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This paper aims to discuss the utility of eye movement desensitization and reprocessing (EMDR) therapy as a treatment for children with intellectual disabilities (ID) who have experienced trauma.

Relevant National Institute for Health and Care Excellence (NICE) guidance and literature were reviewed to provide support for the use of EMDR as a treatment for trauma in children with ID.

There is a growing body of evidence which demonstrates that EMDR therapy is successful for the treatment of trauma in adults and children. However, for children with ID, the research is limited despite those with ID being more likely than non-disabled peers to experience trauma such as abuse or neglect.

EMDR can only be facilitated by trained mental health nurses, psychiatrists, psychologists (clinical, forensic, counselling or educational) or occupational therapists or social workers with additional training. Finally, general practitioners who are experienced in psychotherapy or psychological trauma and have accreditation. Therefore, this highlights that there may be a lack of trained staff to facilitate this intervention and that those who are generally working with the client closely and long term such as learning disability nurses are not able to conduct this intervention.

This paper presents an account of NICE guidance and evidence of the efficacy of EMDR as a treatment for adults, children and those with ID.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.

There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.

Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.

This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.

Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.

It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.

Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.

Globally “non-urgent” health care services were ceased in response to the 2020 outbreak of COVID-19, until 2021, when restrictions were lifted. In the UK, this included speech and language therapy services. The implications of COVID-19 restrictions have not been explored. This study aimed to examine the impact of the UK’s COVID-19 response on speech and language therapy services.

An online survey of the practice of speech and language therapists (SLTs) in the UK was undertaken. This explored SLTs’ perceptions of the demand for their services at a time when COVID-19 restrictions had been lifted, compared with before the onset of the pandemic. The analysis was completed using descriptive statistics and content analysis.

Respondents were mostly employed by the UK’s National Health Service (NHS) or the private sector. Many participants reported that demands on their service had increased compared with before the onset of the pandemic. The need to address the backlog of cases arising from shutdowns was the main reason for this. Contributing factors included staffing issues and redeployment. Service users were consequently waiting longer for NHS therapy. Private therapy providers reported increased demand, which they directly attributed to these NHS challenges.

This presents the only focused account of the impact of the national response to COVID-19 on speech and language therapy services in the UK. It has been identified that services continue to face significant challenges, which indicate a two-tier system is emerging. Healthcare system leaders must work with service managers and clinicians to create solutions and prevent the system from being overwhelmed.

Although some architects have found spatial order and proportion strategy effective in designing the environment for autistic children, it is not clear what spatial ratios are preferred for autistic people. Therefore, this study aims to find the desired ratio among autistic and non-autistic children.

The scale model questionnaire was chosen to determine the difference in the ratio preferences for autistic and non-autistic children, whereas two access types between the space zones are also considered. The questionnaire was administered to 50 autistic children, with a half-and-half distribution of moderate and mild autism groups, while males are twofold. It was also administered to 50 non-autistic children, approximately equal in terms of gender division. The scale model was designed in the form of a dollhouse to be played with a doll in 6 varied rooms categorized by 3 different ratios (1:1, golden ratio, 1.6:1 and 5:2) and 2 access types (linear and radial access) to measure how many times each room was selected by each group to run numerical analysis.

It was shown that, although the golden ratio has been previously considered in space design for autistic children, they appealed to the ratio of 2:5 with high frequency. While there is a significant difference between the spatial ratios preferred by autistic and non-autistic children choosing the golden ratio, the same type of space access system is preferred by both groups in their results.

Despite the prevalent use of the golden ratio in design for autism design, this research shaped an empirical study for autistic users concluding a different perspective in design for autism.

By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.

TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.

There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.

Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.

To the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.

This study aims to offer a comprehensive exploration of the potential and challenges associated with sensor fusion-based virtual reality (VR) applications in the context of enhanced physical training. The main objective is to identify key advancements in sensor fusion technology, evaluate its application in VR systems and understand its impact on physical training.

The research initiates by providing context to the physical training environment in today’s technology-driven world, followed by an in-depth overview of VR. This overview includes a concise discussion on the advancements in sensor fusion technology and its application in VR systems for physical training. A systematic review of literature then follows, examining VR’s application in various facets of physical training: from exercise, skill development and technique enhancement to injury prevention, rehabilitation and psychological preparation.

Sensor fusion-based VR presents tangible advantages in the sphere of physical training, offering immersive experiences that could redefine traditional training methodologies. While the advantages are evident in domains such as exercise optimization, skill acquisition and mental preparation, challenges persist. The current research suggests there is a need for further studies to address these limitations to fully harness VR’s potential in physical training.

The integration of sensor fusion technology with VR in the domain of physical training remains a rapidly evolving field. Highlighting the advancements and challenges, this review makes a significant contribution by addressing gaps in knowledge and offering directions for future research.

The evolution and trends of special education and educational leadership are evident, especially in recent years. The former has strived to provide equitable educational opportunities to students with disabilities. The latter has dealt with how people in positions of authority in K-12 schools create policy, use resources, and influence other people to achieve educational goals. Together, these notions constitute an idea that school leaders and administrators can provide insight, oversight, assistance, and guidance toward creating educational environments for students with and without disabilities. This chapter examines the current state of special education and educational leadership by exploring the evolution of special education, relevant legal cases, and the enactment of inclusive education. Furthermore, this chapter addresses contemporary issues for leaders, such as the influence of the COVID-19 pandemic, while dealing with special education and the increasing pressure from families for equity for students with disabilities.

Acute and chronic obstructive pulmonary disease (COPD) is a common and progressive lung disease that makes breathing difficult over time and can even lead to death. Despite this, there is no definitive treatment for it yet. This study aims to evaluate the studies on single and combined herbal interventions affecting COPD.

In this study, all articles published in English up to 2020 were extracted from the Web of Science (WoS) database and collected using Boolean tools based on keywords, titles and abstracts. Finally, the data required for bibliographic analysis, such as the author(s), publication year, academic journal, institution, country of origin, institution, financial institution and keywords were extracted from the database.

A total of 573 articles were analyzed. The number of papers in the lung disease field showed an upward trend from 1984 to 2021, and there was a surge in paper publications in 2013. China, Korea and Brazil published the highest number of studies on COPD, and Chinese medical universities published the most papers. Three journals that received the highest scores in this study were the Journal of Ethnopharmacology, International Immunopharmacology and Plos One. In the cloud map, expression, activation and expression were the most frequently researched subjects. In the plus and author keywords, acute lung injury was the most commonly used word. Inflammation, expression of various genes, nitric oxide-dependent pathways, NFkappa B, TNFalpha and lipopolysaccharide-dependent pathways were the mechanisms underlying COPD. Scientometric analysis of COPD provides a vision for future research and policymaking.

This study aimed to evaluate the studies on single and combined herbal interventions affecting COPD.

Work-life challenges experienced by employees navigating pregnancy, maternity, and parenting young children are well documented in the literature. Correspondingly, work-life balance policies and provisions aimed at supporting affected staff are well established in many modern organizations. Within this agenda however, complications within maternity journeys, and specifically the intersection with mental health has been neglected. In this chapter, we consider the work-life issues associated with perinatal (pregnancy and post-birth) mental illness. After introducing perinatal mental illness, and its impact on individuals and families, we consider the two-way relationship between illness and work: how employment factors influence the development of perinatal mental illness and recovery trajectories, with implications for family life; and how such illnesses impact work and employment. We offer key insights from our empirical research on this topic in the context of UK policing, highlighting challenges linked to the nature of police work and organization culture, and issues that are more broadly applicable to how maternity and mental illness are treated in the workplace. The chapter offers recommendations for people management practice aimed at reducing or mitigating occupational factors that exacerbate illness and maximizing those facilitating recovery in the perinatal period and beyond, thus advancing work-life inclusion.