclosure in the wrong language for them and most parents reporting little post-disclosure support. Parents identified good practice in disclosure as prompt disclosure in the appropriate language, with the partner present (where possible), with emotional support as part of the process, with clear and practical information, and linked to post-disclosure support from a keyworker. Conclusions, Good practice in disclosure was also associated with parental understanding of their child, and parents being more likely to mobilize informal and formal supports. The implications of these findings are discussed. [source] Attitudes towards Sexuality, Sterilization and Parenting Rights of Persons with Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2002M. Aunos Background and Methods We review articles pertaining to attitudes towards sexuality, sterilization, procreation and parenting by people with intellectual disabilities. Most empirical studies were conducted after the appearance of the principles of normalization and role valorization in the 1970s. Results Across studies, special education teachers and university students appear to hold more positive attitudes towards sexuality and sexuality education programs than parents and service workers. People with intellectual disabilities have conservative attitudes towards sexual intercourse and homosexuality, but may be accepting intimate contact by familiar persons. Despite the ban on involuntary sterilization, it appears that many parents and teachers of persons with intellectual disabilities still support it as a form of contraception, especially for persons with severe intellectual disabilities. Likewise, attitudes towards parenting by persons with intellectual disabilities remain negative, and these attitudes may adversely affect the provision of competency-enhancing supports and services for parents with intellectual disabilities and their children. Conclusions It is recommended that new studies should be undertaken, comparing attitudes across different groups involved with persons with intellectual disabilities and examining the impact of prejudicial attitudes on sexual expression and parenting by persons with intellectual disabilities. [source] The Cost-Effectiveness of Supported Employment for People with Severe Intellectual Disabilities and High Support Needs: a Pilot StudyJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2000Julia Shearn The costs and outcomes of supporting seven people with severe intellectual disabilities and high support needs in part-time employment were compared with those of a Special Needs Unit (SNU) of a day centre, both within-subject and against an equal-sized comparison group. The income of those employed was described. Direct observation of the employment activities and representative SNU activities were undertaken to assess participant engagement in activity and receipt of assistance, social contact in general and social contact from people other than paid staff. Costs of providing service support were calculated taking account of staff : service user ratios, staff identities and wage rates and service-administrative and management overheads. Employment was associated with greater receipt of assistance, higher task-related engagement in activity and more social contact from people other than paid staff. SNU activities were associated with greater receipt of social contact. Supporting people in employment was more expensive than in the SNU. Cost-effectiveness ratios of producing assistance and engagement in activities were equivalent across the comparative contexts. The SNU was more cost-effective in producing social involvement; employment in producing social contact from people other than paid staff. [source] Parental negotiations of the moral terrain of risk in relation to young people with intellectual disabilitiesJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 4 2009Kathryn Almack Abstract This paper draws upon parental accounts from a study of the process of transition for a cohort of 28 young people with relatively severe intellectual disabilities who left special schools in 2004 and 2005 in two adjacent English localities. This paper examines how parents negotiate these boundaries and position themselves in relation to risk. A primary concern identified by parents during this transition period focuses on the risk of harm facing these vulnerable young people (whether through accidents or through sexual, emotional, physical or financial abuse) as they move into the adult world. These concerns are juxtaposed with discourses that increasingly promote the possibilities for people with intellectual disabilities to express and follow their own wishes and aspirations. For example, the policy agenda in England and Wales actively endorses the start of adult life as a time of opportunity for young people and promotes the values of independence and choice. In accounting for the management of risk in the young people's lives, we conclude that parents navigate complex boundaries between being seen to be over-protective and ,letting go'; between trusting others to act in the young adults' best interests and allowing these young people the autonomy to negotiate risk. Copyright © 2008 John Wiley & Sons, Ltd. [source] Unnoticed post-void residual urine volume in people with moderate to severe intellectual disabilities: prevalence and risk factorsJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 9 2009K. H. De Waal Abstract Background Increased post-void residual urine volume (PVR) is often seen in geriatric populations. People with intellectual disabilities (ID) have risk factors in common with these populations. Aims To investigate in adults with ID: ,,Feasibility of portable ultrasound bladder scanning; ,,Prevalence of PVR; and ,,Relations with proposed risk factors for PVR. Methods In a cross-sectional design, PVR was measured using ultrasound scanning in 346 adults with moderate to severe ID aged 18,82 years. Relationship between increased PVR and the following risk factors was assessed: age, level of ID, gender, ambulancy, medication, chronic illnesses, incontinence and profound multiple disabilities (PMD). Acceptation of scanning and manageability were noted. Results Feasibility: All participants were cooperatively undergoing the ultrasound scan and all outcomes were sufficiently interpretable. Prevalence: PVR , 150 mL was newly identified in 30/346 persons (8.7%, 95% confidence interval 5.92,12.14). Associations: Higher age (P = 0.001), laxative use (P = 0.001), chronic illnesses other than epilepsy (P = 0.005), profound ID (P = 0.008), incontinence (P = 0.048) and immobility (P = 0.005) are determinants that were associated with urinary retention. Conclusions The bladder ultrasound scan is a feasible method to identify increased PVR in adults with more severe levels of ID. The prevalence of PVR in adults is similar to prevalences found in the geriatric general population. [source] Characteristics and experiences of children and young people with severe intellectual disabilities and challenging behaviour attending 52-week residential special schoolsJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2007N. Pilling Abstract Background This study sought to gather information about the characteristics and experiences of children and young people with severe intellectual disabilities and severe challenging behaviour attending 52-week residential special schools. Method Staff of nine schools completed postal questionnaires on the characteristics and experiences of 156 pupils. Results Those attending residential schools are predominantly male, teenagers and in long-term placements. Most have limited communication skills and autistic spectrum disorders. All display high numbers of challenging behaviours, many of them serious. Children have a greater range and complexity of needs than pupils at day severe learning difficulties (SLD) schools, albeit with some overlap. Conclusions Children at 52-week residential schools present needs that both families and local services struggle to meet. Residential placement may provide the intensity of educational input and social support that is required, but may increase the vulnerability of the children. Local alternatives to residential schools should be investigated. [source] Handicaps and the development of skills between childhood and early adolescence in young people with severe intellectual disabilitiesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 12 2005O. Chadwick Abstract Background While a number of studies have examined the development of skills in children with intellectual disabilities (ID), most have been cross-sectional, most have been concerned with particular syndromes such as Down's syndrome or autism and few have attempted to identify factors associated with improvements in skills. Methods From a sample of 111 children with severe ID who had been identified from the registers of six special schools at 4,11 years of age, 82 were traced and reassessed 5 years later at the age of 11,17 years. On both occasions, information on the children's handicaps and skills was collected by interviewing their main carers using a shortened version of the Vineland Adaptive Behaviour Scales and the Disability Assessment Schedule. Results and conclusions There were small but statistically significant improvements in Vineland age-equivalent communication and daily living skills scores, but not in Vineland Socialization scores, over the 5-year period of follow-up. This pattern of improvement was observed in most aetiological subgroups. Improvement in skills was greatest in younger children, and was associated with reductions in behaviour problems and in levels of parental stress. In spite of the improvements in age-equivalent scores, Vineland standard scores showed significant declines over the same period of time, indicating that the improvements observed were smaller than would be expected in a general population sample of children of the same age. The dangers of using standard scores or quotients to quantify the level of functioning of children with severe ID are highlighted. [source] Impact of Mental Health Training for Frontline Staff Working With Children With Severe Intellectual DisabilitiesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008Teresa Whitehurst Abstract, The risk factors for young people with intellectual disabilities developing a mental health disorder are higher than those found in the general population, yet training is very rarely available to frontline staff. A recent study in the United Kingdom cited prevalence rates of mental ill health among adults with intellectual disabilities ranging from 35.2 to 40.9%, depending upon the sensitivity of the diagnostic tool used (Cooper et al., 2007). The ability to identify mental health problems is crucial to early intervention, but is particularly difficult when the symptoms of intellectual disability often mask emerging problems and confound differential diagnosis. The literature relating to mental health training focuses largely on changes in knowledge base and attitude, falling short of considering the primary focus of training,its impact upon practice and how this ultimately benefits people with intellectual disabilities. This study highlights the need for training, considers a training package provided to all frontline (direct care) staff in a residential school in the United Kingdom, catering to young people between the ages of 6 and 19 with severe intellectual disabilities, and investigates the impact of training upon practice and its influence upon the organization. [source] | ||||||||||