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Modern healthcare services are commonly based on shared models of care, in which a strong emphasis is placed upon the views of those in receipt of services. The purpose of this paper is to examine the parents’ experiences of their child’s neuropsychological assessment.

This was a mixed-methodology study employing both quantitative and qualitative measures.

The questionnaire measure indicated a high overall level of satisfaction. Qualitative analysis of parental interviews provided a richer insight into the parental experience and indicated four major themes.

Implications covered three major areas. Firstly, whilst a high value was placed upon the assessment, the need for further comprehensive neurorehabilitation and intervention was highlighted. Secondly, this study highlights the significant adversity experienced by such families and subsequent unmet psychological needs which also require consideration. Finally, findings from the current study could assist in improving future measures of satisfaction in similar services.

This is the first published study of parental experiences of and satisfaction with paediatric neuropsychological assessment in the UK.

In accordance with the Mental Capacity Act 2005, this paper aims to explore the steps taken to maximise an individual's ability to make decisions in regards to making a Will.

Concepts relating to testamentary capacity are discussed and assessed thematically.

The case work illustrates how a systematic, structured, evidence‐based and individually focused approach to assessing and optimising capacity (under the terms of the Mental Capacity Act 2005) can be effective.

The paper sets out a framework for maximising capacity for decision making.

A significant number of people held within the secure forensic hospital estate in this country suffer from neuropsychological deficits (e.g. Lowings, 2010; Williams et al., 2010). These deficits, many of them cognitive, have a detrimental impact on patient's abilities to benefit from psycho-educational materials thereby slowing the progress of their rehabilitation. Understanding these difficulties enables interventions to be more effectively targeted and facilitated to the patients’ cognitive strengths. It was against the backdrop of the evidence that a review was commissioned into neuropsychological activity at Rampton Hospital.

The review of the neuropsychological assessment activity was confined to the male patients residing within Mental Health Services (MHS) and the National High Secure Learning Disability Service (NHSLDS) of the hospital. With regards to the MHS, 129 patient files were examined in order to identify the volume of neuropsychological assessment previously undertaken and the make up of the neuropsychological test batteries administered with the current patient group. With regard to the NHSLDS 48 files were similarly examined. In addition, MHS psychologists were surveyed to assess their knowledge of patients within that service who to their knowledge had previously suffered an acquired brain injury (ABI) or had suffered a significant neurological illness likely to have resulted in cognitive impairment.

A scoping exercise identified that a significant amount of neuropsychological assessment was being undertaken, albeit in an unstructured way. This led to a number of patients being subjected to a significant delay before the need for neuropsychological testing and rehabilitation possibilities became apparent. There was a huge variance on when a patient was tested ranging from one month to 14 years and the size of the test battery used, with the number of tests conducted per patient ranging between one single test to 16 tests during a patients stay at the hospital.

Opportunities to more appropriately place patients based upon their abilities could be achieved if the hospital were to adopt a policy of conducting neuropsychological assessments, including cognitive functioning, for all patients upon admission to the hospital. A proportion of patients were known to have had a ABI or a significant illness likely to have resulted in cognitive impairment. This was considered to be an underrepresentation and the taking of a thorough history specifically covering ABI and specific illnesses known to have an impact on cognitive ability and behaviour was also recommended.

In light of this review, services are to take a more systematic approach to assessing neuropsychological difficulties. Consideration is being given to neuropsychological screening becoming part of the admission process.

Senior individuals are far more commonly the victims of aggression than the perpetrators, but a small minority of older adults do commit crimes. This paper describes the case of a male older adult who battered his wife to death and presented with amnesia about the attack. It describes the neuropsychological, risk and personality assessment procedures adopted to assess functioning, evaluate risk of re‐offending and formulate about the offence. It proposes formulations for the offence and illustrates the treatment provided to ameliorate distress and enhance memories of what had taken place. Finally it highlights areas for future research and service development. With a growing older adult population, the need for specialist assessment and risk management of older adults who offend is likely to increase, so more resources should be allocated to meeting the needs of such individuals.

This paper aims to summarise key models of the neuropsychology of memory function, illustrating how they can be used to inform the assessment and formulation of memory disorders in clinical practice.

Models of short term and working memory, long-term memory and prospective memory are described. Commonly used tools and methods to assess these functions in adults are summarised.

It is argued that a clearer understanding of models of memory function adds value to the process of cognitive assessment, guiding the selection of appropriate tests and aiding diagnosis, formulation and rehabilitation planning.

This paper is intended to serve as a resource for professionals who encounter memory disorders in their clinical practice.

Hyperfocus (HF) is characterised by an intense state of concentration/focus. The purpose of this study is to explore in what ways HF has been found to contribute towards offending behaviour and what treatments have been found to be efficacious to reduce offending behaviour where HF was a contributing factor.

The systematic review was performed according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Papers were screened for quality appraisal and risk of bias. The initial search yielded 9,446 articles. Fifty-seven papers were deemed as meeting the inclusion criteria.

HF was noted to act as a vulnerability factor for aggression, sexual offending, radicalisation and stalking. HF was also observed in clients with psychopathy, autism, mental illness and those without a diagnosis. Thus, HF was not found to be offence or diagnosis specific. Furthermore, HF was found across males and females and adults and adolescents. The results identified themes in relation to the mechanisms by which HF may contribute to offending and suggested interventions for HF and offending.

Practitioners working with clients with HF currently lack evidence on the extent to which this contributes towards offending and recidivism and how HF could be addressed in interventions. Future research is needed to establish the role of HF in offending behaviour. Ideally, this should involve longitudinal data collection, retrospective analysis of data and sophisticated statistical analysis. This should also include exploration of the ways in which HF may be interconnected with offence risks/need factors which contribute towards offending. Research could inform the development of formal measurement tools for HF which are validated with norms for adult and adolescent offender samples. Practitioners should use case formulation to explore if HF represents a treatment need for clients they are working with.

This review noted that although HF has been postulated as being an important contributing factor to offending behaviour, few studies have tested this directly. From the limited studies available, HF was found to be relevant across different types of offences. HF was noted to contribute to offending due to neuropsychological mechanisms linked to executive functioning deficits and positive rewards associated with offending behaviour. Reasons for the lack of HF research are noted and recommendations for future research are discussed.

Needs of people following acquired brain injury vary over their life-course presenting challenges for community services, especially for those with “hidden” neuropsychological needs. Characterisation of subtypes of rehabilitation service user may help improve service design towards optimal targeting of resources. This paper aims to characterise a neuropsychologically complex group of service users.

Preliminary data from 35 participants accepted for a holistic neuropsychological rehabilitation day programme were subject to cluster analysis using self-ratings of mood, executive function and brain injury symptomatology.

Analysis identified three clusters significantly differentiated in terms of symptom severity (Cluster 1 least and Cluster 2 most severe), self-esteem (Clusters 2 and 3 low self-esteem) and mood (Cluster 2 more anxious and depressed). The three clusters were then compared on characteristics including age at injury, type of injury, chronicity of problems, presence of pre-injury problems and completion of rehabilitation. Cluster 2 were significantly younger at time of injury, and all had head injury.

Results suggest different subgroups of neuropsychological rehabilitation service user, highlighting the importance of early identification and provision of rehabilitation to prevent deterioration, especially for those injured when young. Implications for design of, and research into, community rehabilitation service design for those with “hidden disability” are considered.

The paper findings suggests that innovative conceptual frameworks for understanding potentially complex longer term outcomes are required to enable development of tools for triaging and efficient allocation of community service resources.

The purpose of this paper is to explore to what extent neuro-typical theories of sexual offending apply to clients with Levels 2 and 3 autism with a co-morbid intellectual disability (ID). The paper develops a model of harmful sexual behaviour (HSB) for this client group and makes suggestions for how these behaviours can be understood and reduced.

The revised Integrated Theory of Sexual Offending (ITSO) (Ward and Beech, 2016) is used as a starting framework to understand HSB in this client group. This attends to specific neuropsychological systems, brain development, motivation and emotional processing.

The revised ITSO has some utility in understanding HSB in this client group. This is improved when neuro-atypical specific state factors are identified. Practical ways of establishing these state factors are made which attend to the function of the behaviour in line with “Good Lives” model of rehabilitation.

Recommendations for ways in which the function of HSB in this client group can be identified are made as well as recommendations for how treatment can be tailored dependent on the function of behaviour in this client group.

The paper makes practical recommendations for how interventions for people with ID and autism in line with Ward, Clack and Haig’s (2016) Abductive Theory of Method which noted that interventions should be adopted to consider wider explanations for offending thus acknowledging that treatment could extend beyond cognitive behavioural therapy for clinical phenomena. Future treatments for clients with autism and LD are suggested which attend to sensory needs, teaching alternative communication strategies for seeking out “deep pressure” or attention in ways that do not involve sexual offending, using picture communication, information technology or Makaton to communicate needs or using social stories to explain the consequences of behaviour. In addition, neuro-atypical interventions which attend to the neuropsychological functioning of clients could also be included in treatment for neuro-typical clients, thus ensuring that interventions attend to every aspect of the ITSO and not purely clinical phenomena.

Enhancing treatment interventions for clients with ID and autism could both reduce risk and enhance quality of life for this client group.

Much of the work to date exploring HSB in clients with autism has attended to clients with Level 1 autism or those without an additional ID. This paper provides practitioners with a theory upon which to understand HSB in clients with a dual diagnosis of Levels 2/3 autism and an ID as well as practical recommendations for reducing HSB in this client group.

Feynman's claim that a positron is an electron moving backwards in time implies a paradox. The purpose of this paper (Part I of II) is to prevent the contradiction in physics due to this paradox.

Both physical considerations and neuropsychological considerations are applied.

The physical considerations imply that assuming multidimensionality of time prevents Feynman's paradox and additional physical paradoxes. This multidimensionality in explained by neuropsychological considerations.

A suggested method of obtaining unlimited quantity of clean energy based on the principle of annihilating matter and antimatter is presented in Part II.

This theory is entirely new. Its approach is different from that of other approaches to the multidimensionality of time.

The purpose of this paper is to examine the role of a variety of developmental factors on sexual homicide offenders (SHOs), while taking into account other components of sexual homicide theoretical models.

A series of logistic regression models are performed using a total of 616 incarcerated adult male sexual offenders from Canada to distinguish between three groups of sexual offenders, SHOs, violent non-homicidal sex offenders (NHSOs) and NHSOs.

Results indicate that contrary to theoretical models, experiences of victimization are not central to the development of SHOs. Instead, it is the adoption of various problematic behaviors in childhood that appear as most important in the etiology of this particular type of sexual crime. This suggests that the various existing theoretical models of sexual homicide need to be revised and/or tested with additional empirical data.

This is the first study to look at developmental factors using two control groups of NHSOs and violent NHSOs.