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Based on a literature and practice review, the purpose of this paper is to examine the theoretical and clinical basis for using wordless books with patients who have intellectual disabilities (ID) and/or autism.

A literature review identified seminal peer-reviewed English language articles relating to the neuroscience of information and emotion processing for adults with ID and/or autism. In addition to published examples, illustrative case examples were contributed by clinicians regularly using wordless books.

Many people, including those with ID, selectively attend to visual information. Minimising the cognitive load by using wordless pictorial narrative reduces anxiety, and empowers the patient. Clinicians using such resources describe positive clinical outcomes. Only the Beyond Words wordless books have been identified in published clinical trials.

Although existing evidence suggests a strong positive impact, further research into the use of wordless books for people with ID is needed.

Wordless books are reported to help develop staff skills and empathy for supporting adults with ID. The books facilitate some legally required reasonable adjustments to increase service access. Staff training is needed for effective use of wordless books.

Wordless books specifically designed with and for adults with word processing difficulties, ID and/or autism to enhance health literacy and explore their own narratives and emotional responses around health experiences and personal traumas are a unique approach. This paper may also offer the first exploration of their neuropsychological underpinnings.

Past research has shown individuals with autism spectrum disorder (ASD) visit hospital emergency departments (ED) at high rates. In order to assist individuals with ASD, their families and health care providers to improve ED care, it is important to understand these encounters in greater detail. The purpose of this paper is to provide a descriptive summary of the ED experiences of adolescents and adults with ASD, from the perspective of their families.

A subset of data from a larger prospective cohort study was used. Specifically, 46 parents of adolescents and adults with ASD provided details concerning 49 ED visits over a 12-month period.

Results suggest a range of presentations requiring ED use, and also diverse profiles of those with ASD who visited the ED, in terms of age, gender, and ASD severity. While overall degree of satisfaction with care received in the ED was high, parents provided recommendations to improve the ED experiences for their family members with ASD.

This is the first study to provide detailed accounts of ED visits from the perspective of parents of adolescents and adults with ASD. Families play an important role in the lives of individuals with ASD across the lifespan and it is important to include their perspective to improve hospital-based care for those with ASD.

The paper provides a Canadian perspective on the use of psychotropic medication in the management of problem behaviours in adults with intellectual disabilities in Canada. Psychotropic medication and intellectual disabilities were explored in the context of Canadian health and social services, clinical practices, medical training and factors that have shaped these over the past few decades. Informal physician intellectual disabilities networks and the newly formed Canadian Network of the National Coalition on Dual Diagnosis provided the opportunity to survey the use of psychotropic medication for problem behaviours across the country. Geographic, political, cultural and other influences on the development of health and social services are described, as well as training requirements for physicians. Survey responses were received from all provinces and represented clinicians in mental health multidisciplinary teams, health and social services ministry representatives, agency staff (up to executive director level) and family members of individuals with intellectual disabilities. Psychiatry and family medicine perspectives of the authors from working in Canada and the UK with people with intellectual disabilities presenting with problem behaviours are described. In Canada there are no national, provincial or territorial policies or guidelines on use of psychotropic medication for the management of such behaviours. There are no requirements for physicians prescribing these medications to have training in the care of people with intellectual disabilities. Services for people with intellectual disabilities and behaviour problems in Canada appear to be more crisis‐reactive than those in the UK.

During the last few years the prevalence of autism and Autism Spectrum Disorder (ASD) has increased greatly. A recurring issue is the overlap and boundaries between Intellectual Developmental Disorder (IDD), ASD and Schizophrenia Spectrum Disorders (SSD). In clinical practice with people with IDD, the alternative or adjunctive diagnosis of ASD or SSD is particularly challenging. The purpose of this paper is to define the boundaries and overlapping clinical characteristics of IDD, ASD and SSD; highlight the most relevant differences in clinical presentation; and provide a clinical framework within which to recognize the impact of IDD and ASD in the diagnosis of SSD.

A systematic mapping of the international literature was conducted on the basis of the following questions: first, what are considered to be core and overlapping aspects of IDD, ASD and SSD; second, what are the main issues in clinical practice; and third, can key diagnostic flags be identified to assist in differentiating between the three diagnostic categories?

Crucial clinical aspects for the differentiation resulted to be age of onset, interest towards others, main positive symptoms, and anatomical anomalies of the central nervous system. More robust diagnostic criteria and semeiological references are desirable.

The present literature mapping provides a comprehensive description of the most relevant differences in the clinical presentation of ASD and SSD in persons with IDD.

The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM) diagnostic criteria; the prevalence of reported autism spectrum disorders (ASD); and the extent to which assessment of developmental issues is central to the diagnosis of psychotic disorder, in patients discharged with a diagnosis of psychotic disorder and intellectual disabilities.

Of all patients discharged with psychotic disorder during a four‐year period (n=3339), chart reviews were completed on those also diagnosed with intellectual disability or borderline IQ.

The findings if this paper are threefold: only 39 percent of the 41 individuals discharged with a diagnosis of psychotic disorder and intellectual disability met documented DSM criteria for intellectual disability; the prevalence of reported ASD was much lower than expected; and the average number of different discharge diagnoses per individual over time was 4.8. Schizophrenia diagnoses were made early in the diagnostic process and tended to persist even when ASD concerns were documented.

The results support the need to systematically assess the developmental issues of patients with intellectual disability as part of the psychiatric diagnostic formulation. Differential diagnoses of psychotic‐like behaviours seen in people with intellectual disability, and alternative frameworks for understanding these behaviours, which in turn should guide more effective interventions and treatment, are discussed.

To examine the literature on employee morale and to construct a model of this area pertaining to nurses. This framework seeks to present morale in a holistic manner, illustrating the causal factors that influence nursing morale, the changes that occur in morale when these input variables are altered, and the consequences to patient care and individual and group nursing practices.

A number of published works on morale, its causal factors and resulting consequences are critiqued. The findings from this literature review are used to develop a framework for nursing morale.

The paper presents a definition of morale and, from the literature review, concludes that previous models on morale are fragmented; only tending to explore the variables that influence the employees' emotional state. Consequently, a framework of nursing morale is constructed in order to illustrate this topic from a holistic point‐of‐view.

The paper concludes with a number of management and research implications. The management implications consist of a number of useful suggestions for senior nurses to enhance the morale within their units.

This paper fulfils an identified gap in the literature, namely the lack of a holistic model of nursing morale, and offers practical help to senior nurses so that they can initiate processes within their wards that can improve their subordinates' morale.

DURING much of the Second World War, the affairs of the Library Association were conducted for the Council by an Emergency Committee. The record of its meeting on 10th June 1941, includes the following: “A resolution having been received suggesting that a committee be formed to consider post‐war reconstruction, it was resolved that by means of a notice in the LIBRARY ASSOCIATION RECORD, Branches and Sections should be invited to formulate suggestions for the consideration of the committee. A draft questionnaire for the purpose of an enquiry into the effects of the war on the public library service was approved”. In July, the Committee reported “further arrangements … for carrying out an exhaustive survey designed to give the necessary data for full and detailed consideration and ultimate recommendation as to the future of public libraries, their administration and their place in the social services”. The promised notice appeared as an editorial in September.

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.

More and more organisations are using teams to solve problems, plan for the future and improve products, processes and services. One method of enhancing group effectiveness is to use a facilitator. Facilitators, however, need to be trained in order to accomplish their role effectively. This can only be achieved successfully if trainers are aware of the competencies and skills needed to undertake the facilitation process. Explores the facilitation process and presents both the general and specific competencies that are essential for facilitation. General competencies are those that are vital no matter what type of group is meeting. Specific competencies, on the other hand, are those that are distinctive to the level of group development. Groups that are highly experienced and well‐developed will require the facilitator to have more sophisticated skills than groups that are less‐developed.