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This paper examines how developmental risk factors associated with depression in typically developing adolescents may interact with the particular life experience of…
This paper examines how developmental risk factors associated with depression in typically developing adolescents may interact with the particular life experience of adolescents with intellectual disabilities and influence vulnerability to depression. We suggest that a consideration of developmental factors and their interaction with the person's social environment may offer a possible framework for prevention and early intervention with adolescents with intellectual disabilities.
The Improving Access to Psychological Therapies (IAPT) programme was established to treat people with mild to moderate depression and anxiety and bring them to recovery…
The Improving Access to Psychological Therapies (IAPT) programme was established to treat people with mild to moderate depression and anxiety and bring them to recovery. Although the Positive Practice Guide for people with intellectual disabilities was published in 2009, no geographical areas are listed as having a special interest in specifically rolling out IAPT to people with intellectual disabilities. Issues related to whether current IAPT services can meet the needs of people with intellectual disabilities are considered, along with adaptations that would be needed to ensure the service is accessible and meets the needs of people with intellectual disabilities.
It is increasingly recognised that people with intellectual disabilities have poorer access to health care. One of the recommendations from the independent report…
It is increasingly recognised that people with intellectual disabilities have poorer access to health care. One of the recommendations from the independent report, Healthcare for All is compulsory undergraduate medical teaching about people with intellectual disabilities. The purpose of this paper is to investigate the attitudes of medical students towards people with intellectual disabilities. The authors hypothesised that knowledge and attitude will change over the course of a 14‐week Neurosciences block, which included a taught intellectual disabilities module and opportunity to undertake a clinical placement.
The authors conducted a naturalistic prospective study in a London university. Data were collected at the beginning and the end of each of the three 14‐week Neurosciences blocks during the year. Attitude was measured using a self‐report questionnaire, including an amended short form of the Community Living Attitudes Scale (CLAS), administered in hard and e‐copy.
In total 136 medical students (35 per cent response rate) completed the questionnaire at the beginning and 133 (34 per cent response rate) at the end of the block. By the end of the block, students had increased knowledge of the definition of intellectual disability. Medical students showed generally favourable attitudes towards people with intellectual disabilities but there was no significant change in attitude between the start and end of the block.
This study shows that didactic teaching and limited exposure to people with intellectual disabilities, although it increases knowledge, is not enough to affect the kind of changes required to improve attitude. Increased face to face contact with people with intellectual disabilities and other innovative teaching methods are more likely to influence attitude in future medical practitioners. These will require further evaluation.
Patients who have intellectual disability and mental illness will occasionally need inpatient treatment. However, research is sparse on psychosocial factors influencing…
Patients who have intellectual disability and mental illness will occasionally need inpatient treatment. However, research is sparse on psychosocial factors influencing psychiatric units for patients with intellectual disabilities. The aim of this study is to examine whether adults with intellectual disabilities can reliably rate the Ward Atmosphere Scale – Real Ward (WAS‐R).
A total of 17 patients with mild and moderate intellectual disability and 21 staff members were asked to complete the WAS‐R. The authors used six subscales (involvement, support, practical orientation, order and organisation, angry and aggressive behaviour, and staff control) that have proved to be of major importance for patient satisfaction and treatment outcome to measure the patients' and the staff members' perceptions of the treatment milieu. To examine the internal consistency Cronbach's alpha was calculated for the patient and staff scores, respectively.
A total of 16 patients completed the form. Patients with mild intellectual disabilities were able to answer the WAS with some help, whereas patients with moderate intellectual disabilities had major difficulties with understanding more than half of the WAS items. These difficulties were also reflected in the internal consistency scores. Cronbach's alpha was satisfactory (≥0.50) for five subscales for patients with mild intellectual disabilities, but only satisfactory for two of the six subscales for patients with moderate intellectual disabilities.
A replication study should use a shorter version of the WAS‐R, and family or caregivers should answer the WAS‐R additionally to the patients.
This study may encourage more research on treatment milieu for patients with intellectual disability and mental illness.
Children and young people with an intellectual disability (referred to in this article as young people) have a higher incidence of mental illness and challenging behaviour…
Children and young people with an intellectual disability (referred to in this article as young people) have a higher incidence of mental illness and challenging behaviour than individuals without cognitive impairment. Inpatient assessment and treatment in a learning disability‐specific provision rather than mainstream inpatient child and adolescent mental health services (CAMHS) is most beneficial for those young people who experience a more severe intellectual disability or whose presenting complaint is challenging behaviour not associated with a co‐morbid mental illness. Assessment and treatment of this complex group of young people can only be successful if the services which manage them have access to a highly experienced and comprehensive multidisciplinary team. Admission is only worthwhile if recommendations that arise from the assessment can be transferred to the community and those involved in supporting the young person are motivated to work in collaboration with the inpatient team.
According to international conventions and UK government policy, parents with intellectual disability have a right to have children and should have access to support to…
According to international conventions and UK government policy, parents with intellectual disability have a right to have children and should have access to support to help them bring them up successfully. Government good practice guidance sets out what form that support should take, but in practice parents with intellectual disability are still disproportionately at risk of having their children taken from them. This article reviews the challenges parents face in holding on to their children and the support they need, both from professionals and from the wider extended family where appropriate. The importance of having access to independent advocacy, especially in child protection or court proceedings is highlighted; such advocacy is not widely available, despite recent policy commitments in this area.
It has been suggested that the emotional needs of people with intellectual disabilities have been neglected (Kroese, 1998). More recently there has been evidence of…
It has been suggested that the emotional needs of people with intellectual disabilities have been neglected (Kroese, 1998). More recently there has been evidence of increased clinical and research activity in this area (Beail, 2003; Bouras & Holt, 2007; Foundation for People with Learning Disabilities, 2004). Currently much of the focus in this area is on mental ill‐health. This article will consider briefly the literature on mental ill‐health, with particular emphasis on the development of individual treatment approaches. From this discussion it will be evident that much of the research and theory in this area focuses on deficits and disadvantage. I will go on to suggest that a clinical and research focus that explores strengths and resilience will offer a more positive agenda for developing understanding of emotional well‐being and mental ill‐health in people with intellectual disabilities.
The study explored the relationship between self and informant reports of emotional problems in a forensic intellectual disability sample. The Emotional Problems Scales…
The study explored the relationship between self and informant reports of emotional problems in a forensic intellectual disability sample. The Emotional Problems Scales (EPS) (Prout & Strohmer, 1991), which comprises a Self Report Inventory (EPS‐SRI) and an informant Behaviour Rating Scale (EPS‐BRS), was routinely administered to 30 individuals with intellectual disability in a secure forensic setting, as part of a standard clinical assessment procedure. It was hypothesised that there would be a moderate relationship between corresponding scores on the EPS‐SRI and EPS‐BRS. However, there were no significant relationships between corresponding scales of the EPS‐SRI and EPS‐BRS, apart from the EPS‐SRI and EPS‐BRS scales measuring anxiety (r = .376, p<.05). The results continued to be non‐significant, even when positive impression management was controlled for. The findings suggest little relationship between self and informant ratings in a forensic intellectual disability sample, and therefore support the need to gather information from multiple sources when assessing such individuals.
The aim of this paper is to gather information that will be useful to practitioners who are assessing and trying to understand the difficulties of people with intellectual…
The aim of this paper is to gather information that will be useful to practitioners who are assessing and trying to understand the difficulties of people with intellectual disabilities who may have experienced sexual abuse. In the first part of this paper the research into the effects of sexual abuse on people with learning disability is reviewed. In the second part of this paper, the major clinical implications of these findings are explored. These include the implications for abuse evaluations, identification of individuals at increased risk of disturbance, implications for treatment and provision of psychotherapeutic services.
This chapter traces the history of intellectual disabilities by exploring significant historical periods and personalities who impacted the disability field and…
This chapter traces the history of intellectual disabilities by exploring significant historical periods and personalities who impacted the disability field and specifically the area of intellectual disability. Like other documented histories, the purpose of this chapter is to instruct and inform readers about the historical underpinnings of the labels, practices, and programs related to intellectual disability that are in effect today. While this chapter is not intended to be prescriptive in how the information presented here is to be interpreted, we are acutely aware that historical accounts are often interpreted based upon contemporary ideologies, knowledge, and practices. As such, as a historical account, this chapter is no exception. Current belief and practices about intellectual disabilities indeed influence the choices that, we as the chapter authors, made about the relative importance of the events that we select to highlight in this chapter. Nonetheless, this account reflects the events and personalities who, in our estimation, transformed and/or advanced the field of intellectual disability. We open with a brief prologue of the representations of the intellectual disability in popular culture and its potential impact on perceptions of persons with intellectual disability.