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Background: Placement behaviours of families of adults with intellectual disabilities has received little or no attention of researches to date. Methods: A prospective design was adopted to examine changes in placement decisions of 75 family carers over a 12-month period. Factors associated with changes were also examined. Results: Over 12 months, 30 families moved closer to considering an out of home placement. Of these 14 had placed their relative in out of home care. Proactive coping strategies were significantly associated with an increased likelihood of continued home care. Conclusion: While the results were similar to studies with children with intellectual disability (ID) or autism spectrum disorder (ASD), a move out-of-home occurred more quickly for adults. This may reflect current social policy and societal attitudes where moving out of home is more normative for adults with ID. The lack of association with all but one carer or care recipient factors suggest that changes in placement tendencies for adults may differ from that of children.

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.

Very little is known about factors potentially affecting the performance of therapists delivering applied behavior analysis (ABA) interventions for young children with autism. Eighty-one therapists working in ABA schools participated in a questionnaire study focused on their reports of burnout and perceived therapeutic self-efficacy in their work role. Perceived supervisor support played a central role in the prediction of reduced therapist burnout and increased therapeutic self-efficacy. In addition, perceived supervisor support moderated the impact of work demands on personal accomplishment burnout. Those therapists reporting high work demands and lower levels of supervisor support had lower personal accomplishment scores on the Maslach burnout inventory. Clinical implications include the importance of supervisor support for therapists and also supervisor style.

The purpose of this study was to determine the effects of a cooperative learning (CL) intervention on the levels of social and task engagement of a child with autistic spectrum disorder (ASD) conducted in a mainstream class setting and a child with ASD implemented in a special needs class setting. The target children were two 8-year-old boys diagnosed with high functioning autism. Both children were placed in CL groups which included three typically developing peers, one male and two females. Four baseline sessions taught in a traditional teaching format and seven CL intervention sessions based on a "learning together/conceptual approach" took place. All sessions were recorded for video analysis. CL was found to be successful in substantially increasing the level of social engagement for both the child in the special needs class and the child in the mainstream class. CL was not found to facilitate task engagement. Active task engagement was found to remain relatively stable and passive task engagement was found to decrease for one child and remain stable for the other. Teacher concerns and issues relating to the practical implementation of CL in both settings are discussed. (Contains 1 table, 2 figures and 2 notes.)

Background: Effectively supporting individuals with intellectual disabilities who display challenging behaviours continues to be a priority for service providers. Person-focused training (PFT) is a model of service delivery which provides staff with skills in functional assessment and intervention development. Existing longitudinal data from a study of 138 cases suggest that implementation of staff-developed behaviour support plans through PFT is effective in reducing challenging behaviour in approximately 77% of cases [McClean et al. "Journal of Intellectual Disability Research" (2005) vol. 49, pp. 340-353]. However, no control group was used in this study. Method: The current study involves the use of a control group of individuals with challenging behaviours matched against those selected for PFT over a 6-month period. Groups were matched on type of challenging behaviour, duration of challenging behaviour, gender and level of disability. Information on the frequency, management difficulty and severity of challenging behaviour was collected pre- and post-training using the Checklist of Challenging Behaviours (CCB) for both groups. Observational data were collected for the target group alone. Rates of psychotropic medication were tracked across the training period. Results: Significant reductions in the frequency, management difficulty and severity of challenging behaviour were found for service users in the target group but not in the control group after 6 months. No significant changes were found in the use of psychotropic medication for either group over the 6-month period. Conclusion: Overall results suggest that PFT is an effective model for providing support to individuals with challenging behaviours.

Purpose: Bursitis is a common musculoskeletal cause of shoulder pain and treatment varies, thus correctly diagnosing and grading bursitis is paramount in deciding management. Our aim was to assess reliability in grading shoulder bursitis on ultrasonography among fellowship trained musculoskeletal radiologists at our institution. Methods: Retrospective study of patients diagnosed with bursitis on ultrasonography. Single-sonographic images of the subacromial-subdeltoid bursa were collected for each patient and randomized to form a test-bank of varying degrees of bursitis. Three months after the test was administered, the cases were randomized and readministered. The radiologists graded each case as: within normal limits, mild, moderate or severe. Intraobserver variability was measured using Cohen's kappa coefficient. Linear regression model was performed to assess correlation between years of experience and kappa. Results: 10 radiologists reviewed 70 cases of bursitis. Kappa values ranged from.53 to.91, indicating 'moderate' to 'almost perfect' variability amongst radiologists. A moderate positive correlation of improving variability (r =.69) with increasing years of experience exists. Conclusion: Fellowship trained musculoskeletal radiologists were able to grade shoulder bursitis with moderate to almost perfect variability, with a positive correlation of improved variability with increasing experience. This may help clinicians choose the correct treatment more confidently in their patients with shoulder pain. [ABSTRACT FROM AUTHOR]

Thirty-four staff providing services to people with intellectual disabilities completed the Challenging Behaviour Attribution Scale with respect to a specific client before, during, and after completing a course in assessment and intervention for challenging behavior. Significantly more staff attributed challenging behavior to negative reinforcement and self-stimulation after training and fewer staff attributed such behavior to positive reinforcement. (Contains references.) (Author/DB)