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Article
Publication date: 6 March 2023

Meredyth Goldberg Edelson

The purpose of this paper is to educate forensic interviewers about autism spectrum disorder (ASD) and tools for interviewing youth with ASD when there are concerns of child sexual

Abstract

Purpose

The purpose of this paper is to educate forensic interviewers about autism spectrum disorder (ASD) and tools for interviewing youth with ASD when there are concerns of child sexual abuse (CSA).

Design/methodology/approach

Research is reviewed to discuss risk factors for CSA in youth with ASD, why CSA is often not recognized and research-based strategies for forensically interviewing youth with ASD.

Findings

Youth with ASD are at increased risk of CSA compared to neurotypical peers, but recognition of CSA in youth with ASD can be difficult. Forensic interviewing strategies can help interviewers obtain reports of CSA from youth with ASD.

Practical implications

Given the increase in prevalence of ASD and the increased risk of CSA, forensic interviewers need to have information about ASD, about why CSA may not be recognized, about risk factors for CSA and, especially, about how to accommodate for ASD when conducting forensic interviews.

Originality/value

This paper provides a novel framework for considering evidence-based practices for forensically interviewing youth with ASD when there are concerns of CSA. Specifically, this paper includes multiple, but related areas, in one article including research related to ASD, risk factors for CSA in those with ASD, obstacles to identifying CSA and the implications of this research for specific strategies regarding how to forensically interview youth with ASD when there are concerns of CSA.

Article
Publication date: 18 December 2019

Deborah J. Morris, Shubhinder Shergill and Elizabeth Beber

People with an intellectual disability (ID) are more at risk of experiencing adverse childhood events. Moreover, prolonged exposure to ACEs results in enduring changes and…

Abstract

Purpose

People with an intellectual disability (ID) are more at risk of experiencing adverse childhood events. Moreover, prolonged exposure to ACEs results in enduring changes and impairments in neurological, physiological and psycho-social systems and functioning. In response, van der Kolk et al. (2009) have put forward the concept of developmental trauma disorder (DTD) to reflect the “constellation of enduring symptoms” and complex care needs of this population. The purpose of this paper is to ascertain the level of exposure to adverse childhood events and the prevalence of DTD in an inpatient forensic ID population.

Design/methodology/approach

A retrospective file review and consensus approach to diagnosis were used in a sample of adults with an ID detained in a secure forensic service.

Findings

Results revealed that 89 admissions (N=123) had been exposed to at least one significant ACE, with 81 being exposed to prolonged ACEs. A total of 58 admissions (47 per cent) met criteria for PTSD and 80 (65 per cent) met the criteria for DTD. Significant gender differences were noted in MHA status, primary psychiatric diagnoses, exposure to ACEs and DTD.

Research limitations/implications

The discussion explores the implications for working with forensic ID populations who report high incidents of childhood trauma and the utility, strengths and weaknesses of the proposed DTD, its relationship to ID diagnoses is explored.

Originality/value

The study outlines the prevalence of DTD and PTSD in ID forensic populations and suggests additional key assessment and treatment needs for this population.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 11 no. 1
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 1 December 2007

Kiriakos Xenitidis, Elena Paliokosta, Stefanos Maltezos and Vangelis Pappas

The general public and professionals from a range of backgrounds have increasingly become interested in autism spectrum disorders. This interest is particularly relevant to…

Abstract

The general public and professionals from a range of backgrounds have increasingly become interested in autism spectrum disorders. This interest is particularly relevant to learning disability practitioners. Both autism and learning disabilities are independently associated with increased risk of mental health problems. Thus, when a person has learning disabilities and an autism spectrum disorder, a comprehensive assessment for mental health problems is of paramount importance. This paper provides an overview of the assessment of mental health problems in adults and children with neurodevelopmental disorders. The general assessment principles are outlined followed by assessment issues related to specific conditions such as psychoses, mood disorders and attention deficit hyperactivity disorder. Finally conclusions on the clinical implications are drawn.

Details

Advances in Mental Health and Learning Disabilities, vol. 1 no. 4
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 1 March 2008

Jenny Torr

This article reviews the literature on personality disorder in offenders with learning disabilities, using Medline, PsychoInfo and CINAHL databases, and search terms ‘offending’…

447

Abstract

This article reviews the literature on personality disorder in offenders with learning disabilities, using Medline, PsychoInfo and CINAHL databases, and search terms ‘offending’, ‘personality disorder and intellectual disabilities’, ‘learning disabilities’ and related terms. Methods of defining offending population, personality disorder and learning disabilities vary greatly, and few studies focus specifically on personality disorder, learning disability and offending. The definition of learning disability often encompasses both borderline learning disability and low average intelligence. Personality disorder, especially anti‐social personality disorder, is prevalent in offenders with learning disabilities, but less than in the general population, and is associated with higher levels of security and poorer outcomes. The study concludes that there is a continuum of offenders with borderline and mild learning disabilities, reflected in learning disability forensic services.

Details

Advances in Mental Health and Learning Disabilities, vol. 2 no. 1
Type: Research Article
ISSN: 1753-0180

Keywords

Book part
Publication date: 3 October 2015

Victor Villarreal and Maria J. Castro

Although many educators feel insecure about reporting suspected child maltreatment, educators are in a unique position to identify and, subsequently, intervene in such cases. This…

Abstract

Although many educators feel insecure about reporting suspected child maltreatment, educators are in a unique position to identify and, subsequently, intervene in such cases. This is particularly true for those working in early childhood education settings, as the youngest children – those most vulnerable to the effects of maltreatment – are at the greatest risk for being victims of most types of maltreatment. Thus, early childhood educators should be familiar with child maltreatment and be prepared to act in these cases. The purpose of this chapter is to provide a general overview of child maltreatment. Definitions and prevalent issues will be discussed, and the potential effects of child maltreatment across a variety of domains, including cognitive, academic, social, and behavioral functioning, will be highlighted. Finally, the authors explore various responsibilities, such as mandated reporting and intervention and prevention activities, of early childhood educators.

Details

Discussions on Sensitive Issues
Type: Book
ISBN: 978-1-78560-293-1

Keywords

Article
Publication date: 14 November 2016

Morna Browning, Rosemary Gray and Rose Tomlins

The purpose of this paper is to explore the characteristics of adults with intellectual disabilities supported by a Community Forensic Learning Disability Team (CFT) and…

Abstract

Purpose

The purpose of this paper is to explore the characteristics of adults with intellectual disabilities supported by a Community Forensic Learning Disability Team (CFT) and interventions delivered. It discusses the clinical implications of these and examines outcomes such as recidivism.

Design/methodology/approach

A retrospective case note review of all 70 service users open to the CFT during June 2013 was carried out, using a structured service evaluation tool.

Findings

The majority of service users (74.3 per cent) had a mild intellectual disability. Multiple mental health and/or physical health diagnoses were common, and 28 per cent had problematic drug or alcohol abuse. Almost half of service users had been victims of physical or sexual abuse, or neglect. Sexual offences were the most common index offence, followed by assault and fire-setting. A wide range of multi-disciplinary interventions were delivered within the Community Forensic Team. Following CFT involvement there was an increase in service users living in supported living in the community and a decrease in people in secure or out of area placements. Over half of service users engaged in no further offending behaviour since their referral, and those who did offend generally showed a decrease in the severity of offending behaviours. There was a large decrease in the number of convictions received.

Practical implications

The study shows the benefits of a multi-disciplinary Community Forensic Team for offenders with intellectual disabilities in terms of reduced recidivism and range of interventions delivered. It highlights the importance of clinicians within such a team having the skills to work with people with co-morbid diagnoses (e.g. autism) and people with trauma backgrounds and problematic substance use.

Originality/value

This paper demonstrates the complexity of the service users who are supported by the CFT, as well as the integral role played in supporting individuals to move to less restrictive settings, with positive outcomes.

Article
Publication date: 24 April 2024

Elanor Webb, Benedetta Lupattelli Gencarelli, Grace Keaveney and Deborah Morris

The prevalence of exposure to adversity is elevated in autistic populations, compared to neurotypical peers. Despite this, the frequency and nature of early adverse experiences…

Abstract

Purpose

The prevalence of exposure to adversity is elevated in autistic populations, compared to neurotypical peers. Despite this, the frequency and nature of early adverse experiences are not well understood in autistic adults, with several underlying methodological limitations in the available literature. The purpose of this study is to systematically synthesise and analyse the prevalence of childhood adversity in this marginalised population, in accordance with the adverse childhood experiences (ACEs) framework.

Design/methodology/approach

Peer-reviewed empirical research articles were systematically searched for from electronic databases and screened against established inclusion criteria. Pooled prevalence rates for individual ACE types were calculated.

Findings

Four papers were included (N = 732), all of which used a predominantly or exclusively female sample. Only sexual abuse was reported in all papers, with a pooled prevalence rate of 38%. Physical abuse and emotional abuse were less frequently explored, with two papers reporting on these ACEs, though obtained comparable and higher pooled prevalence rates (39% and 49%, respectively). Pooled prevalence rates could be calculated for neither neglect nor “household” ACEs because of insufficient data. The limited state of the evidence, in conjunction with high levels of heterogeneity and poor sample representativeness found, positions the ACEs of autistic adults as a critical research priority.

Originality/value

To the best of the authors’ knowledge, this study is the first to systematically synthesise the prevalence of early childhood adversities, as conceptualised in accordance with the ACEs framework, in adults with autistic traits.

Details

Advances in Autism, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-3868

Keywords

Article
Publication date: 21 July 2010

Gina de la Cuesta

Claims that people with autism spectrum disorders (ASD) are overrepresented in offending populations and are more likely to commit crimes than others are explored in this review…

Abstract

Claims that people with autism spectrum disorders (ASD) are overrepresented in offending populations and are more likely to commit crimes than others are explored in this review. Evidence to date makes these claims difficult to substantiate, although methodological difficulties make this area particularly challenging. ASD does not appear to account for a large number of crimes in society, though certain characteristics may render those on the spectrum vulnerable to offending. Comorbid psychiatric conditions such as depression and psychosis, when present in a person that additionally has ASD, are important risk factors. Once in the criminal justice system, people with ASD are often misunderstood and open to bullying. Very little is known about what treatment programmes are effective for offenders in this population. This review summarises some of the important studies in this field.

Details

Journal of Learning Disabilities and Offending Behaviour, vol. 1 no. 2
Type: Research Article
ISSN: 2042-0927

Keywords

Article
Publication date: 29 November 2018

Clare Sarah Allely and Larry Dubin

As recently highlighted by Creaby-Attwood and Allely (2017), it is crucial that the possible innate vulnerabilities that contributed to sexual offending behaviour in an individual…

Abstract

Purpose

As recently highlighted by Creaby-Attwood and Allely (2017), it is crucial that the possible innate vulnerabilities that contributed to sexual offending behaviour in an individual with an autism spectrum disorder (ASD) are taken into consideration for the application of a diversion programme to avoid the stigma of a criminal conviction or during sentencing for a non-custodial outcome. Specifically, in those defendants with a diagnosis of what used to be referred to as Asperger’s syndrome (AS) and now is recognised as an ASD and who are charged and convicted of a non-contact sexual offense, education and mental health intervention will best serve the interests of justice. The paper aims to discuss this issue.

Design/methodology/approach

This paper focusses on one particular type of sexual offending behaviour, namely, possession of child pornography. A systematic PRISMA review was conducted.

Findings

The authors linked examples of child pornography in the research literature to the ASD symptomology and describe how the symptomology explains such behaviour as not reflecting actual sexual deviance.

Originality/value

Downloading and viewing of child pornography by individuals with ASD has received relatively little research outside the mental health field. This review is of particular importance to those in the criminal justice system who may not have much knowledge and understanding of ASD. It is suggested that diversion programmes and mental health courts should be set up for this particular population charged with this particular crime in mind so that the necessary treatment/intervention/support and care can be given to this particular group.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 9 no. 4
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 17 August 2022

Joseph Sakdalan and Yvonne Maxwell

Despite some advances in the assessment and treatment of autism spectrum disorder (ASD), there remains a paucity of intervention and research literature in treating adults with

Abstract

Purpose

Despite some advances in the assessment and treatment of autism spectrum disorder (ASD), there remains a paucity of intervention and research literature in treating adults with ASD. There is growing evidence supporting a relationship between the core features of ASD and emotion dysregulation. There is an overlap between ASD and borderline personality disorder (BPD) characteristics such as emotional dysregulation, sensory issues and social skills deficits. This paper aims to explore the applications of dialectical behaviour therapy (DBT) concepts and skills in treating ASD individuals who display challenging or offending behaviours. The similarities in characteristics between ASD and BPD and the core issue of emotion dysregulation hold promise in the utility of DBT with ASD.

Design/methodology/approach

This is a conceptual paper that includes a case vignette.

Findings

A DBT-informed treatment approach using the adaptations and reconceptualization, i.e. risky mind–wise mind outlined in this paper, can be considered promising in addressing issues for ASD individuals, particularly those with challenging and/or offending behaviours. DBT incorporates different elements of applied behaviour analysis, cognitive behavioural therapy, mindfulness skills, sensory-based treatments, psychosocial interventions and emotion regulation skills, which makes it a more cohesive and integrated approach to treatment. The authors assert that DBT can be considered a more integrated, strengths-based, habilitative and trauma-informed approach which can be promising in its application to address challenging behaviours or offending in ASD individuals.

Research limitations/implications

It is recommended that research be carried out to evaluate the effectiveness of adapted DBT programs in treating ASD individuals presenting with challenging and/or offending behaviours. Future research can focus on evaluating the effectiveness of the different DBT concepts and skills and the different DBT modules to determine which components of the program are particularly useful for this client group.

Practical implications

Treatment manuals have already been developed for clients with intellectual disability and developmental disabilities who exhibit challenging and/or offending behaviour; hence, it is recommended that modifications be made to make it more applicable and appropriate for ASD individuals. Modifications should address ASD-specific issues (e.g. black and white thinking, cognitive rigidity, sensory issues, impaired theory of mind, emotion dysregulation issues, social skills deficits and anxiety issues). The use of DBT has much wider implications regarding addressing comorbid mental health conditions and personality issues in this client group.

Originality/value

There are limited psychological interventions that prove to be useful for individuals with ASD with complex presentations and challenging or offending behaviours. This paper discusses the application of adapted DBT concepts and skills that appear to be promising in the treatment of this client group.

1 – 10 of 76