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The effectiveness of different types of adult learning practices for promoting practitioner and parent use of different kinds of assistive technology and adaptations with young children of 18–105 months of age was the focus of a research synthesis described in this chapter. Six operationally defined adult learning methods and between two and five practices for each method were used to code and analyze the results for both adult (practitioner and parent) and child outcomes. The assistive technology and adaptations that were the focus of training included speech generative devices (e.g., CheapTalk), computers (e.g., adapted keyboards), and switch-activated devices and toys. Results showed that a combination of five or six of the most effective adult learning method practices were associated with the largest differences in both adult and child outcomes, but that few studies included the most effective practices. The relationship between the number of practices and the study outcomes was moderated by the type of training (individual vs. group) and whether the training included in vivo use of the devices with children with disabilities. The results point to at least several factors that explain non-use of assistive technology with young children with disabilities and highlight the need for better designed and implemented training.

Using data from the National Longitudinal Transition Study (NLTS) and the National Longitudinal Transition Study-2 (NLTS2), this study compared the post-high school outcomes of young adults with learning disabilities (LD) or emotional/behavioral disorders (EBD) in 1990 and 2005. These cohort comparisons reveal how the results of special education have changed over that time period as evidenced in the post-high school outcomes of nationally representative samples of youth. The extended data collection time period of NLTS2 (2001–2009) also enabled an assessment of the evolution in the post-high school outcomes of young adults with LD or EBD who had been out of high school up to 8 years. The post-high school outcomes considered included high school completion, postsecondary education enrollment and completion, employment status and wages, and community integration as illustrated by living arrangements and criminal justice system involvement. Findings for both the NLTS/NLTS2 cohort comparisons and the longitudinal analyses from NLTS2 indicate progress in efforts to improve outcomes for youth and young adults with LD or EBD but also underscore the work ahead in setting these groups on a path to successful adulthood. Implications for practice and research are discussed.

The purpose of this article is to advance knowledge concerning outcomes among the former residents of therapeutic children's homes, especially those located in England.

In total, 16 young adults who had been resident in one of seven therapeutic homes took part in interviews.

It appeared, from the information they gave in these interviews, that their outcomes were good in terms of their emotional and behavioural well‐being, physical health, accommodation, and absence of early parenthood and substance use. Some of the young adults also had good outcomes in respect of their education and absence of criminal convictions. A small number of the young adults did less well on these latter two measures but few of them were particularly poor in either of these respects. The young adults had limited contact with their family members.

The evidence from this research is that young adults who have been in therapeutic residential care can have good outcomes.

This study aims to explore which outcome measures are used by occupational therapy staff in adult social care settings in the UK, and the factors affecting use of outcome measures.

A quantitative descriptive research design was used, using a cross-sectional study to explore occupational therapy staff views on the use of outcome measures. A 38-question survey was developed on Microsoft Forms. Recruitment occurred online over a three-week period in 2021 via the social media platform “Twitter”. Results were analysed using Excel using descriptive statistics and qualitative results used thematic analysis.

Participants (n = 20) used a range of outcome measures (13) in adult social care settings in the previous 12 months. Standardised measures were used by half the sample in the previous 12 months. The Therapy Outcome Measure and Barthel Index were in most use. The breadth of adult social care practice and practical factors such as caseload and lack of a meaningful tool were found to be barriers to outcome measure use. Facilitators included service improvement, accountability, use of audit and professional occupational therapy leadership.

The overall use of outcome measures can be considered low in this setting, with manager support seen to be key to the use of outcome measures. Further research is needed to investigate nationwide use.

Training, time and manager support are key to use of standardised tests and outcome measures in the adult social care settings. The use of occupational performance measures should be considered to demonstrate unique professional impact.

This contemporary study reveals use of outcome measures within occupational therapy adult social care services in the UK, which is an under researched and under published area.

The purpose of this paper was to establish the extent to which safeguarding procedures in North Somerset identified and reviewed outcomes for the alleged adult at risk. The project aimed to address whether outcomes could be achieved and what steps need to be taken to make the experience of safeguarding personal.

Three social care teams with a responsibility for following up safeguarding referrals were asked to participate in the work and provide feedback on cases completed within the project timeframe. Data were gathered centrally on specific forms and through focus group discussions with social workers.

The findings confirmed the need for a change in practice to ensure safeguarding procedures are personal.

The number of completed cases in the timeframe of the project was small and this limits the conclusions.

The paper identifies change needed to training and recording systems and recognises that further work is needed to embed the learning from this work and explore the implementation of alternative approaches.

The paper establishes the extent to which existing safeguarding practice is outcome focused.

There are currently no national adult safeguarding outcome measures that focus on people who have been through an adult safeguarding investigation in England. There is a need for local authorities (LAs) and their partners to be able to measure whether the services provided to adults at risk of abuse and neglect are effective. The paper aims to discuss these issues.

This paper describes the cognitive testing phase of a study to develop and implement a standardised adult at risk outcome measure in adult safeguarding for use by LAs in England. An outcome measure (a set of seven survey questions administered in a face to face interview) was cognitively tested in three LAs with adults at risk (or their carers/advocates) for whom an investigation of abuse had been concluded (n=40), with the aim of assessing whether it was commonly understood. A set of guidance notes was designed and LA staff (n=12) who assisted with the survey were interviewed about its usability and the feasibility of administering the survey.

The survey questions required modifications to improve their reliability, validity and comparability. LA staff also suggested improvements were needed in the guidance document and survey. LA managers, adults at risk (and their relatives/carers/advocates) were willing to be involved in the survey and it was considered feasible to proceed with piloting the measure.

The development of this unique survey is of interest to those working in adult safeguarding, user involvement, survey management and outcome measurement in LAs.

Although incarceration may have life-long negative health effects, little is known about associations between child incarceration and subsequent adult health outcomes. The paper aims to discuss this issue.

The authors analyzed data from 14,689 adult participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health) to compare adult health outcomes among those first incarcerated between 7 and 13 years of age (child incarceration); first incarcerated at>or=14 years of age; and never incarcerated.

Compared to the other two groups, those with a history of child incarceration were disproportionately black or Hispanic, male, and from lower socio-economic strata. Additionally, individuals incarcerated as children had worse adult health outcomes, including general health, functional limitations (climbing stairs), depressive symptoms, and suicidality, than those first incarcerated at older ages or never incarcerated.

Despite the limitations of the secondary database analysis, these findings suggest that incarcerated children are an especially medically vulnerable population.

Programs and policies that address these medically vulnerable children’s health needs through comprehensive health and social services in place of, during, and/or after incarceration are needed.

Meeting these unmet health and social service needs offers an important opportunity to achieve necessary health care and justice reform for children.

No prior studies have examined the longitudinal relationship between child incarceration and adult health outcomes.

The Health and Social Care Information Centre undertook the development and piloting of a new adult safeguarding outcome measure (a face-to-face survey) for local authorities (LAs) that could be added to the adult social care outcomes framework (ASCOF). The ASCOF is a national collection of social care outcomes performance indicators collected from the perspective of people receiving partial or total funding from a LA for care services. The projected costs of introducing the survey as a new statutory measure in England were assessed. The paper aims to discuss these issues.

An outcome measure (a face-to-face interview based survey consisting of seven questions) was piloted during 2014 in 40 LAs with 20 adults at risk (or other informant) in each site who had been the subject of a safeguarding investigation (n=382). LAs were asked to estimate the cost to their LA of conducting the survey for two years, interviewing at least 15 per cent of their completed safeguarding cases each year.

Extrapolating cost findings to the full 152 LAs in England would give an estimated total cost of implementing the survey of approximately £3 million in Year 1 and £2.1 million in Year 2. Set-up costs for the survey can therefore be estimated at around £900,000. Wide variations were identified in the costs per interview between LAs and reasons for this are discussed.

The benefits of this unique survey are it enables LAs to measure how they are undertaking their adult safeguarding work from the perspective of adults at risk and others with a close interest. It also enables LAs to meet their new obligations under the Care Act 2014 Guidance to “understand what adults at risk think of adult safeguarding”.

Several studies have used secondary data sources in order to learn about outcomes for adults who have been in contact with the care system in childhood. This article discusses two of the large‐scale longitudinal datasets in the UK that are available to researchers and which include information on adults who were looked after in childhood: The National Child Developmental Study (NCDS) and The British Cohort Study (BCS70). These databases are considered to be among the best sources available to investigate long‐term outcomes for looked‐after children in the UK. This article describes these databases and the use made of them by researchers exploring the life chances of looked‐after children. It also identifies the advantages as well as the limitations of these datasets and presents implications for this field of research.

The purpose of this paper is to report the findings from research into the outcomes of adult protection in Scotland, with particular focus on how service users, family members and service delivery professionals perceive the effectiveness of the protection orders in the Adult Support and Protection (Scotland) Act 2007.

The study comprised analysis of Adult Protection Committee biennial reports on implementation of the 2007 Act to the Scottish Government, key informant interviews and workshops with professionals involved in adult protection leadership and practice, and case study interviews with service users, family members and practitioners.

Concerns about the potential for paternalistic practice and excessive use of the protection orders within the 2007 Act have not materialised. The principle of proportionality appears to be firmly embedded in adult protection practice. Service delivery professionals, service users and family members remain acutely aware of the tensions between autonomy and protection but point to beneficial outcomes for adults at risk from the careful use of protection orders, especially banning orders.

Only ten case studies were able to be included in the study. However, the use of mixed methods enabled triangulation of the findings. Common themes emerge from across the data sources. The findings also resonate with conclusions drawn by other researchers.

The paper identifies outcomes and challenges in respect of protecting adults at risk in Scotland. Strengths and limitations of the 2007 Act are identified.

The paper offers a formal evaluation of the outcome of protection orders for adults at risk in Scotland. The findings are of wider policy relevance given the debates on how to legislate for adult safeguarding in England and Wales.