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Article
Publication date: 2 May 2017

Verity Chester, Anthony Scott Brown, John Devapriam, Sharon Axby, Claire Hargreaves and Rohit Shankar

There is increasing emphasis on caring for people with intellectual disabilities in the least restrictive, ideally community settings. Therefore, the purpose of this paper…

Abstract

Purpose

There is increasing emphasis on caring for people with intellectual disabilities in the least restrictive, ideally community settings. Therefore, the purpose of this paper is to explore the risk factors considered by clinicians involved in discharging people from secure services.

Design/methodology/approach

The views of five senior clinicians were sought in semi structured interviews. Data were analysed thematically.

Findings

Themes related to risk assessment, risk management, and multidisciplinary and multiagency working. Illustrative quotes are used to evidence themes.

Practical implications

This study described the risk assessment and management factors considered during the discharge of patients from secure to community services, which are of direct relevance to multiple stakeholders post-Winterbourne.

Originality/value

Challenges when facilitating discharge were highlighted, such as ongoing risk management issues, or unexpected discharge from tribunals, and how these were addressed, via the development of extensive risk assessment and management processes, and interdisciplinary and interagency working.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 11 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

Content available
Article
Publication date: 3 August 2021

Verity Chester

Abstract

Details

Advances in Autism, vol. 7 no. 3
Type: Research Article
ISSN: 2056-3868

Content available

Abstract

Details

Advances in Autism, vol. 5 no. 3
Type: Research Article
ISSN: 2056-3868

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Article
Publication date: 8 July 2020

Samuel Tromans and Verity Chester

The purpose of this paper is to provide a commentary on “being diagnosed with autism in adulthood: a personal case study”.

Abstract

Purpose

The purpose of this paper is to provide a commentary on “being diagnosed with autism in adulthood: a personal case study”.

Design/methodology/approach

A commentary on an individual’s personal experiences of being referred to autism assessment services and subsequently receiving a diagnosis of autism in adulthood.

Findings

Many individuals are not diagnosed with autism until their adult life, and as a result, miss the benefits of timely introduction of sources of support, such as during their schooling. Receiving an autism diagnosis can come as a relief and promote self-understanding, but availability of high-quality post-diagnostic support services and accommodating employers are both highly important.

Originality/value

A commentary on an original viewpoint is published in this special edition on gender and diversity.

Details

Advances in Autism, vol. 7 no. 3
Type: Research Article
ISSN: 2056-3868

Keywords

Content available

Abstract

Details

Advances in Autism, vol. 5 no. 1
Type: Research Article
ISSN: 2056-3868

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Article
Publication date: 11 March 2021

Bethany Driver and Verity Chester

Autistic women and girls have received comparatively less attention within clinical practice and research. Research suggests women tend to be diagnosed later than men, and…

Abstract

Purpose

Autistic women and girls have received comparatively less attention within clinical practice and research. Research suggests women tend to be diagnosed later than men, and are more likely to experience misdiagnosis.

Design/methodology/approach

This paper aims to report a narrative literature review that examines research on the presentation, recognition, and diagnosis of autistic women and girls.

Findings

Findings suggest that autistic females present differently to males and highlight low recognition of the female presentation of autism among the general public, in social spheres, educational, clinical and forensic settings. This lack of recognition appears to affect the likelihood of females being referred for diagnosis, the reliability of diagnostic assessments and subsequent access to support.

Originality/value

Recommendations for clinical practice focus on initiatives to increase awareness of the female presentation of autism, improving the diagnostic process for females, increasing female representation within autism training and for future research to support these goals.

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Article
Publication date: 30 June 2020

Samuel Tromans, Verity Chester, Eli Gemegah, Kristian Roberts, Zoe Morgan, Guiqing Lily Yao and Traolach Brugha

The purpose of the paper is to review autism identification across different ethnic groups. Diagnosis of autism may be missed or delayed in certain ethnic groups, leading…

Abstract

Purpose

The purpose of the paper is to review autism identification across different ethnic groups. Diagnosis of autism may be missed or delayed in certain ethnic groups, leading to such groups being underserved relative to their needs. This can result in members of such groups being effectively denied essential avenues of support that can substantially improve the quality of life of autistic persons as well as those whom care for them.

Design/methodology/approach

A literature search for articles reporting autism identification across ethnic groups was undertaken. Data are compared, with a special focus on possible explanations for any inter-group variation.

Findings

Autism identification appears to be generally lower in minority ethnic groups relative to the majority population. Individuals presenting with autism from minority groups appear to have more severe forms of the condition.

Originality/value

There are a multitude of potential explanations for inter-ethnicity variation in autism identification, including health care-related factors, broader environmental influences, cultural factors and possible biological differences. Implications for clinical practice and public health include a need to look at means of ensuring equitable access to relevant autism diagnostic and support services across ethnic groups. Further work is required to better understand the belief systems that operate within specific ethnic groups, how this may potentially impact upon autism identification and measures to address the concerns of such groups.

Details

Advances in Autism, vol. 7 no. 3
Type: Research Article
ISSN: 2056-3868

Keywords

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Article
Publication date: 3 October 2016

Regi Alexander, Peter E. Langdon, Verity Chester, Magali Barnoux, Ignatius Gunaratna and Sudeep Hoare

Individuals with diagnoses of autism spectrum disorder (ASD) within criminal justice settings are a highly heterogeneous group. Although studies have examined differences…

Abstract

Purpose

Individuals with diagnoses of autism spectrum disorder (ASD) within criminal justice settings are a highly heterogeneous group. Although studies have examined differences between those with and without ASD in such settings, there has been no examination of differences within the ASD group. The paper aims to discuss these issues.

Design/methodology/approach

Drawing on the findings of a service evaluation project, this paper introduces a typology of ASD within forensic mental health and intellectual disability settings.

Findings

The eight subtypes that are described draw on clinical variables including psychopathy, psychosis and intensity/frequency of problem behaviours that co-occur with the ASD. The initial assessment of inter-rater reliability on the current version of the typology revealed excellent agreement, multirater Kfree =0.90.

Practical implications

The proposed typology could improve understanding of the relationship between ASD and forensic risk, identify the most appropriate interventions and provide prognostic information about length of stay. Further research to refine and validate the typology is ongoing.

Originality/value

This paper introduces a novel, typology-based approach which aims to better serve people with ASD within criminal justice settings.

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Article
Publication date: 20 February 2019

Samuel Tromans, Verity Chester, Chaya Kapugama, Amy Elliott, Sarah Robertson and Mary Barrett

The purpose of this paper is to explore the perspectives of healthcare professionals on autism in adult females with intellectual disability (ID), including regarding the…

Abstract

Purpose

The purpose of this paper is to explore the perspectives of healthcare professionals on autism in adult females with intellectual disability (ID), including regarding the gender ratio of autism, the clinical manifestation of autism in females, and the recognition, screening and diagnosis of autism.

Design/methodology/approach

The questionnaire was developed following a review of the relevant literature and distributed to professionals within three healthcare trusts as well as members of two clinical research groups. The questionnaire was completed by 80 ID healthcare professionals. Data were aggregated and analysed using Microsoft Excel.

Findings

ID healthcare professionals had a lack of recognition of the smaller gender ratio of autism in patients with ID as compared to those without ID. Most respondents reported believing that autism manifests differently in females; with women demonstrating a greater ability to mask their symptoms. A considerable proportion of participants reported feeling less confident in recognising, screening and diagnosing autism in female patients, with many endorsing a wish for additional training in this area.

Practical implications

These findings suggest that ID healthcare professionals are keen to improve their skills in providing services for women with autism. Training programmes at all levels should incorporate the specific needs of women with ASD, and individual professionals and services should actively seek to address these training needs in order to promote best practice and better outcomes for women with autism.

Originality/value

This is the first published questionnaire exploring the perspectives of healthcare professionals regarding autism in adult females with ID.

Details

Advances in Autism, vol. 5 no. 3
Type: Research Article
ISSN: 2056-3868

Keywords

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Article
Publication date: 3 April 2018

Rahul Rai, Samuel Tromans, Chaya Kapugama, Verity Chester, Ignatius Gunaratna, Peter Langdon and Regi T. Alexander

The diagnosis of psychosis in individuals with autism spectrum disorder (ASD) poses a unique clinical challenge. The presence of intellectual disability (ID) further…

Abstract

Purpose

The diagnosis of psychosis in individuals with autism spectrum disorder (ASD) poses a unique clinical challenge. The presence of intellectual disability (ID) further complicates the diagnostic picture. Reliable and timely diagnosis of psychosis in such individuals minimises the duration of untreated psychotic symptoms and the subsequent impact on the quality of life of the patients concerned. The paper aims to discuss this issue.

Design/methodology/approach

The authors present four patients with psychosis, ASD and ID, who have received care within forensic mental health and ID settings. These examples demonstrate the interaction between these conditions, as well as issues pertaining to diagnosis and management.

Findings

In all four patients, sustained use of antipsychotic medication was objectively associated with an improvement in psychotic symptoms and quality of life. In instances where autistic phenomena were accentuated upon development of psychosis, such features returned to the baseline levels evident prior to the onset of psychosis.

Practical implications

The discussion and related case examples could improve the understanding of the possibility of psychosis in individuals with ASD and ID, and increase awareness of this diagnostic possibility among healthcare professionals.

Originality/value

This is the first published case series illustrating the challenges of diagnosing psychosis in individuals with ASD and ID.

Details

Advances in Autism, vol. 4 no. 2
Type: Research Article
ISSN: 2056-3868

Keywords

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