Search

Aim: To explore the usefulness of a co‐designed wordless book showing processes of receiving COVID‐19 vaccines designed by, and for, adults with intellectual disabilities. Methods: A qualitative evaluation of the resource using mixed methods. Semi‐structured interviews were conducted with people with intellectual disabilities, carers and health professionals about resource content, and use. This was analysed thematically. A survey was circulated to intellectual disabilities networks to understand resource need, use, sharing and content. Results: Understanding the COVID‐19 vaccine was a process, not a single event using one resource. A visual resource had a place in facilitating conversations about vaccines between people with intellectual disabilities and carers. Differing perspectives were expressed regarding personal needs, existing awareness of vaccine programmes and communication preferences. Changes were suggested to improve the suggested storyline and relevance around COVID‐19 restrictions changing. Conclusion: A visual resource may help conversations about the COVID‐19 vaccine for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background: Parents with learning disabilities report facing a widely held 'presumption of incompetence', placing them under pressure to prove their parenting competence. In collaboration with a learning disability theatre company, an inclusive research methodology explored experiences of parenting with learning disabilities, with a specific focus on the operation of stigma in parents' lives. Method: Interviews with 17 mothers and 5 fathers who self‐identified as having learning disabilities were co‐facilitated by learning‐disabled co‐researchers, and analysed using thematic analysis, with input from people with learning disabilities. Results: Thematic analysis generated four key themes; (1) positions of powerlessness, (2) assumptions of incompetence, (3) challenging assumptions and proving competence and (4) claiming power. Conclusion: Parents reported experiencing stigma and disempowerment within their networks, yet continued to embrace their valued parental identity and drew strength from involvement with self‐advocacy organisations. The research informed arts‐based performance pieces and resources aimed at training professionals and raising public awareness. [ABSTRACT FROM AUTHOR]

Background People with intellectual disability or borderline intellectual functioning may have poorer mental health than their peers. The present authors sought to (i) estimate the risk of poorer mental health among British adults with and without intellectual impairments and (ii) estimate the extent to which any between-group differences in mental health may reflect between-group differences in rates of exposure to common social determinants of poorer health. Materials and Methods The present authors undertook secondary analysis of confidentialized unit records collected in Wave 3 of Understanding Society. Results British adults with intellectual impairments living in general households are at significantly increased risk of potential mental health problems than their non-disabled peers (e.g. GHQ Caseness OR = 1.77, 95% CI (1.25-2.52), P < 0.001). Adjusting for between-group differences in age, gender and indicators of socio-economic position eliminated this increased risk [ GHQ Caseness adjusted OR = 1.06, 95% CI (0.73-1.52), n.s]. Conclusions Our analyses are consistent with the hypothesis that the increased risk of poor mental health among people with intellectual impairments may be attributable to their poorer living conditions rather than their intellectual impairments per se. Greater attention should be given to understanding and addressing the impact of exposure to common social determinants of mental health among marginalized or vulnerable groups. [ABSTRACT FROM AUTHOR]

Background People with severe and profound intellectual disabilities often spend substantial time isolated and disengaged. The nature and quality of the support appears to be important in determining quality of life. Methods Structured observations and staff questionnaires were used to explore the quality of life and quality of support for 110 people with severe and profound disabilities and complex needs. Results On average, people spent approximately 40% of their time engaged in meaningful activities, received contact from staff 25% of the time (6% in the form of assistance to be engaged). Just over one-third received consistently good active support, which was associated with other measures of quality of support and emerged as the strongest predictor of outcomes. Conclusions Quality of life and quality of support were relatively poor, although with about one-third of people receiving skilled support. Consistently good active support was the best predictor of outcome and proposed as a good indicator of skilled support. [ABSTRACT FROM AUTHOR]

Background The role of support workers and other professionals in the psychotherapeutic process has been commented upon but not as yet been systematically investigated. Method To explore their views and expectations of cognitive behaviour therapy ( CBT) for adults with intellectual disabilities, eleven paid support workers and professionals were recruited and interviewed before the CBT sessions commenced for their service users and nine took part in the second interview that took place after nine sessions. Results Thematic Analysis of the interview transcripts indicates that staff members do not perceive CBT as a long-term solution for psychological problems have little knowledge of CBT and do not feel included in the process. Nevertheless, after nine sessions, most participants reported improved psychological well-being for their service users and expressed a wish for longer-term involvement of the therapist. Conclusions The results suggest that for CBT to be effective in the longer term, the therapist is required to consider a wider systemic approach including staff training and supervision, staff and management consultancy and creating a delicate balance between confidentiality and sharing the psychological formulation with 'significant others' to ensure maintenance and generalisation of improved psychological well-being. [ABSTRACT FROM AUTHOR]

Background The cognitive interview ( CI) has been shown to increase correct memory recall of a diverse range of participant types, without an increase in the number of incorrect or confabulated details. However, it has rarely been examined for use with adults with intellectual disability. Measures and Method This study compared the memory recall of twenty-one adults with a mild intellectual disability ( ID) ( IQ 70-50) and twenty-one adults from the general population ( GP). Participants viewed a film of a staged distraction theft and were interviewed using either the CI or the structured interview ( SI). Results The CI, when compared to the SI, enhanced the correct recall of person, action and conversation (gist) detail for both participant types, without increasing the number of incorrect or confabulated details reported. The ID group reported significantly less correct information than the GP regardless of the interview used. Conclusion The findings suggest that the CI can enable adults with intellectual disability to provide a fuller picture about an experienced event. Implications of this research are discussed. [ABSTRACT FROM AUTHOR]

Background Specialist short break services aim to provide enhanced support to family carers as a means of preventing children whose behaviours severely challenge from being placed in full-time residential care. To date, there is limited evidence as to the functioning and effectiveness of such services. Methods In all, 17 children were selected at random from the 123 who were currently receiving services or had done so in the past 2 years from three specialist short break and community support services. For each child, interviews were conducted with a parent, the child's key worker within the service and the professional (mostly social workers) who had referred families to the services. Results Five core themes captured the informants' common experiences: the complexities underlying the provision of services; the negotiations required to implement, maintain and adjust service packages; the relationships forged by the services; and the benefits they brought to children and families plus concerns about the future also featured. Conclusions Specialist short break services can make a vital contribution to retaining children within their families, but under some important conditions which this study has identified: notably, the management of complexity, the formation of trusted relationships and creation of tangible benefits for the family and for the child. [ABSTRACT FROM AUTHOR]

Background In other populations, the psychological impact of abuse has been conceptualized as Post Traumatic Stress Disorder (PTSD, DSM-IV, American Psychiatric Association (APA), 1994), but little is known about whether this is appropriate for adults with severe intellectual disabilities and very limited communication skills. Methods An informant interview, based on the framework provided by PTSD, but supplemented with additional questions, was developed and was used to elicit the emotional, behavioural and physiological symptoms of alleged abuse in 18 people with intellectual disabilities at three time points: in the 3 months immediately prior to the alleged abuse ( Time 1), in the 3 months immediately after the abuse ( Time 2) and in the last 3 months prior to interview ( Time 3). Results The reports of the family and carer informants indicated that, following their alleged abuse, the victims experienced marked increases in the frequency and severity of emotional, physiological and behavioural symptoms of psychological distress. Over time, there was some alleviation of these difficulties, but psychological functioning remained severely compromised. Conclusions While the established PTSD framework is appropriate for examining the psychological impact of abuse, some amendments are required to enable clinicians to examine fully the distress of alleged victims with severe intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background The provision of skilled support is dependent on staff knowledge and understanding (Beadle-Brown J., Beecham J., Mansell J., Baumker T., Leigh J., Whelton R. & Richardson L, unpublished data). Influencing staff knowledge and understanding is an important component of interventions. Materials and Methods Fourteen individual semi-structured interviews elicited staff views and experiences of knowledge development. These were analysed using a thematic network analysis (Attride-Stirling 2001, Qualitative Research 1, 385-405). Results Three global themes were identified; skills are developed from experience, service aims influence service delivery and practice is more important than theory. This article focuses on the first of these themes. Relationships between staff and service users played a central role in enabling development of knowledge. Although some skills were seen as transferrable, experience of a particular service user was described as being essential. Conclusions Support staff may not see the relevance of research findings, professional knowledge or training, unless these have involved direct work with the service user in question. [ABSTRACT FROM AUTHOR]