Tizard Learning Disability Review最新文献

{"title":"Capable environments","authors":"P. McGill, J. Bradshaw, G. Smyth, Maria Hurman, Ashok Roy","doi":"10.1108/tldr-05-2020-0007","DOIUrl":"https://doi.org/10.1108/tldr-05-2020-0007","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to outline the role played by different aspects of the social, physical and organisational environments in preventing behaviour described as challenging in people with learning disabilities.\u0000\u0000\u0000Design/methodology/approach\u0000Conceptual elaboration drawing on research and practice literature.\u0000\u0000\u0000Findings\u0000Community placements for people with learning disabilities should develop the characteristics of capable environments. Such characteristics are associated with prevention of challenging behaviour and improved quality of life outcomes.\u0000\u0000\u0000Originality/value\u0000The notion of the capable environment may help to shift the focus from the individual who displays behaviour described as challenging to the characteristics of the social, physical and organisational supports that they receive.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41782526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on a “unified approach to behaviours that challenge”: against consensus – why we need a new field of challenging behaviour studies","authors":"S. C. Simplican","doi":"10.1108/tldr-08-2020-0021","DOIUrl":"https://doi.org/10.1108/tldr-08-2020-0021","url":null,"abstract":"\u0000Purpose\u0000This paper challenges the value of consensus within the field of learning disability. In this commentary, the author argues that consensus threatens to silence multiple viewpoints, hides how power operates and stifles creativity.\u0000\u0000\u0000Design/methodology/approach\u0000The author focuses on two articles within this special issue to suggest that the consensus celebrated is more about a set of shared values, rather than a set of shared practices. This should make us question the depth of the field’s consensus.\u0000\u0000\u0000Findings\u0000The presumption that multiple paradigms can be “unified” actually hides how power operates to resolve disagreements among positive behaviour support, active support and human rights approaches. A similar erasure occurs in the language of “capable environments,” which the author argues obscures the role of individuals, relationships and organizational cultures in impacting quality of life.\u0000\u0000\u0000Research limitations/implications\u0000We need to create and build a new interdisciplinary field of challenging behaviour studies that is willing to embrace conflict and disagreement in research, policy and practice.\u0000\u0000\u0000Practical implications\u0000The author believes that this approach is more likely to empower people, including people with learning disabilities whose behaviour challenges, family members, and direct support workers because it is more likely to recognize their experiences and expertise.\u0000\u0000\u0000Originality/value\u0000A new multidisciplinary field of challenging behaviour studies may encourage more theoretical diversity that makes us challenge the value of consensus and embrace creativity.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47524100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of children with special educational needs and disabilities and their families in the United Kingdom during the coronavirus pandemic","authors":"B. O’Hagan, Stephen Kingdom","doi":"10.1108/tldr-09-2020-0025","DOIUrl":"https://doi.org/10.1108/tldr-09-2020-0025","url":null,"abstract":"Purpose: The purpose of this paper is to outline the experiences of children with special educational needs and disabilities (SEND) and their families during the coronavirus pandemic Design/methodology/approach: This paper draws on research gathered and collated by three different organisations working with families of children and young people with SEND Findings: There were a number of common findings across all three surveys In particular: the rapid collapse of external support for children and families;the reduction/withdrawal of support exacerbated the stress and exhaustion already experienced by many families;it proved very difficult to establish home learning and get adequate support from schools;there was little government recognition of families’ vulnerability and need for support;and, paradoxically, a significant minority of children and families reported increased well-being Originality/value: Findings carry clear implications both for the provision of child and family support during any further lockdowns and, more generally, in respect of government policy and funding of family support © 2020, Emerald Publishing Limited","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46810813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An audit of the well-being of staff working in intellectual disability settings in Ireland during the COVID-19 pandemic","authors":"M. McMahon, C. Hatton, J. Stansfield, G. Cockayne","doi":"10.1108/tldr-09-2020-0027","DOIUrl":"https://doi.org/10.1108/tldr-09-2020-0027","url":null,"abstract":"Purpose: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions of people worldwide Individuals with intellectual disability are at a disproportionate risk of mortality, given the health inequalities they experience This puts a significant burden of responsibility on staff who support these individuals Consequently, this study aims to establish a baseline of the well-being of staff working in intellectual disability services in Ireland during the COVID-19 pandemic Design/methodology/approach: An online survey was carried out using the Copenhagen Burnout Inventory, a brief measure of depression (Patient Health Questionnaire-9) and a brief measure of anxiety (General Anxiety Disorder-7) Findings: In total, 285 staff in the Republic of Ireland completed the survey These staff reported moderate levels of personal and work-related burnout and mild levels of anxiety and depression Higher mean scores were recorded across scales from staff who worked in independent living settings and from staff who supported individuals with challenging behaviour Originality/value: This study, an audit, provides initial data on the well-being of staff working with individuals with intellectual disability in Ireland during the COVID-19 pandemic It highlights that employers need to consider staff well-being, given the levels of personal and work-related burnout, and anxiety and depression that were found This is particularly true for staff who work in independent living settings and with adults with challenging behaviour Future research should focus on proactive strategies for improving staff well-being in the short term, given the current resurgence of COVID-19 in Ireland © 2020, Emerald Publishing Limited","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42143485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Narrative therapy groups for people with intellectual disability: a critical review of the literature”","authors":"Mark Haydon-Laurelut","doi":"10.1108/tldr-10-2020-0031","DOIUrl":"https://doi.org/10.1108/tldr-10-2020-0031","url":null,"abstract":"\u0000Purpose\u0000This paper is a commentary inspired by Laura McKenzie-Smith’s review paper.\u0000\u0000\u0000Design/methodology/approach\u0000This commentary provides a personal perspective on the intersections of narrative practice and the support of people with a learning disability.\u0000\u0000\u0000Findings\u0000This commentary highlights some further possibilities of narrative ideas beyond therapy. This paper explores examples of record keeping and research as sites for story construction about lives and identities.\u0000\u0000\u0000Research limitations/implications\u0000This is a personal perspective of a systemic psychotherapist and academic working with people with a learning disability.\u0000\u0000\u0000Practical implications\u0000This paper argues that the stories we tell ourselves and others about our work and the people we support are powerful in ways of which we may not always be aware.\u0000\u0000\u0000Social implications\u0000In common with person-centred planning, narrative ideas highlight the power of the stories circulating about a person and their network and the implications they may have for their lives and identities.\u0000\u0000\u0000Originality/value\u0000This commentary explores narrative practices beyond the context of therapy, highlighting organisational, administrative and research practices as story-constructing activities that co-create identities of persons with a learning disability, their networks of support and health and social care professionals.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46512462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “A reflective evaluation of the Bradford positive behaviour support – in reach service”","authors":"Catherine Sholl","doi":"10.1108/tldr-09-2020-0023","DOIUrl":"https://doi.org/10.1108/tldr-09-2020-0023","url":null,"abstract":"The purpose of this paper is to consider the needs of children and young people with intellectual disabilities (ID), autism and challenging behaviour including those with mental health difficulties in the light of the article “A reflective evaluation of the Bradford Positive Behaviour Support – In Reach Service”.,The author’s reflections on experiences of working with this cohort as a clinician and manager are presented in this paper. Also, this paper presents the following: consideration of recent policy, guidance and literature associated with the provision of support to children and young people with ID or autism at risk of residential placement or hospital admission; reflection on gaps in research and practice in how to best support this group of children, young people and families with complex and diverse needs.,The success of the Bradford and other similar services is discussed along with a reflection about the benefits and potential gaps in Positive Behavioural Support services working to meet the needs of this group of children and young people, and their families.,The importance of areas providing more consistent and high quality multi-agency early preventative support and intensive support for those in crisis is discussed. The need for further research and development of ways of working with this cohort, including harder to reach young people and families, is discussed.","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42728423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are narrative therapy groups effective for people with intellectual disabilities? A critical review of the literature","authors":"L. McKenzie-Smith","doi":"10.1108/tldr-05-2020-0008","DOIUrl":"https://doi.org/10.1108/tldr-05-2020-0008","url":null,"abstract":"\u0000Purpose\u0000Narrative therapy has been suggested as particularly relevant to people with intellectual disability (ID), with group formats potentially offering additional benefits. This paper aims to critically review studies which evaluated narrative group interventions for people with ID.\u0000\u0000\u0000Design/methodology/approach\u0000The seven papers identified for review were critically appraised for their quality using a quality appraisal tool appropriate to their design, along with additional factors including adaptations made to improve accessibility.\u0000\u0000\u0000Findings\u0000The studies suggest that there may be some small benefits of narrative group therapy for those with ID. However, alongside issues limiting the studies’ evaluations, it is noted that the research paradigms used in the studies conflict with narrative approaches.\u0000\u0000\u0000Research limitations/implications\u0000The limited evidence base suggests the need for further research. The randomised controlled trial would ordinarily be seen as the gold standard for such research. However, narrative interventions may require a different approach to evaluation.\u0000\u0000\u0000Originality/value\u0000This is the first review of published literature on the evaluation of narrative therapy groups for people with ID.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47067887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Keep safe: collaborative practice development and research with people with learning disabilities”","authors":"M. Clifton, Steve Chapman","doi":"10.1108/tldr-07-2020-0013","DOIUrl":"https://doi.org/10.1108/tldr-07-2020-0013","url":null,"abstract":"Inspired by the work of the Keep Safe Advisory Group, this paper aims to explain and make the case for co-production as a powerful model for working alongside people with learning disabilities.,The collaborative approach of the Keep Safe advisory group is the authors’ springboard for a deep dive into the power and potential of co-production as a model. As organisational leaders – one with and one without a learning disability – the authors draw on their personal experience to argue that co-production is essential to recognising the adulthood of people with learning disabilities.,Co-production means the equal sharing of power and responsibility from the start, best served by the leap of faith of a blank agenda. Co-production values different kinds of expertise as complementary – broadly considered as expertise from lived experience and professional expertise. When working co-productively, a deep investment of time to understand people pays dividends in outcomes and everyone’s personal and professional growth. Co-production enriches the lives of everyone taking part.,Co-production, though common currency in health and social care, remains too rarely understood and practiced. Readers will benefit from this reflective viewpoint, which aims to clarify and deepen what co-production really means. In particular, enabling people with learning disabilities to take responsibility for themselves and others is rarely considered but is presented here as foundational to human maturity and adulthood.","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44722952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A reflective evaluation of the Bradford positive behaviour support – in reach service","authors":"M. Hodder, Tom Syson, Zobia Aziz, Anthony Handy, Hafsa Khan, J. Lancaster","doi":"10.1108/tldr-06-2020-0010","DOIUrl":"https://doi.org/10.1108/tldr-06-2020-0010","url":null,"abstract":"\u0000Purpose\u0000Without effective support and intervention, young people with learning disabilities and severe challenging behaviour are at risk of placement in out-of-area residential settings or highly specialist child and adolescent mental health service (CAMHS) units. Such placements may be inappropriate and result in significant reductions to the quality of life of young people and their families. This paper aims to evaluate the effectiveness of the Bradford positive behaviour support (PBS) service model in terms of its aims to improve quality of life, develop skills and maintain children living with their families in their own homes.\u0000\u0000\u0000Design/methodology/approach\u0000A service evaluation using quantitative and qualitative data from a range of sources to review the effectiveness of the PBS model being applied in Bradford and Calderdale was the methodology used.\u0000\u0000\u0000Findings\u0000When consistently implemented, the Bradford positive behaviour support–in reach service may improve quality of life, facilitate skill development in young people and their carers and reduce placements in residential and CAMHS inpatient units. Avoidance of such placements is likely to reduce the overall costs of service commissioning in Bradford.\u0000\u0000\u0000Originality/value\u0000This paper evaluates a novel approach being applied by a third sector agency to implement effective PBS with a small group of children, their families and networks. There is scope for this model to be successfully implemented in other areas.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49178846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenging behaviour, inpatient services and governance in England","authors":"T. Joyce","doi":"10.1108/tldr-07-2020-0015","DOIUrl":"https://doi.org/10.1108/tldr-07-2020-0015","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to describe the current situation in relation to restrictive interventions, and some actions that could be taken to reduce them. The quality of care provided by inpatient services for people with intellectual disabilities has come under increasing scrutiny in recent years – from Winterbourne View in 2011 to Whorlton Hall in 2019, there has been increasing concern that admission to hospital does not always result in a good outcome for the patients. For some people, it has resulted in further deterioration in their physical and mental health, separation from families and supports and reduced probability of living as part of their community. This is in spite of knowledge and evidence of what good practice looks like.\u0000\u0000\u0000Design/methodology/approach\u0000This paper examines the extent to which inpatient services deliver good practice in treatment and care and, where this is not happening, the extent to which they are subject to effective governance.\u0000\u0000\u0000Findings\u0000People admitted to inpatient services can be at risk of poor-quality care and the overuse of restrictive interventions. There is guidance available that addresses what should be in place for them to receive high-quality care and treatment, and this clearly is available to many people. However, others can find themselves placed in increasingly restrictive environments and in circumstances where their human rights are at risk of being breached. There is increasing evidence that these services do not follow good practice guidance in terms of staff skills, development and implementation of effective care plans and governance arrangements that address these issues. Regulators, commissioners and managers could, and should, focus on these issues to ensure that the most vulnerable receive the care and treatment they need while in hospital.\u0000\u0000\u0000Originality/value\u0000Service providers are aware of the difficulties in developing alternative community services. This places even more importance on the need to ensure that care and treatment in hospital is of a good standard, and that the use of restrictive interventions is minimised. McGill et al. (this issue) describe the features of a capable environment and it may be that hospitals consider that the requirements are unlikely to be implemented effectively in a ward/unit setting. However, a shift of focus in doing this could result in a reduction in restrictive interventions and a better experience – potentially for both the staff and the patients. And families could have some reassurance that their relative was receiving the best quality care and treatment, and that their human rights were being upheld.\u0000","PeriodicalId":54179,"journal":{"name":"Tizard Learning Disability Review","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42197075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}