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The purpose of this paper is to illustrate an interdisciplinary system of targeted student supports, drawing from social and emotional learning (SEL), culturally responsive practices (CRP) and positive behavioral interventions and supports (PBIS). While these approaches are not often synthesized in research literature, innovative educators are integrating multiple theories and practices to achieve better outcomes for students.

The paper uses a descriptive, participatory case study method, including quantitative and qualitative data from a three-year period. The author was a participant in the change process, as well as an observer documenting the outcomes. The case study takes place in a Spanish/English bilingual elementary school.

PBIS was a strong influence in the three-year systems change process, due in part to the availability of free, research-based tools. The educators adapted PBIS practices to incorporate SEL, and CRP approaches in several instances. Quantitative data show the increase in PBIS implementation fidelity and one student’s progress with a targeted intervention. Qualitative data illustrate the creative, interdisciplinary and contextualized adaptations made by the team.

Guidance is available for educators seeking to implement SEL, CRP and/or PBIS approaches in isolation. To a lesser extent, integrated models are emerging in the literature. There is a need for more descriptive, real-world case examples of how these approaches are implemented and adapted in practice. This study provides educators with one example that can offer examples and implications for practice.

The purpose of the study was to examine whether there were differences in the provision of non-pharmacological interventions based on the level of intellectual disability and the presence or absence of autism. Mental health conditions are often underdiagnosed in adults with intellectual disability and do not always receive psychological interventions as recommended by the National Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of stopping the overuse of medications in people with intellectual disability, it is important that these individuals have access to appropriate non-pharmacological interventions. The authors examined the relationship between an individual’s level of intellectual disability and the presence or absence of autism with access to relevant non-pharmacological interventions from specialist community intellectual disability services.

A cross-sectional study of adults accessing four specialist intellectual disability services in North West England in 2019.

There was a high prevalence of mental health comorbidity, even higher for autistic adults. However, a relatively small percentage of the study population was receiving psychological interventions. The most frequent non-pharmacological intervention was a positive behaviour support plan, irrespective of comorbid mental illnesses.

Not having access to psychological interventions for the treatment of mental illness could result in poor health outcomes and increasing health inequalities. The study highlights the need for developing psychological interventions, particularly for those with moderate to severe intellectual disability and for those with associated autism.

This large sample study examined the relationship between intellectual disability level and the presence of autism with accessing psychological interventions.

This study aims to understand whether psychotropic prescribing practices for people with intellectual disabilities are in keeping with best practice guidelines.

This service evaluation project was a retrospective analysis of routinely collected data from the care records of all 36 people with intellectual disability discharged from an intellectual disability assessment and treatment unit during the first five years of the Stop Over medicating People with Intellectual Disabilities and/or autistic people (STOMP) initiative. Data were gathered at four time points (pre-admission, discharge, 6- and 12-month follow-up) before being analysed to understand whether psychotropic prescribing differed among people with different clinical characteristics/traits/diagnoses. Changes over time were also explored to ascertain whether and how prescribing altered from admission to discharge, and over the subsequent year of community living.

Most people with intellectual disabilities left the assessment and treatment unit on fewer regular psychotropic medications and at lower doses than at admission. These optimised regimes were still apparent 12 months post-discharge, suggesting effective discharge planning and community care packages. Inpatients with severe intellectual disabilities generally received more anxiolytics and hypnotics, at higher doses. Autistic people tended to receive more psychotropics in total and at higher cumulative doses, a pattern that persisted post discharge. A third of the sample were admitted on regular anti-psychotic medications despite having no corresponding psychotic diagnosis, a proportion that remained relatively stable through discharge and into the community.

This study highlights subsets of the intellectual disability population at particular risk of receiving high doses of psychotropics and a feasible template for providers intending to undertake STOMP-focused evaluations.