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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 article seeks to provide a fresh perspective on the methodological approach to studying caregiving in a transnational context by analysing, local caregiver’s lifeworld, informal interpreting/translation and professional communication with foreign retirees.

This project explores the complex and multifaceted meanings of everyday objects through diffractive vignettes to illuminate the communicative entanglements that arise between caregivers and foreign retirees receiving care in Thailand. To identify intra-actions in caregiving, we collected data through informal interviews, observations and various artefacts before combining them in a group of potential communicative relationships by creating a narrative summary of situations.

Communicative relationships in the vignettes are multidimensional, with diverse logics underlying choices, rapport formation and communication effectiveness. This premise also illuminates how caregivers perceive and intra-act with their accommodation strategies, considering trust, comfort and comprehension. Our findings were also discussed with the concept of communication accommodation theory.

As an extension of the post-humanist approach to the diffractive reading of vignettes, this study sees its value in studying agent-related informal translation/interpreting and human-to-human relationships.