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Forensic health-care workers are frequently exposed to behaviours that challenge and traumatic material, with notably high levels in developmental disorder (DD) services. The provision of support is key in alleviating distress and improving work functioning. This paper aims to incite clarity on whether staff in DD services are more likely to access trauma support. The prevailing needs and outcomes for this population are also explored.

Data was extracted retrospectively from a database held by an internal trauma support service (TSS) for staff working in a secure psychiatric hospital. Overall, 278 permanent clinical staff accessed the TSS between 2018 and 2020, 102 (36.7%) of whom worked in an adult DD forensic inpatient service.

Staff working in DD services were over-represented in referrals to the TSS with a greater number of referrals per bed in DD services than in non-DD services (0.94 vs 0.33). DD staff were comparatively more likely to access support for non-physical, psychologically traumatic experiences. Psychological needs and outcomes following support were comparable between staff across services.

The findings highlight the more frequent need for trauma support of staff in forensic inpatient DD settings. Embedding a culture of safety and openness, and establishing appropriate and responsive models of staff support reflect key priorities for inpatient DD health-care providers, for the universal benefit of the organisation, workforce and service users.

This study offers novel insight into levels of access to support for staff working with people with DDs.

Adverse childhood experiences (ACEs) are highly prevalent in people with developmental disorders who engage in offending behaviour. Many violence-based risk assessment tools include items pertaining to ACEs, and may inflate risk scores in trauma-exposed groups. This paper aims to explore the relationships between ACEs, risk assessment scores, incidents of risk and restrictive practices, in adolescents with developmental disorders in a forensic inpatient setting.

Secondary analysis was conducted on clinical data for 34 adolescents detained to a developmental disorder service. Data were extracted for Structured Assessment of Violence Risk in Youth (SAVRY) risk scores and risk behaviours and restrictive practices, as measures of observed risk.

Participants exposed to more ACEs had higher SAVRY risk scores (p < 0.001, two-tailed), with elevations specifically on the historical subscale (p < 0.001, two-tailed). Neither ACEs nor risk scores were associated with the frequency of risk behaviours. Nevertheless, participants exposed to four or more ACEs were secluded more frequently (p = 0.015, two-tailed), indicating a potential association between trauma and risk severity. Those with more complex developmental disorders experienced fewer ACEs (p = 0.02, two-tailed) and engaged in self-harm behaviours less frequently (p = 0.04, two-tailed).

The inclusion of ACEs in risk assessment tools may lead to the inadvertent stigmatization of trauma-exposed individuals. Further investigation is necessary to offer clarity on the impact of early adversity on risk assessment accuracy and levels of institutional risk, and the role of developmental disorders in this relationship.

To the best of the authors’ knowledge, this study is the first to explore the relative associations between ACEs, risk assessment scores and observed institutional risk and does so in a highly marginalized population.

People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not well understood. Furthermore, considerably less is known about the exposure to, and impact of, ACEs in detained adolescents with complex developmental disorder needs. This paper aims to explore the exposure to ACEs in an adolescent population detained in a secure specialist developmental disorder service.

A retrospective file review was used to explore ACEs and placement histories within a specialist developmental disorder inpatient service. Data was collated for a convenience sample of 36 adolescents, 9 of whom were female, aged 13–20 years (M = 17.28 years).

A total of 33 participants (91.7%) had experienced at least 1 ACE, with 58% experiencing 4 or more ACEs and 36% experiencing 6 or more ACEs. The most common ACEs reported were physical abuse (61.6%), parental separation (58.3%) and emotional abuse (55.6%). The majority of participants had also experienced high levels of disruption prior to admission, with an average of four placement breakdowns (range 1–13, standard deviation = 3.1). ACEs held a significant positive association with the total number of placement breakdowns and total number of mental health diagnoses.

Adolescents detained in specialist developmental disorder secure care had, at the point of admission, experienced high levels of adversities and had been exposed to high levels of experienced and observed abuse. The level of exposure to adversity and ongoing disruptions in care suggests that Child and Adolescent Mental Health Services’ developmental secure services should consider adopting dual treatment frameworks of developmental disorder and trauma-informed care.

This study explored the early-life and placement experiences of a marginalised and understudied population.

The purpose of this study is to consider informed consent with those who may be legally judged incapable of consent. Frequently individuals with traumatic brain injuries and intellectual disabilities may fall into this category. This paper seeks to consider aspects of guardianship, moral and legal implications and best practices for mental health professionals.

This practice piece reviews literature regarding informed consent, as well as pertinent issues in the professional literature regarding types of guardianship as well as the occurrence of “Lucid intervals.” Furthermore, literature from moral philosophy and current legal research was examined to fully provide readers with a grasp of the legal and ethical landscape of this issue.

The paper finds that treating consent as a one-time binary event is lacking in both practicality and nuance. Moral philosophy and issues regarding paternalism are raised, as well as practice approaches to assessment of capability and how to engage in therapy in meaningful ways.

This paper provides insight into providing dignity-affirming therapy with a population that is often not considered in the literature of mental health ethics. When it is considered, the suggestions are so vague as to be of limited use. This manuscript provides nuance and practical applications to be a therapist that promotes dignity in those who might have varying levels of capacity to consent.

There are few publications on personality disorder in adults with intellectual disability (ID), and on borderline personality disorder (BPD) specifically. Publications concerning treatment are sparse, despite the high symptom burden in these patients. This paper aims to discuss these issues.

Six patients with BPD and ID were recruited from the same inpatient unit. Behaviour problems and mental health symptoms were scored on admission and discharge. Information about treatment, length of stay, etc. was taken from case files.

Both mental health symptoms measured by the SCL-90-R, and behaviour problems measured by the Aberrant Behaviour Checklist were significantly reduced on discharge. In the active treatment period, the two main aspects of treatment were validation and practicing new solutions when emotional and behavioural problems occur, i.e. skills training.

The limitations related to this study are that the study is conducted in one milieu only. Another limitation is that the patients were admitted over a five-year period, where, some changes were made in the treatment approach.

Inpatient treatment of this patient group seems to be effective if individually adjusted to the patient’s psychopathology, ID and communication style. Close co-operation between the individual therapist and milieu therapists is essential.

There is a need for intervention studies on BPD in ID. This study may be a valuable contribution.

The purpose of this study is to investigate the information-seeking behavior of Egyptian parents of autistic children.

The study sample consists of 61 parents across Egypt, divided into six focus groups, as equal as possible, to represent Northern, Middle and Southern Egypt.

Dmographically, of the 61 parents, 32 (52.5%) were fathers, and 29 (47.5%) were mothers. A large number of parents' ages ranged from 31 to 45 years old. The highest percentage of them was holding a BA, followed by a high school/diploma, and the highest percentage was found to be married. The parents of autistic children followed many methods and channels to obtain supportive information related to their children's disease. They used many types of information, which varied between formal and informal sources. While just over a quarter of Egyptian parents prefer to use formal sources (books, newspapers, magazines, health publications, pamphlets, as well as specialized libraries), more than three-quarters of them used informal sources, such as mobile/smartphones, the Web, social media and social networking sites. The information related to the search for institutions supporting autistic people came in the first place, then that information related to searching for specialized centers in treating autistic children, then information related to rehabilitation, integration and psychological support centers for these children and then information related to the search for financial aid provided by charitable or even government agencies. Some parents were found to have limited awareness of their children's treatment mechanism, as some of them do not consider the need to treat their children in a systematic, continuous, and systematic manner. Similarly, the lack of basic services and shortage of government centers specializing in the treatment of these children. Parents also emphasized the lack of government support, as well as the lack of curative research centers. Some also pointed out that there was a shortage of workshops for the rehabilitation of their children and themselves as well.

This research is considered to be the first research of its kind at the local and Arab levels, which is also one of the few studies at the regional level that is interested in this community of information seekers. The findings of this research can raise awareness about the information behavior of Egyptian parents of autistic children among those who are interested in the role of the information and its use by specific groups of the information society, as well as decision makers.

The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-11-2020-0494

Annoying and bothersome behaviours among persons with developmental disabilities (DD) is a relatively frequent phenomenon. However, not all behaviour that is difficult to accept in its surroundings should be seen as abnormal or problem behaviour (PB). Some of these behaviours may be an expression of a person’s psychosocial needs and may be considered as adaptive and normal. The paper aims to discuss these issues.

Authors attempt to discuss relevant issues in persons with DD which have an impact on their behaviour, intending in this way to define criteria for a reliable differentiation between normal and abnormal behaviour and psychiatric disorders.

Differentiating between normal and abnormal may be a difficult task for a professional treating persons with DD because of the lack of adequate criteria for such differentiation. The problem becomes even more complex when one attempts to differentiate between PB and psychiatric disorder. By approaching the subject from a developmental perspective and by determining the level of the person’s emotional development, insight in subjective person’s experiences was achieved. On the ground of a “good practice” the authors made schemata outlining criteria for differentiation between these constructs.

The application of these schemata in the practice made it easier to establish appropriate diagnoses and was favourable for the planning of adequate treatment and support of persons with DD and mental health problems.

Students with developmental/intellectual disabilities (ID/DD) often have serious health issues that require additional medical care and supervision. Serious health issues also mean increased absence and additional lags in academic achievement and development of adaptive and social skills. The incorporation of artificial intelligence in the education of a child with ID/DD could ameliorate the educational, adaptive and social skill gaps that occur as a direct result of persistent health problems.

The literature regarding the use of artificial intelligence in education for students with ID/DD was collected systematically from international online databases based on specific inclusion and exclusion criteria. The collected articles were analyzed deductively, looking for the different gaps in the domain. Based on the literature, an artificial intelligence–based architecture is proposed and sketched.

The findings show that there are many gaps in supporting students with ID/DD through the utilization of artificial intelligence. Given that the majority of students with ID/DD often have serious and chronic and comorbid health conditions, the potential use of health information in artificial intelligence is even more critical. Therefore, there is a clear need to develop a system that facilitates communication and access to health information for students with ID/DD, one that provides information to caregivers and education providers, limits errors, and, therefore, improves these individuals' education and quality of life.

This review highlights the gap in the current literature regarding using artificial intelligence in supporting the education of students with ID/DD. There is an urgent need for an intelligent system in collaboration with the updated health information to improve the quality of services submitted for people with intellectual disabilities and as a result improving their quality of life.

This study contributes to the literature by highlighting the gaps in incorporating artificial intelligence and its service to individuals with ID/DD. The research additionally proposes a solution based on the confounding variables of students’ health and individual characteristics. This solution will provide an automated information flow as a functional diagnostic and intervention tool for teachers, caregivers and parents. It could potentially improve the educational and practical outcomes for individuals with ID/DD and, ultimately, their quality of life.

Very little is known about the frequency and nature of police contacts with individuals with intellectual or developmental disabilities (I/DDs). The purpose of the study is to examine the characteristics of police contacts with persons with I/DD and how they differ from other behavioral health-related encounters.

The authors draw on data from two large National Institute of Mental Health (NIMH)-funded studies of police response to mental/behavioral health crises and the Crisis Intervention Team (CIT) approach. Both projects used the same incident report form. The authors examine detailed information from 219 calls in which officers perceived that the subject had I/DD, either alone or co-occurring with a mental illness or substance use disorder and compared them with calls in which I/DD was not indicated (n = 1,305).

Calls with subjects with I/DD most frequently occurr ed in homes or on the street and were resolved without formal action. The most frequent subject symptoms/behaviors noted were confusion and anxiety. Some differences from calls with individuals without I/DD were noted in term of presentation and outcomes.

Data relied on officer perception of subject having I/DD, which may miss more subtle indicators.

There is a need for specific research attention to police contacts with persons with I/DD that differentiates those contacts from other behavioral health-related encounters.

There is still much the authors do not know about police contacts with persons with I/DD. However, findings provide a preliminary glimpse into the nature of these contacts and suggest they may differ somewhat from other behavioral health related police encounters.

In this paper, the authors summarize the empirical and theoretical gaps in understanding of police contact with individuals with intellectual and/or developmental disabilities at the individual, interactional, organizational and systems level and introduce the special issue papers which address these gaps. The authors close with a discussion of future directions for research in this area.

The authors’ objective in producing this issue was to create a platform to generate and facilitate research in this area. The authors chose papers that represented research that could “move the needle” around the understanding of policing and intellectual and/or developmental disabilities.

The papers in this special issue reflect four thematic areas: (1) the nature of interactions between the police and individuals with intellectual and/or developmental disabilities; (2) police interactions about individuals with intellectual and/or developmental disabilities with criminal justice systems, social services and mental health services, (3) experiences of the police when encountering individuals with intellectual and/or developmental disabilities and finally, (4) the experiences within police encounters of individuals with intellectual and/or developmental disabilities.

Research on intellectual and/or developmental disabilities is still in its infancy, particularly within the field of criminology and criminal justice. This special issue brings together innovative international research that adds critical information surrounding the nature of interactions between the police and individuals with intellectual and/or developmental disabilities, the experience for both parties during that interaction and the context of these interactions in the larger organizational ecosystem of criminal justice organizations and social service agencies.