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Background: Longitudinal research is needed to strengthen evidence for risk factors for challenging behaviour in children with intellectual disabilities and to understand patterns of change over time. Methods: Data on challenging behaviour were collected for 225 students in one school over four annual time points and a range of potential risk correlates. Data were analysed using Generalised Estimating Equations. Results: Prevalence of challenging behaviour, aggression and self-injury did not vary significantly over time. Stereotyped behaviours increased over the 4-year period. Challenging behaviour was associated with lower levels of adaptive skills and autism. Stereotyped behaviour increased with age. Self-injurious behaviour was less likely to be shown in children with profound intellectual disabilities over time. Conclusions: These findings are consistent with previous research in terms of potential risk factors identified. Implications for schools include proactive interventions for children with intellectual disabilities at high risk; especially those with autism and poorer adaptive skills.

Background: People with intellectual disabilities are at risk of experiencing stigma and require the skills and confidence to deal with stigma in their daily lives. Method: Development and piloting of a 5-session manualised psychosocial group intervention designed to increase the capacity of people with intellectual disabilities aged 16+ to manage and resist stigma. Ten pre-existing groups (N = 67) in third sector and education settings participated. Interviews with participants (n = 26), facilitators (n = 9) and significant others (n = 7) 2-4 months after the intervention assessed perceived impact. Results: Perceived benefits of the intervention for participants included increased understanding, improved connections with others, drive for advocacy, increased activity and self-efficacy, and opportunity to process difficult events and emotions. Differential impact depending on individuals' pre-existing self-advocacy skills was noted. Conclusions: This early-stage study indicates that further evaluation is merited to examine feasibility and outcomes of the STORM intervention.

Background: Early Positive Approaches to Support (E-PAtS) is a co-produced and co-facilitated group programme that aims to provide early years support to family caregivers of children with Intellectual and Developmental Disabilities. Method: Thirty-five caregivers who had attended E-PAtS groups took part in individual interviews or focus groups. Caregiver experiences concerning attendance of E-PAtS were explored, in relation to process variables and perceived outcomes. Interviews were thematically analysed. Results: Three major themes were identified: our group, evolving emotions, and positive approaches. Being with and being supported by other families was very important to caregivers. Families reported increased confidence and greater realisation of the need for self-care. Children were reported to show fewer behaviours that challenge and increases in adaptive skills. Findings corresponded to mechanisms and outcomes in the E-PAtS logic model. Conclusion: E-PAtS shows promise as one way families and children with Intellectual and Developmental Disabilities can access early years support.

Background: Existing research has predominately focused on dyadic relationships in families of children with intellectual disabilities. The aim of this study was to build on emerging literature exploring triadic relationships between a mother, sibling, and child with intellectual disability, investigating how they influence each other's well-being. Method: An online survey was used to collect information regarding the mother's mental health and the emotional and behavioural problems of the sibling and the child with intellectual disability in 573 families. Results: Using structural equation modelling, we found that maternal psychological distress was associated with higher levels of behaviour problems in the sibling, and the behaviour problems of the child with intellectual disability were associated with higher levels of maternal distress. Conclusions: Family member well-being is inter-related in families of children with intellectual disabilities. Clinical interventions that improve the behaviours of children with intellectual disabilities should be considered.

Background: Positive behavioural support (PBS) can be effective in supporting children and young people (CYP) with developmental disabilities. This systematic review focused on describing the components and nine characteristics of PBS that have been used with CYP with developmental disabilities in special education settings, and the evidence for PBS effectiveness in these settings. Additionally, facilitators and barriers to PBS implementation, and experiences of stakeholders, were investigated. Method: Systematic searches followed a registered protocol, and 30 studies were identified, narratively synthesised, and critically appraised. Results: From the 30 studies included, 10 reported the presence of all 9 PBS characteristics, 17 reported on 8 PBS characteristics, and 3 reported on 7 characteristics. Overall, 28 studies demonstrated significant decreases in behaviours that challenge and increases in alternative behaviours, if increasing alternative behaviours was part of the interventions. Conclusions: There was a lack of evidence on facilitators and barriers, and a lack of qualitative studies exploring experiences of stakeholders with PBS in special education settings. The available evidence suggested that not all studies reported on all PBS characteristics when describing the approach followed. In addition, available evidence suggested that most studies demonstrated effectiveness of PBS regarding the measured outcomes. Implications and future directions are discussed.

Background: Health professionals were trained to deliver adapted psychological interventions for depression to people with learning disabilities and depression alongside a supporter. Exploring the delivery of psychological interventions can help increase access to therapy. Method: Twenty-seven participants took part in six focus groups, and the data were subject to a Framework Analysis. Results: The structure and focus of the manualised therapies, and the use of specific techniques were perceived as key to service-user engagement. Supporters' involvement was valued by therapists if they had a good relationship and regular contact with the individual they supported. Regular clinical supervision was regarded as vital in understanding their role, assessing progress and delivering the interventions. Conclusions: The findings highlight that health professionals can embrace a focussed therapeutic role and increase access to psychological therapies for people with intellectual disabilities.

Background: Early intervention (EI) can improve a range of outcomes for families of children with developmental disabilities. However, research indicates the level of access does not always match the level of need. To address disparities, it is essential to identify factors influencing access. Method: We propose a framework where access to EI is conceptualised as a "process" that includes three main phases. A narrative review examined potential barriers, facilitators and modifiers of access for each phase. Results: The process of access to EI includes the following: 1) recognition of need, 2) identification or diagnosis and 3) EI provision or receipt. Several factors affecting access to EI for each phase were identified, related to the family, services, the intersection between family and services, and the context. Conclusion: A broad range of factors appear to influence the process of access to EI for this population. Our framework can be used in future research investigating access. Broad implications for policy, practice and future research to improve access to EI are discussed.

Background: Based on self-reported social capital, different typologies of family networks of people with intellectual disabilities were examined. Associations between behavioural and emotional problems or well-being and typologies were investigated. Method: 137 participants with mild intellectual disability were interviewed using the Family Network Method-Intellectual Disability to assess their emotionally supportive family relationships. Data on participants' well-being and behavioural and emotional problems were also gathered. Latent class analysis was used to identify family typologies based on social network measures. Results: Four distinguishable typologies were identified, two supportive and two less supportive. A small association was found with behavioural and emotional problems and one of the supportive typologies. Associations with constructs of well-being were found for both supportive and less supportive typologies. Conclusions: A variety of family types were found, with implications for sensitive professional support.

Background: People with intellectual disabilities commonly experience multiple barriers to 'going out'. Aims: This paper explores what barriers prevented people from going out, and if the extent and nature of going out changed over time for people with intellectual disabilities as the COVID‐19 pandemic progressed. Methods: Data are drawn from a wider study that explored, at four time points, the experiences of people with intellectual disabilities through the COVID‐19 pandemic in the United Kingdom. Findings: The number of people leaving the house for almost all reasons increased over time through the pandemic, except for some outdoor participation and exercise. However, there was a significant decrease in outdoor exercise at the final time point of the study. Reliance on other people and a lack of availability of support were identified as barriers. Conclusion: A combination of factors restricted the extent to which people were going out even after COVID‐19 protections were lifted. [ABSTRACT FROM AUTHOR]

Background: The aim of this feasibility study was to adapt and model a behavioural intervention for anxiety with autistic adults with moderate to severe intellectual disabilities. Method: Twenty‐eight autistic adults with moderate or severe intellectual disabilities, 37 carers, and 40 therapists took part in this single‐group non‐randomised feasibility study designed to test intervention feasibility and acceptability, outcome measures, and research processes. Results: The intervention was judged as feasible and acceptable by autistic adults with intellectual disabilities, carers, and therapists. Minor intervention revisions were suggested. Carers completed 100% of outcome measures and the missing data rate was low. Complying with legislation governing the inclusion of participants who lack capacity to decide whether they wanted to take part in this study led to an average 5‐week enrolment delay. Conclusion: The intervention and associated study processes were judged to be feasible and acceptable and should now be tested within a larger randomised trial. [ABSTRACT FROM AUTHOR]

Background: Structured assessments have been shown to assist professionals to evaluate the risk of aggression in secure services for general offender populations and more recently among adults with intellectual disabilities. There is a need to develop intellectual disability sensitive measures for predicting risk of aggression in community samples, especially tools with a focus on dynamic variables. Methods: The study prospectively followed 28 participants for up to 2 months to test whether the Current Risk of Violence (CuRV) and Short Dynamic Risk Scale (SDRS) were able to predict verbal and physical aggression in a community sample of adults with intellectual disability. Results: CuRV and SDRS ratings significantly predicted verbal and physical aggression over a 2-month period. Conclusions: The current study supports the use of the CuRV with adults with intellectual disability living in community settings. The CuRV and SDRS are worthy of future development and evaluation in independent investigations.

Background: Previous evaluations of community PBS teams have not investigated whether behaviour change is both statistically reliable and clinically significant. Few previous studies have reported quality of life (QoL) and social validity outcomes. Method: The present authors collected data on 85 people referred to a specialist PBS team. The present authors used a unique set of multiple measures and statistical change metrics to evaluate outcome. Results: Statistically significant improvements in QoL and health-related QoL (HRQoL), with medium to large effect sizes, were demonstrated following PBS input. Mean Behaviour Problems Inventory-Short Form scores reduced from 37.74 (SD = 30.54) at baseline to 12.12 (SD = 12.24) at follow-up, with a large effect size (d = 0.84). Stakeholders reported valuing the process and outcomes of PBS, findings which support the social validity of PBS for people with developmental disabilities. Conclusion: This study demonstrates successful PBS outcomes in QoL, HRQoL, challenging behaviour and social validity in a community setting.

Background: Clinicians recommend including carers or others in a supporting role in the therapy as an important adaptation of psychological therapies for people with intellectual disabilities. This nested qualitative study from a larger trial explored supporters' experiences of supporting people with intellectual disabilities receiving behavioural activation or guided self-help therapies for depression. Method: Twenty-one purposively sampled supporters were interviewed. The semi-structured interviews were subject to framework analysis, covering expectations of therapy, views of therapy sessions, relationships with therapist and participant, and perceived changes. Results: Supporters were positive about both therapies and reported both therapy-specific and nonspecific therapeutic factors that had significant positive impacts on people's lives. Most supporters reported their involvement contributed to the interventions' effectiveness, and helped establish closer relationships to the people they were supporting. Conclusions: The presence of supporters within psychological therapies for people with intellectual disabilities can be an effective adaptation to therapies for this population.

Background: To enhance social inclusion of people with intellectual disability, policy is aimed at increasing informal support networks. Nevertheless, staff continue to play a vital role in their support networks. Method: Six individuals with mild intellectual disability, living in community-based settings, were interviewed following a semi-structured format. In-depth accounts of participants' support experiences were established using Interpretative Phenomenological Analysis. Results: Three main themes were identified: relationships with staff placed within a personal history, relationships with staff within an organisational context, and staff support and interviewees' place in the world. Conclusions: Relationships with staff were often one of the closest and most significant social relationships participants had. As living in the community had not necessarily led to meaningful inclusion for participants, the findings point at the important role of staff in supporting and facilitating friendships and close relationships of people with intellectual disability.

Background: Informal supportive networks of individuals with intellectual disability have become increasingly important. The aim of this paper is to describe how the Family Network Method--Intellectual Disability (FNM-ID) offers a way to gather the perspective of people with mild intellectual disability on their family support. Method: The FNM is designed to explore how individuals define their family contexts, and more specifically how they perceive existing supportive relationships in these contexts. Results: By carefully piloting ways of questioning people with mild intellectual disability, systematic adaptations were made to the original FNM. Data obtained by the FNM-ID can be analysed using social network analysis. Thereby, the FNM-ID provides rich, theoretically significant information on emotional support in the family networks of individuals with mild intellectual disability. Conclusions: The FNM-ID is a useful and successfully adapted tool for other researchers and professionals to systematically explore the family support experiences of individuals with mild intellectual disability.

Background: The review examined the effectiveness of Active Support (RQ1) and stakeholders' experiences of the model (RQ2). Method: Data were meta-analysed (RQ1; studies = 14) and synthesized narratively (RQ2; studies = 10). Results: By follow-up (6 months post-training), effect sizes (RQ1) for resident total activity engagement were significant and ranged from small (d = 0.33, 95% CIs: 0.10-0.50) to large (Tau-U = 0.95, 95% CIs: 0.64-1.25) depending on study design. Follow-up changes in staff assistance were moderate (d = 0.56, 95% CIs: 0.23-0.89; Tau-U 0.63, 95% CIs: 0.32-0.93) and large for quality of support (d = 1.03, 95% CIs: 0.61-1.44). Other outcomes did not change. Conclusions: Active Support was more effective following complete staff training, in larger settings, at lower staff-to-resident ratios and with less experienced staff. Active Support training and outcomes were valued by staff and residents (RQ2), and staff experienced increased job satisfaction. Lower staff turnover and organizational readiness appear crucial for maintaining implementation.

Background: Parenting an individual with intellectual and developmental disabilities (IDD) can be challenging, particularly during adulthood. It is important to better understand ways of supporting families as individuals with IDD age. Self-compassion is a potential internal coping resource for parents, and is strongly linked to positive mental health outcomes, though research has yet to examine it in parents of adults with IDD. Method: The current study examines the association between self-compassion and measures of well-being for 56 parents of adults with IDD. Results: Greater self-compassion was related to lower levels of stress and depression, even after accounting for other known stressors, such as economic disadvantage, having a child with an Autism Spectrum Disorder diagnosis, and high parent burden. Conclusions: Self-compassion may offer resiliency against these parenting challenges.

Background: Providing long-term care to an adult relative with intellectual disability can impact negatively on caregivers' health and well-being. Methods: Data were collected via online and postal questionnaires on 110 family carers' physical and psychological health, family stress and perceived positive gains from caring. Psychological adaptation and carers' satisfaction with available support were also examined. Results: Study participants reported more health problems than general populations. Higher support needs of care recipients were associated with increased family stress. Carers being female were associated with lower family stress. Older age and better socio-economic position were associated with better psychological outcomes. Other associations were consistent with psychological adaption and perceived helpfulness of support buffering negative outcomes and facilitating positive gains from caring. Conclusions: Family carers of adults with intellectual disability appear to experience poorer health outcome than population norms. Adaption to the caregiving role may buffer negative outcomes. Further large scale, population-based, longitudinal research is needed.

Background: Arabs with intellectual disabilities and/or autism may exhibit challenging behaviour that affects them and their caregivers. Early, appropriate intervention may reduce these effects. This review synthesised and critically appraised challenging behaviour intervention research for this population. Methods: All published empirical research on challenging behaviour interventions for Arabs with intellectual disabilities and/or autism was included. In September 2022, 15 English and Arabic databases yielded 5282 search records. Studies were appraised using the MMAT. Review findings were narratively synthesised. Results: The 79 included studies (n = 1243 participants) varied in design, intervention, and evaluation method. Only 12.6% of interventions were well‐designed and reported. Arab interventions primarily targeted children, were applied collectively on small samples, lacked individualised assessment, and were based on an inconsistent understanding of challenging behaviour. Conclusion: The evidence base on interventions for Arabs with intellectual disabilities and/or autism and challenging behaviour needs strengthening. Attention should be given to culturally relevant adaptations. [ABSTRACT FROM AUTHOR]

Background: People with severe to profound intellectual disabilities experience similar or higher levels of depression than those with more mild intellectual disabilities. Yet, there is an absence of evidence about how to adapt existing psychological therapies for this population. Method: A behavioural activation intervention (BeatIt) for people with mild to moderate intellectual disabilities was adapted for people with severe to profound intellectual disabilities and depression. Key considerations include: (i) beginning with a more in‐depth assessment process; (ii) including the person in session activities and developing a relationship with them; (iii) formulation and the use of film to document the link between activity and mood; and (iv) addressing barriers to change at an individual and inter‐personal level and considering how the carer could support the person's engagement in activity. Results: Successfully adapting BeatIt represents a first step towards gathering evidence about the effectiveness of behavioural activation for people with severe to profound intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background: The perceptions of individuals with Down syndrome are conspicuously absent in discussions about the use of prenatal testing. Method: Eight individuals with Down syndrome were interviewed about their views and experience of the topic of prenatal testing. Results: Interpretative phenomenological analysis revealed two major themes with subthemes: (1) a devalued condition and a valued life and (2) a question of "want"? Foucauldian discourse analysis highlighted two main discursive practices: (i) social deviance and (ii) tragedy and catastrophe of the birth of a baby with Down syndrome. Conclusions: The findings suggest that individuals with intellectual disabilities can make a valuable contribution to discussions surrounding the use of prenatal testing. Implications for clinical practice include the use of information about Down syndrome given to prospective parents, and the possible psychological impact of prenatal testing practices on individuals with Down syndrome.

Background: Several studies have reported relationships between life events and psychological problems in people with intellectual disabilities. In contrast to the general literature, data have consistently been collected via proxy informants and putative moderator variables such as social support have not been examined. Materials and Methods: Thirty-eight adults with intellectual disabilities completed three psychological measures in a semi-structured interview setting: the Bangor Life Events Schedule for Intellectual Disabilities Self-Report, the Brief Symptom Inventory, and the Social Network Map. Results: Exposure to life events was positively associated with measures of psychological problems. Social support was generally not found to be associated with psychological problems, although more psychological problems were reported by participants who also reported more criticism of them by others. Conclusion: Findings are broadly consistent with the proxy-report literature, though self-report measures may prove more sensitive. A number of methodological issues, clinical implications, and future research directions are discussed.

Background: Interactive training (IT) is one of the two staff training components of the active support (AS) model. The present study explores how effective IT is when offered to staff divorced in time from the AS workshops, the other training component. We explored the effects of IT on resident activity engagement, challenging behaviours and staff assistance. Materials and Methods: Twenty-one adults with an intellectual disability living in residential settings participated. Observations and ratings of staff and resident behaviours were obtained before, immediately after the training sessions, and at 6 months follow-up. Results: Group-level analyses indicated a short-lived improvement in quality of staff support but, in general, there was an overall lack of change in staff behaviours, resident engagement and--observed and rated--challenging behaviours. However, subgroup analyses indicated that there was a significant improvement in engagement immediately after IT for a distinct subgroup of participants; those who had significantly higher aggressive behaviour ratings at the beginning of the study. Conclusions: Findings support the combination of the training components of AS for improvements in the quality of life for people with intellectual disability. IT may also be worthy of future study as a potential stand-alone intervention for people with the most difficult challenging behaviours.

Background: Previous research with mothers of children with intellectual disabilities has shown that psychological acceptance is related to maternal psychological well-being. The present research extended this line of enquiry to fathers and explored the potential for psychological acceptance to mediate the impact of children's behaviour problems on paternal well-being. Method: Ninety-nine fathers of 67 boys and 32 girls with intellectual disability, between 6 and 18 years of age, participated in a questionnaire study. Psychological acceptance of difficult/negative emotions and thoughts associated with interactions with the child with intellectual disability were measured alongside ratings of the child's behaviour problems and paternal negative (stress, anxiety, depression) and positive ("positive gain") well-being. Results: Psychological acceptance was found to partially mediate the impact of child behaviour problems on paternal stress, anxiety, and depression. Acceptance was also a positive predictor of fathers' perceptions of positive gain associated with raising their child with intellectual disability. However, it could not function as a potential mediator of positive gain in the present research because fathers' ratings of their child's behaviour problems were not associated with paternal positive gain. Conclusions: Implications for practice include the potential of acceptance-based interventions, and other psychological interventions targeting acceptance and avoidance processes (e.g. mindfulness-based approaches), to positively affect paternal psychological adjustment.

Background: Staff in intellectual disability services can be at risk of stress and burnout at work. Given that staff well-being has implications for the quality of life of the staff themselves and people with intellectual disabilities themselves, this is an important research and practical topic. In this paper, we review work stress theories that have been applied within intellectual disability research. Method: A search of the literature identified five stress theories that have been applied in intellectual disability research: person-environment, demand-support-control, cognitive-behavioural, emotional overload, and equity theory. Results: Each of the five work stress theories is described and the extent to which data within intellectual disability research relates to these theories is explored. Some of the key theoretical constructs within these work stress models have been explored in intellectual disability research but frequently the underlying processes within work stress models have not been fully tested. Conclusion: Partial exploration of work stress theories means that theoretical understanding of how best to explain work stress in intellectual disability staff is limited. Suggestions for future research are discussed, particularly concerning the relationship between empirical research and work stress theory.

Background: Individuals with intellectual disability are at higher risk of premature death compared with individuals without intellectual disability, and therefore parents of people with intellectual disability are more likely to outlive their children. However, there has been relatively little research investigating the bereavement experiences of parents of deceased children with intellectual disability. Method: Semi-structured interviews were used to explore the experiences of nine mothers whose child with intellectual disability had died. The transcripts were analysed qualitatively using Interpretative Phenomenological Analysis. Results: Five themes emerged from the analysis: loss, benefit finding, coping, sources of support and medical relationships. An analysis of the accounts indicated similarities and differences between the experiences of the mothers. In particular, continuing in their caring role by working within the world of intellectual disability following the death of their child was important to all of the mothers. Support from similarly bereaved parents was the most useful source of support, although it was not always readily accessible. Conclusions: Implications for theory and practice are described including suggestions that service providers should aim to maintain links with families after the death of their child, a parent-to-parent programme that enables parents to contact others in a similar situation might be beneficial, and further research into the functions of coping strategies and supports in loss would be worthwhile.

Background: A range of factors have been suggested as determinants of staff behaviour in the context of working with people with challenging behaviour. The purpose of this study was to evaluate whether a typical challenging behaviour staff training course had an effect on staff feelings of efficacy, their negative emotional reactions to challenging behaviour, and their causal beliefs. Methods: Forty-eight staff attending a 3-day training course on understanding challenging behaviour and managing stress were assessed pre-training and at a 3-month follow-up. Questionnaires assessing self-efficacy, emotional reactions and causal beliefs were used. Results: Perceived self-efficacy in dealing with challenging behaviours increased significantly from pre- to post-training. There were no significant changes in either emotional reactions to challenging behaviours or causal beliefs. Conclusion: In common with previous research, there was a sizeable impact on staff confidence and efficacy after a 3-day training course. Given the potential significance of emotional reactions both in terms of staff behaviour and their psychological well-being at work, more research is needed to explore how these reactions might best be dealt with in staff training interventions.

Background: The working culture surrounding challenging behaviour may have a strong effect on staff behaviour. As a first step to influencing staff talk about challenging behaviour, the aim of the present study was to explore whether a 1-day training workshop could have an effect on staff causal explanations. Methods: Fifty-four front line staff, in six separate groups, completed an adapted version of the Self-Injury Behavioural Understanding Questionnaire (SIBUQ; Oliver et al. 1996) both before and after a 1-day training workshop. The workshops were based on principles of Applied Behaviour Analysis. The SIBUQ comprised questions about causes of challenging behaviours presented in 11 short scenarios. The four possible response options for each scenario reflected behaviourally correct, behaviourally incorrect, internal emotional, and internal organic causal explanations. Results: The number of correct behavioural causal hypotheses increased significantly from pre- to post-training. The proportion of incorrect causal explanations that were behavioural in orientation also increased significantly from pre- to post-training. Conclusions: Staff causal explanations for challenging behaviour can be changed using a relatively brief intervention. Further research is needed to establish whether such changes can be used to influence working culture in challenging behaviour services.

Background: There is a high rate of physical violence in populations with intellectual disabilities, and this has been linked to problems for the victim, the assailant, members of staff and services. Despite the clinical significance of this behaviour, few studies have assessed methods of predicting its occurrence. The present study examined clinical and actuarial methods of predicting violence in a forensic intellectual disability hospital. Methods: The sample for the study consisted of people resident in the hospital during a 1-year period (n = 124). Clinical prediction used a risk rating made by members of the person's clinical team, whereas actuarial prediction used the number of violent incidents in the 6-months before the date of the clinical risk assessment. Computerized hospital records of violence in the 6 months after the assessment were used to examine the predictive accuracy of the two methods. Results: The clinical method produced an area under the curve of 0.74 (95% CI: 0.65-0.83) in a receiver-operating characteristic curve analysis. The value for the actuarial method was 0.77 (95% CI: 0.69-0.86). Both methods performed at levels significantly above chance, but no one method was found to be superior to the other. Conclusions: These findings suggest that it is possible to predict who is at risk of violence in forensic populations with intellectual disabilities. Here, the authors discuss the clinical implications of these findings and the clinical application of risk prediction within clinical services.

Background: Hastings, R. P. ["American Journal on Mental Retardation" (2002) Vol. 107, pp. 455-467] hypothesized that staff negative emotional reactions to challenging behaviour might accumulate over time to affect staff well-being. Only one previous study (Mitchell, G.& Hastings, R. P. ["American Journal on Mental Retardation" (2001) Vol. 106, pp. 448-459] has explored this relationship. The present analyses were designed to replicate these findings. Methods: Data were analysed from two samples of staff. In study 1, 101 staff rated their typical emotional reactions to challenging behaviours experienced as a part of their work and completed the Maslach Burnout Inventory (MBI). In study 2, 99 staff rated their negative emotional reactions to written challenging behaviour vignettes and also completed the MBI. Results: In both studies, significant positive correlations were found between negative emotional reactions to challenging behaviour and emotional exhaustion and depersonalization burnout but no association was found with personal accomplishment scores. Conclusions: These findings replicate previous results, but cannot be used to support the putative causal relationship between emotional reactions to challenging behaviour and staff well-being. Clinical implications of a focus on staff emotional reactions to challenging behaviour are discussed.

Background: Previous research has identified various dimensions of social support that are positively associated with parental well-being. However, most research does not include multiple measures of social support and uses heterogeneous samples in terms of child characteristics such as age and severity of intellectual disability. Methods: Thirty-three parents of adolescent children with moderate-profound intellectual disabilities completed measures of parental well-being (stress, anxiety and depression, and caregiving satisfaction), social support (informal and formal sources, and practical and emotional support), and child characteristics (adaptive and problem behaviours). Results: Correlation analyses showed that parental well-being was associated with the child's adaptive and problem behaviours and with the child's autism diagnosis. Parents' ratings of the helpfulness of informal sources of support (spouse, extended family, friends, etc.) was most reliably associated with parental well-being, and remained so after controlling for child characteristics. Parents' access of service and professional support was not associated with parental well-being, but there was some evidence that it was related to their child's needs. Conclusions: The research emphasizes the significance of including multiple measures of social support in research with families of children with an intellectual disability. Furthermore, the possibility that parents, during their child's adolescence, may be especially vulnerable to the disruption of their informal support networks is an important practical consideration.