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Article
Publication date: 13 August 2021

Eddie Chaplin, Amina Rawat, Bhathika Perera, Jane McCarthy, Ken Courtenay, Andrew Forrester, Susan Young, Hannah Hayward, Jess Sabet, Lisa Underwood, Richard Mills, Philip Asherson and Declan Murphy

This paper aims to examine effective diagnostic and treatment pathways for attention deficit hyperactivity disorder (ADHD) in prison settings given the high prevalence of…

Abstract

Purpose

This paper aims to examine effective diagnostic and treatment pathways for attention deficit hyperactivity disorder (ADHD) in prison settings given the high prevalence of ADHD and comorbidities in the prison population.

Design/methodology/approach

Two studies were carried out in two separate prisons in London. Firstly, data were collected to understand the prevalence of ADHD and the comorbidities. The second study used quality improvement (QI) methodology to assess the impact of a diagnostic and treatment pathway for prisoners with ADHD.

Findings

Of the prisoners, 22.5% met the diagnostic criteria for ADHD. Nearly half of them were screened positive for autistic traits, with a higher prevalence of mental disorders among prisoners with ADHD compared to those without. The QI project led to a significant increase in the number of prisoners identified as requiring ADHD assessment but a modest increase in the number of prisoners diagnosed or treated for ADHD.

Originality/value

Despite various challenges, an ADHD diagnostic and treatment pathway was set up in a prison using adapted QI methodology. Further research is needed to explore the feasibility of routine screening for ADHD in prison and examine at a national level the effectiveness of current ADHD prison pathways.

Details

International Journal of Prisoner Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1744-9200

Keywords

Content available

Abstract

Details

Advances in Autism, vol. 2 no. 2
Type: Research Article
ISSN: 2056-3868

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Article
Publication date: 4 April 2016

Lisa Underwood

The purpose of this paper is to provide a brief, descriptive overview of Tuberous Sclerosis Complex (TSC) research with particular reference to studies on Autism Spectrum…

Abstract

Purpose

The purpose of this paper is to provide a brief, descriptive overview of Tuberous Sclerosis Complex (TSC) research with particular reference to studies on Autism Spectrum Disorder (ASD).

Design/methodology/approach

A search of electronic databases was carried out to identify English language articles on TSC. The literature was explored in more detail with a focus on neurodevelopmental disorders associated with TSC such as ASD.

Findings

The review included 3,679 references. The earliest articles identified were published in the early twentieth century. Since then research on TSC has advanced rapidly and is being carried out worldwide. Just 62 studies have focused on ASD in TSC, although the number of publications is increasing over time.

Research limitations/implications

More research on ASD in TSC is needed to benefit those affected by TSC and the broader ASD scientific community.

Practical implications

Practitioners working with children and adults with ASD should be aware of the wider health issues experienced by those with genetic conditions such as TSC. Similarly, clinicians working with those who have TSC should be aware of the high prevalence of ASD in the group and implications for the way they work with their patients.

Originality/value

This is the first paper to map and characterise the scientific literature on TSC. There remains a focus on the biomedical aspects of TSC with fewer studies on psychosocial/educational or family impacts. The review concludes with recommended research questions for the future.

Details

Advances in Autism, vol. 2 no. 2
Type: Research Article
ISSN: 2056-3868

Keywords

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Article
Publication date: 7 September 2015

Lisa Underwood, Jane McCarthy, Eddie Chaplin and Marco O. Bertelli

Adults with autism spectrum disorder (ASD) present with a range of psychiatric disorders. However, making an accurate diagnosis is challenging. It is important to follow a…

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Abstract

Purpose

Adults with autism spectrum disorder (ASD) present with a range of psychiatric disorders. However, making an accurate diagnosis is challenging. It is important to follow a robust and informed process in the assessment of psychopathology that is centred on the individual and their neurodevelopmental difficulties. The purpose of this paper is to provide clinicians with an evidence-based approach to the assessment process for adults with ASD presenting with a possible co-occurrent psychiatric disorder.

Design/methodology/approach

A review of the recent literature was undertaken focusing on key papers that describe the assessment of mental health problems in adults with ASD.

Findings

The presentation of psychiatric symptoms is influenced by the underlying developmental disorder and it is often quite different from the one of the general population. Thus, it is essential to undertake a comprehensive psychopathological assessment including a diagnostic assessment of ASD. There is a very small evidence base on the use of diagnostic tools in the assessment of adults with ASD.

Originality/value

This is a practice review paper applying recent evidence from the literature.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 9 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

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Article
Publication date: 4 July 2016

Lisa Underwood, Jane McCarthy, Eddie Chaplin, Andrew Forrester, Richard Mills and Declan Murphy

The purpose of this paper is to determine the extent of autism spectrum disorder (ASD) traits among prisoners. The authors tested the hypotheses that ASD traits would: be…

Abstract

Purpose

The purpose of this paper is to determine the extent of autism spectrum disorder (ASD) traits among prisoners. The authors tested the hypotheses that ASD traits would: be continuously distributed among prisoners; be unrecognised by prison staff; and predict whether a prisoner met diagnostic criteria for ASD.

Design/methodology/approach

ASD traits were measured among 240 prisoners in a male prison in London, UK using the 20-item Autism Quotient (AQ-20). Further diagnostic assessment was carried out using the Autism Diagnostic Observation Schedule. Results were compared with ASD data from the 2007 Psychiatric Morbidity Survey.

Findings

There were 39 participants with an AQ-20 score=10; indicating significant autistic traits. The distribution of ASD traits among participants appeared to be normal and was not significantly higher than the rate found in a population-based sample from England.

Originality/value

Few studies have explored ASD traits among prisoners. The authors identified high levels of unrecognised ASD traits among a group of male prisoners, many of whom went on to meet diagnostic criteria for ASD. The study highlights the need for specialist assessment within the criminal justice system for individuals with neurodevelopmental disorders including ASD. The authors discuss the process of carrying out an ASD assessment project in a prison.

Details

Advances in Autism, vol. 2 no. 3
Type: Research Article
ISSN: 2056-3868

Keywords

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Article
Publication date: 23 September 2009

Colin Hemmings, Lisa Underwood and Nick Bouras

Three separate focus groups were conducted to compare the views of service users, carers and specialist health professionals on community services for adults with…

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198

Abstract

Three separate focus groups were conducted to compare the views of service users, carers and specialist health professionals on community services for adults with psychosis and learning disabilities. Participants were asked which staff, treatments or interventions and methods of working or style of service organisation make a significant contribution to helping people with psychosis and learning disabilities. Although there were few direct contradictions or conflicts between the three groups, the priorities of service users, carers and professionals often differed. Development of community services for adults with psychosis and learning disabilities should incorporate the views of service users and their carers as well as clinicians.

Details

Advances in Mental Health and Learning Disabilities, vol. 3 no. 3
Type: Research Article
ISSN: 1753-0180

Keywords

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Article
Publication date: 9 June 2015

Jane McCarthy, Eddie Chaplin, Lisa Underwood, Andrew Forrester, Hannah Hayward, Jessica Sabet, Susan Young, Philip Asherson, Richard Mills and Declan Murphy

The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and…

Abstract

Purpose

The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID).

Design/methodology/approach

The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test.

Findings

Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study.

Originality/value

The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 6 no. 2
Type: Research Article
ISSN: 2050-8824

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Article
Publication date: 30 July 2015

Tanja Sappok, Manuel Heinrich and Lisa Underwood

Diagnosing autism spectrum disorder (ASD) is important over the whole life span. Standardized instruments may support the assessment process. The purpose of this paper is…

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4023

Abstract

Purpose

Diagnosing autism spectrum disorder (ASD) is important over the whole life span. Standardized instruments may support the assessment process. The purpose of this paper is to describe English- and German-screening tools for ASD.

Design/methodology/approach

PubMed was used to search for published tools and evidence on their diagnostic validity.

Findings

Searches identified 46 screening tools for ASD. Most are designed for children, while only few measures are available for adults, especially those with additional intellectual disabilities. Many instruments are under-researched, although a small number such as the Modified Checklist for Autism in Toddlers and the SCQ have been widely examined in a variety of populations.

Originality/value

The study identified and described a number of ASD screeners that can support clinicians or researchers when deciding whether to carry out a more comprehensive ASD assessment.

Details

Advances in Autism, vol. 1 no. 1
Type: Research Article
ISSN: 2056-3868

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Article
Publication date: 29 October 2015

Jessica Sabet, Lisa Underwood, Eddie Chaplin, Hannah Hayward and Jane McCarthy

A wealth of research on autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD) has led to increased understanding and identification of each…

Abstract

Purpose

A wealth of research on autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD) has led to increased understanding and identification of each of these developmental disorders. Existing literature has sparked controversial discussions regarding whether aspects of ASD and ADHD predispose individuals to criminality. The purpose of this paper is to explore the link between these conditions and offending.

Design/methodology/approach

A review of the literature on ASD, ADHD and offending was undertaken. This paper looks at the particular focus of the literature on the involvement of individuals with ADHD and ASD within the criminal justice system.

Findings

There is some evidence of a link between ADHD and criminality. However, the relationship between ASD and offending is a little more difficult to ascertain. Complicating this further is the relatively unexplored subject of comorbid ASD/ADHD and criminal behaviour. This paper found that additional cognitive deficits and conduct problems are associated with comorbid ASD/ADHD, highlighting the need for further research and development of interventions.

Originality/value

This paper seeks to examine whether predictions can be made with regards to what offending behaviour may look like in an individual with comorbid ASD/ADHD. This paper reviews the literature on offending in relation to both disorders to examine whether predictions can be made with regards to what the offending behaviour of an individual with ASD and ADHD may look like.

Details

Advances in Autism, vol. 1 no. 2
Type: Research Article
ISSN: 2056-3868

Keywords

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Article
Publication date: 1 January 2013

Eddie Chaplin, Jane McCarthy and Lisa Underwood

The purpose of this paper is to offer an overview of the issues from studies that have tried to estimate rates of offending.

Abstract

Purpose

The purpose of this paper is to offer an overview of the issues from studies that have tried to estimate rates of offending.

Design/methodology/approach

Brief review.

Findings

There is currently no consensus on the prevalence of people with autism spectrum conditions who offend, due to the limited evidence base. It is also difficult to generalise findings across the criminal justice system and secure services.

Originality/value

This paper brings together a summary of key studies that have estimated the numbers of offenders with autism spectrum conditions over the last 30 years.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 4 no. 1/2
Type: Research Article
ISSN: 2050-8824

Keywords

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