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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.

There is variability in the extent to which mothers are affected by the behavior problems of their children with developmental disabilities (DD). We explore whether maternal resilience functions as a protective or compensatory factor. In Studies 1 and 2, using moderated multiple regression models, we found evidence that maternal resilience functioned as a compensatory factor--having a significant independent main effect relationship with well-being outcomes in mothers of children with DD and autism spectrum disorder. However, there was no longitudinal association between resilience and maternal well-being outcomes. There was little evidence of the role of resilience as a protective factor between child behavior problems and maternal well-being in both studies.

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.

Introduction: Current research findings in the field of intellectual disabilities (ID) regarding the relationship between mental health problems and challenging behavior are inconclusive and/or contradictory. The aim of this study was to further investigate the putative association between these two highly prevalent phenomena in people with ID, and specifically to explore the hypothesis that challenging behaviors may be behavioral equivalents of mental health problems. Methods: A sample of 160 adults accessing secondary care ID health services was assessed using five validated measures. These included ratings of severity of disability, mental health problems, autism behaviors, physical health problems, and four different aspects of challenging behavior. In conjunction with demographic information, four multiple regression analyses were undertaken to examine the interaction between mental health problems (moderated by severity of disability) and ratings of overall challenging behavior, aggression, self-injurious behavior, and stereotypy. In each case, age, gender, autism, and physical health problems were included as covariates. Results: There was a statistically significant association between mental health problems and ratings of overall challenging behavior, as well as the moderating effect of severity of disability. Importantly, the positive association between mental health problems and challenging behavior was only significant at more severe levels of disability. Conclusions: These findings support the "behavioral equivalents" hypothesis for mental health problems and challenging behaviors. However, further longitudinal research is required before this hypothesis can be considered unequivocally supported.

Background: Behaviour support plans (BSPs) are at the core of positive behavioural support for challenging behaviour, but nonadherence to BSPs is common. Generally, nonfluent component knowledge prevents learners achieving fluent application and retention of information, and we hypothesised that this may apply to staff learning BSPs. Method: We compared the effectiveness of fluency training (FT) and precision teaching on staff learning of BSPs with staff receiving consultation as usual, comprising standard support for learning BSPs. All staff completed pre- and postintervention tests measuring frequency of component skill recall and application of component knowledge (composite skills). Results: The FT group made and maintained greater gains in component skill recall and achieved higher composite test scores, suggesting greater application of component skills. These effects were associated with moderate effect sizes. Conclusions: This study offers initial support for the application of FT and precision teaching for staff learning BSP content.

Background: Little is known about the experiences of parents whose sons or daughters are diagnosed with autism spectrum disorder (ASD) during adulthood. Method: In this exploratory study, 6 mothers of adults recently diagnosed with ASD were interviewed about the ASD assessment process. Thematic analysis was used to analyse the interviews. Results: Two superordinate themes are described: (1) biographical continuity, and (2) biographical disruption. Mothers did not experience significant disruption around the ASD assessment itself, as they had sought an explanation for their son's/daughter's behaviour since childhood. Therefore, being referred for an ASD assessment was simply another assessment for their son or daughter and was thus a "biographical continuity." Mothers experienced "biographical disruption" once an ASD diagnosis was received, as they realised that an ASD diagnosis did not result in any additional support, and found this greatly frustrating. Conclusions: There is an unmet need for postdiagnostic support among adults diagnosed with ASD, and for their parents.

Objectives: Behavioral and emotional problems exhibited by children with intellectual and developmental disabilities (IDD) have been identified as significant stressors for family members in both cross-sectional and longitudinal research. However, there is variability in the extent to which family members are affected by behavioral and emotional problems. In the present study, we explored whether perceived social support, positive perceptions, or coping style explain some of this variability and specifically whether these three variables function as protective factors.Methods: One hundred and thirty-eight mothers of children aged between four and 18 years old with IDD participated in a cross-sectional survey. Results: Using moderated multiple regression models, we found consistent evidence that perceived social support functioned as a protective factor -- affecting the relationship between child behavioral and emotional problems and maternal depression, life satisfaction, and positive affect. There was no evidence that coping and positive perceptions acted as a protective factors. Conclusion: Building social support through parental interventions, especially in families of children with behavioral and emotional problems, may result in improved well-being for mothers of children with IDD.

There is a distinct lack of research identifying the interventions used by parents for the support and education of children with autism in the UK. This internet-based survey is the first to report exclusively on data from a UK sample of 160 parents. We sought to identify and describe the interventions used currently and in the past, and explored associations between parent and child characteristics and interventions used. We found that visual schedules, speech and language therapy, and Applied Behavior Analysis (ABA) were currently most in use, and that the majority of parents reported using more than one intervention concurrently. Younger children were more likely to be currently using at least one intervention, and current use of ABA was found to be associated with higher parental educational level. The findings highlight the need for further research into the factors that underlie decision-making in respect to interventions used.

Parents of children with intellectual disabilities and/or autism have been shown to experience higher levels of distress than other parents. Despite such data having been available for several decades, the evidence base for psychological interventions to support parental well-being is small. Recent data suggest that both mindfulness and acceptance processes are associated with decreased psychological distress for parents of children with intellectual disability and/or autism. In addition, some controlled evaluations of mindfulness-based interventions for these parents have resulted in positive outcomes for mothers in particular. In the present study 18 mothers and 3 fathers were recruited via special schools who then attended a Mindfulness Based Well-Being for Parents (MBW-P) group over eight weeks. Parents completed questionnaire measures before and at the end of the course. Statistical analysis showed significant reported increases in mindfulness and self-compassion, and reduced general stress. Parents also reported reductions in anxiety and depression, although these changes were not statistically significant. No significant reductions in their child's behaviour problems or increases in the child's prosocial behaviour were found. Parents also reported high levels of satisfaction with the course. These preliminary data suggest that further research studies testing the effectiveness of the MBW-P course are warranted.

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]

Children with intellectual disabilities often struggle with handwriting, but there is very little research to inform intervention approaches. In this study, we developed a teaching manual based on Handwriting Without Tears®, a comprehensive handwriting programme designed for typically developing children. Three children with intellectual disabilities participated in the study and received handwriting instruction based on the manual three times a week over a 32-week period. Our aims were to explore whether Handwriting Without Tears® can be used as a comprehensive handwriting curriculum for children with intellectual disabilities and to evaluate improvement in handwriting skills. We found that the intervention was successfully incorporated into small group teaching sessions within the child's regular classroom, and that all three children made improvements. Our data show promising results and support the need for larger evaluation studies.

This study evaluated two community based interventions for parents of adults with autism spectrum disorder and other developmental disabilities. Parents in the mindfulness group reported significant reductions in psychological distress, while parents in the support and information group did not. Reduced levels of distress in the mindfulness group were maintained at 20 weeks follow-up. Mindfulness scores and mindful parenting scores and related constructs (e.g., self-compassion) did not differ between the two groups. Results suggest the psychological components of the mindfulness based group intervention were effective over and above the non-specific effects of group processes and informal support.

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.

Research into factors underlying the dissemination of evidence-based practice is limited within the field of Applied Behaviour Analysis (ABA). This is pertinent, particularly in the UK where national policies and guidelines do not reflect the emerging ABA evidence base, or policies and practices elsewhere. Theories of evidence-based practice in education and policy suggest that decision makers' "perceptions" of evidence are significant factors in dissemination. For professionals, scientific evidence is often critical. For others, including parents, experiential and anecdotal evidence can be as important. Within autism education, parents are often, and not necessarily by choice, key decision makers. This study is the first to try to identify and quantify UK parents' beliefs about ABA in the education and support of children with autism. We developed and tested, using an internet survey method, the Parental Beliefs about ABA and Autism scale (P-BAA). Current and/or past use by parents of any behaviorally based approach including ABA was a significant predictor of P-BAA scores as were parent education, household income and child diagnosis: experience of a behaviorally based approach, higher levels of education and income and children at the more "severe" end of the autism spectrum were associated with more positive beliefs about ABA.

The incorporation of mental well‐being provision into school curricula is increasingly the focus of government policy in the UK and internationally. However, it is not clear what well‐being programmes schools provide to pupils, and how these programmes are delivered. The current study was an online survey to assess the use of whole‐school well‐being programmes in primary schools in North Wales. Normalisation Process Theory was utilised as a framework to assess normalisation of the well‐being programmes. One‐hundred and fifty‐one schools in North Wales responded to the survey. The mean number of whole‐school well‐being programmes utilised by schools was 4.59, and nine of the 10 most frequently used programmes had little or no associated evidence base. The well‐being programmes were generally perceived as normalised (i.e. everyday practice) by respondents. Implications for future practice are discussed, including the need to support schools to identify and implement evidence‐based mental well‐being provision. [ABSTRACT FROM AUTHOR]

Traditionally, cluster randomized controlled trials are analyzed with the average intervention effect of interest. However, in populations that contain higher degrees of heterogeneity or variation may differ across different values of a covariate, which may not be optimal. Within education and social science contexts, exploring the variation in magnitude of treatment effect at different points in the population can indicate where the intervention is most effective rather than assuming an average effect. Data from [Owen, K.L., et al., 2021. Implementation support improves outcomes of a fluency-based mathematics strategy: A cluster-randomized controlled trial. Journal of research on educational effectiveness, 14 (3), 523–542.] were reanalyzed using three modeling approaches: conditional mean-modeling reporting the average treatment effect using linear mixed models, and two quantile regression-based methods. Quantile regressions report the quantile treatment effects at different percentiles: 10th, 25th, 50th, 75th and 90th. For the Quantile approaches, a significant intervention effect in the median to upper quantiles was found and linear quantile mixed model showed improved fit over the other approaches. An improved picture of intervention effects may be apparent using quantile regression methods when analyzing cluster randomized trials that have heterogeneous error variance. In particular, the linear quantile mixed model shows improved model fit allowing a multilevel framework to include random effects. There is considerable scope to extend this framework to incorporate more complex RCT designs. [ABSTRACT FROM AUTHOR]

Cross-lagged panel designs were used to examine longitudinal and potential (bi)directional relationships between primary caregiver reported sibling relationship quality and the behaviors of children with intellectual disability (n = 297) and their closest in age siblings. The behavioral and emotional problems of the child with intellectual disability positively predicted sibling conflict over time. When accounting for control variables, this relationship was no longer present. Sibling warmth positively predicted the prosocial behaviors of the child with intellectual disability over time. When accounting for control variables, both sibling warmth and sibling conflict positively predicted the prosocial behaviors of the child with intellectual disability over time. Future research directions and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

There is a general lack of self-report data from service users with an intellectual disability (ID) about their views of psychological interventions. This research explored the views and experiences of female inpatients, with a diagnosis of a personality disorder and an ID, about dialectical behaviour therapy (DBT). Semi-structured interviews were used with 10 women, recruited from two independent mental health hospitals. The interviews were analysed using interpretative phenomenological analysis. Participants showed varying levels of understanding of DBT. Findings highlight the need for a standardized approach with a suitably adapted structure and curriculum to meet the needs of inpatients with an ID. Factors such as the therapeutic relationship were identified as playing a role in participants' motivation, engagement and participation in DBT.