Outcomes of an Intervention Programme for People With Intellectual Disabilities and Behavioural Concerns Based on Emotional Development.

Background: This paper examines clinical outcomes of an approach to referrals for concerns about severe behavioural distress in people with intellectual disabilities (ID) that is based on the concepts of emotional development (EDev) and attachment. Due to research and clinical experiences suggesting that positive behaviour support (PBS) may have limited long-term impact, an alternative approach is proposed, which focuses on relational factors and emotional skills already held by carers.

Methodology: We report the process and outcomes of a brief standardised assessment using the Scale of Emotional Development-Short (SED-S) which then informed an attachment-based workshop. Outcomes were measured by way of the Health of the Nation Outcome Scales-Learning Disabilities (HoNOS-LD) administered at (a) assessment, (b) following 1-2 intervention workshops and (c) at 6-month follow-up.

Results: Significantly fewer sessions and hours of clinical time were required for the EDev intervention than the prior PBS interventions. Results demonstrated significant improvements from assessment to post-intervention, which were maintained 6 months later. Almost half (48%) of the participants were referred while in unsettled accommodation arrangements.

Conclusions: This study provides initial evidence supporting an approach that shows promise as an alternative to existing models of care based upon applied behaviour analysis. Future well-controlled studies across multiple sites are needed, but if these findings are replicated, the priority for intervention may shift from reduction in behavioural risks to robust care relationships which meet the person's emotional needs.