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Tactile defensiveness in autistic individuals is the least investigated sensory modality. The current multi-component, explorative study aimed to understand the experiences of ten autistic adults regarding tactile defensiveness and fabrics, using semi-structured, one-to-one interviews. Participants were asked to discuss the effects of seven provided samples of fabrics and were also asked to bring their ‘favourite’ fabric (s) and express their thoughts about their choices. Using Interpretative Phenomenological Analysis and Content Analysis, the findings showed that some fabrics can impact individuals’ reported wellbeing. Participants’ experiences with several stimuli appeared to have helped them implement coping strategies. By understanding tactile defensiveness, society could move towards increasing autism-friendly approaches with appropriate fabrics. Recommendations for future research, policy and practice are also discussed.

Purpose Amongst other actions the Care Act 2014 emphasised the duties of local authorities (LA) to assess the needs of carers, as well as those they care for and to meet all eligible needs for support. This paper aims to report the findings of a study which explored the experiences of older carers of people with learning disabilities as they navigated LA assessment processes and personnel. Design/methodology/approach Using an explorative design, 21 older carers were interviewed about their experiences. Interview transcripts were qualitatively analysed. Findings Three main themes were identified, namely, needs assessments as ambitions, not outcomes; the effects of funding-cuts projected onto carers; and challenges with social care personnel. Originality/value The study findings attracted a high level of engagement with public awareness and mainstream news and social media. The LA also immediately responded with interventions to address some of the findings, including carer “drop-in” sessions. They are also adapting their carer’s needs assessment processes as a result of the study. It is hoped that the issues raised will be of interest to other social care providers and practitioners.

Background Adults with intellectual disabilities have historically been hindered, rather than supported, in their desire to form loving relationships. This paper sought to explore with them what kinds of support they wanted in the 21st Century. Method Semi-structured in-depth interviews were conducted with 40 adults with intellectual disabilities in the United Kingdom. Results Participants placed a high value on having a partner and being supported to maintain and develop a loving relationship. The factors which constrained them in achieving this included a lack of social opportunities, barriers created by social care services and limits on them exercising autonomy. Facilitating factors included access to specialist dating agencies, strong family and staff support and opportunities to learn about relationships. Conclusions The importance of a loving relationship as a source of pleasure and meaning in the lives of adults with intellectual disabilities who are often disadvantaged in many other spheres of life is emphasised.

Background: Despite the importance of social networks for health and wellbeing, relatively little is known about the ways in which adults with intellectual disabilities in the U.K. experience their social networks. Method: A systematic review was completed to identify research focused on the social networks of adults with intellectual disabilities. Studies published from 1990 to 2019 were identified. Studies were thematically analysed. Results: Quantitative, qualitative and mixed methods studies were analysed to identify key factors influencing social networks. Experiences of people with intellectual disabilities identified themes of identity, powerlessness, inclusion, family, and support. These themes are discussed with reference to theories of stigma and normalization. Conclusions: Stigma and normalization can be used to better understand the needs, desires and dreams of people with intellectual disabilities for ordinary relationships, from which they are regularly excluded. Implications for policy and practice are discussed in relation to building and repairing often spoiled identities.

Purpose Because people with learning disabilities (LD) are living longer, their family carers are likely to continue their caring role for longer. This study aims to explore the experiences of older carers of people with LD. Design/methodology/approach In total, 16 interviews with older carers were carried out and analysed qualitatively. Findings Three main themes emerged from the data: “transition to retirement is a misnomer”; “impact of caring role”; and “fears for the future”. Originality/value Previous studies have not focussed on the specific experiences of “older” carers and their situation risks going unnoticed. Their experiences should be acknowledged by services and society and meaningful support provided.

Access to church communities can be difficult for autistic people. Whilst specific autism guidelines are available for churches to follow, their dissemination among church communities, as well as churchgoers’ attitudes towards autism is unknown. Semi-structured interviews were used with twenty-one adult church-goers from four Protestant churches in England, UK. Using a grounded theory approach to analyze the data, three themes were identified: “different understandings of autism”, “degrees of ableism” and “idiosyncratic practice.” We found positive and pejorative attitudes; this mix of perspectives reflecting the idiosyncratic practice among churches. Recommendations for further research and church practice are provided.

Dating agencies are a small, but growing sector of social care provision for people with intellectual disabilities. The research reported here is the first to explore, with 10 specialist agencies in the UK, why they were set up, how they operate, the barriers and problems they encounter and their success or otherwise in facilitating relationships for people with intellectual disabilities. A strong case is made for the proliferation of such services.

People with intellectual and developmental disabilities often need support to develop and maintain intimate relationships; however, little is known regarding the role of family carers in this area. Focus groups were conducted with 19 family members to explore the support they provide to people with intellectual and developmental disabilities to find a potential partner and any support they may have to provide to support/develop an existing relationship. Family members provided similar support in this area as support staff, including both practical and emotional support. More needs to be done to support the family members providing this support, such as access to specialist resources and advice, as well as facilitated opportunities to discuss concerns.

Context: UK austerity measures following the 2008 financial crisis included budget reductions for health and social care. We aimed to investigate the extent to which austerity-measures had impacted the lives of people with intellectual disabilities in England, and whether their support costs were associated with their characteristics, needs and outcomes.Objectives: We report on what services people with intellectual disabilities were using, whether they had lost care, the costs of their support, and what impact any loss of benefits and services had on individuals’ lives.Methods: 150 participants with intellectual disabilities across England were interviewed about their services and their well-being. Service and individual support costs were calculated. Statistical and thematic analyses were employed.Results: The largest proportion (42%) of our sample had lost care. 14% had experienced changed care, and care had remained the same for 36%. Only 7% said their care had improved. No associations were found between costs and characteristics and needs except for whether the person had mild or severe intellectual disabilities. Those who had lost care engaged in fewer activities and had significantly lower self-esteem and quality-of-life scores compared with those who had not lost care. Loss of care impacted on individuals’ independence and future aspirations.Limitations: A comparative study of austerity impacts across the whole of England was not possible. Our costs data may be underestimated because full information on support from home, key, or support workers was unavailable.Implications: In attempting to mitigate against COVID-19 impacts on people with intellectual disabilities, policy-decisions will need to consider the backlog of a decade of cuts.

Despite efforts of Parliament, the Home Office, police forces and health practitioners, the number of people detained under Section 136 of the Mental Health Act 1983 continues to rise. By analyzing quantitative data from Hampshire Constabulary, this study describes in detail police engagement with the mentally ill. Findings showed how people in mental crisis were increasingly detained by the ambulance service using the Mental Capacity Act and taken to A&E Departments. Nationally, police officers were also found to be increasingly taking Section 136 detainees to A&E. The majority of people contacting Hampshire displayed delusions which were unlikely to result in a police response and may disproportionately account for the overall growth in contact with the police. The data suggest that ‘Triage’ schemes alone will not be effective in reducing detentions. Hampshire’s partnership and discretionary approach is successful in reducing detentions. Recommendations for policy, practice, and further research are provided.

Support staff play an important role in helping people with learning disabilities to meet a partner and have a relationship. Not getting good support can make it difficult for people to have a relationship. Many support staff want to help people to have a relationship, but are worried about people being abused. This is especially true for those who do not have a lot of staff support. Support staff do not always get good support themselves to help people with learning disabilities to have relationships, such as training and a policy to follow. This makes it hard for them to know what they are allowed to help with. Abstract: Background People with intellectual and developmental disabilities face challenges in developing and maintaining intimate relationships, frequently requiring support from staff. Method Focus groups were conducted with 26 social care staff members to explore the support they provided to people with intellectual and developmental disabilities to find a potential partner and/or develop an existing relationship. Results Staff reported that many people with intellectual and developmental disabilities wanted to be in a relationship and that they did what they could to facilitate this, sometimes providing substantial support. Some staff had to address complex issues relating to sexuality, often with no training and with a lack of clear organisational policies. Conclusion The need for external inspection and regulatory bodies to prioritise relationship support is emphasised.

BackgroundAdults with intellectual disability (ID) experience inequality in access to healthcare that is considered to extend to end-of-life care. Their experiences of healthcare at the end of life and how these compare with the general population are unknown.AimTo describe the end-of-life care outcomes for adults with ID living in residential care in the UK using the VOICES-SF questionnaire and compare these with the general population.DesignNationwide population-based postbereavement survey.Participants38 ID care providers took part in the study. The supported over 13 000 people with ID. Over the 18-month period of data collection, 222 deaths were reported. The survey was completed, by care staff, for 157 (70.7%) of those deaths.ResultsDecedents had complex health, functional and behavioural needs. Death was unanticipated in a high proportion of cases. Quality of care provided across care settings was generally well rated. However, hospital care and care provided at the time of was less well rated, particularly in comparison with the general population. Respondents reported low levels of involvement in care and awareness of approaching death among adults with ID, and lower than in the general population.ConclusionsAccess to end-of-life care for adults with ID may be constrained by a failure to identify approaching the end of life. The high proportion of unexpected deaths in this population warrants further study. There is a need to increase and support the involvement of adults with ID to be active partners in planning care at the end of their lives.

Background: Research into hospital treatment and care of children with intellectual disabilities is extremely limited, but available literature points to difficulties. Some children have a co-occurring condition alongside an intellectual disability which requires ongoing treatment, such as a cleft lip/palate. To date, their experiences remain untapped. Method: Semi-structured interviews with 23 participants; five children with intellectual disabilities (aged 11–16), their parents (n = 9) and nine healthcare professionals working in cleft care. Thematic analysis determined patterns across the data. Results: Three key themes were found: struggles (stress and distress, and power imbalance), tensions (perceived levels of choice and control in decision making, lack of training around intellectual disability assumptions and jargon) and good practice (appropriate communication and information, and tailored treatment). Conclusion: Good practice was evident, but was ad hoc. Individualized treatment and communication based upon children's needs are required as is further investigation into general anaesthetic induction for children with intellectual disabilities.

The number of detentions by the police under section 136 of the Mental Health Act has significantly increased over recent years. Over the same period, relative funding of mental health services has declined. The implication is that the latter has in some way caused the former. In this study, the behaviours of people resulting in their detention are examined, as are the motivations of the officers detaining them.\ud Over the last 30 years, behaviours leading to detention have changed significantly. They were overwhelmingly violent, abusive, aggressive, or delusional but now they overwhelmingly relate to self-harm. Treatment rates following detention 30 years ago were over 90% but now this has fallen to around 20%. The lowest treatment rates 30 years ago were for detentions for threats of self-harm and this remains so now.\ud There has also been the emergence of a ‘risk-averse’ culture in policing, fearful of ‘deaths in police contact’, which may have significantly contributed to this increase in detentions. This has resulted in the creation of a new ‘patient pathway’ which gives priority access, through the police, to otherwise difficult to access mental health services.\ud Restricting this pathway explains how ‘street triage’ schemes reduce detentions. Where the officer is advised by a Health professional not to detain a person, they are then indemnified for any subsequent outcomes. In the absence of such advice, officers feel they have no choice but to detain, where there are threats of self-harm.

Background: People with intellectual disabilities have a shorter life expectancy, but healthcare improvements mean that they are beginning to live longer, with associated health difficulties. This means that there is an urgent need to focus research on ageing as well as end-of-life care. This study aimed to explore a specialist intellectual disability service for older people who are dying and how it related to their quality of life and to costs associated with care provided. Method: Data were collected for nine residents and 15 staff members of the specialist service. A single case study design with mixed methods including observations, interviews, standardized questionnaires and costs analysis was utilized. Results: We found positive results regarding overall quality of life, although individuals had limited social networks. Placement fees paid by local health trusts and social services departments were slightly higher than the estimated cost of care reflecting good financial management by a small voluntary sector organization. Conclusion: Whilst the philosophical arguments around “specialist” care persist, this service fills a gap in intellectual disability care provision.

Background: A faith-based (pseudonym, Adam’s House-AH) and a non-faith based care service (pseudonym, Greenleaves-GL) were explored to find out if and how spiritual support was provided for people with intellectual and developmental disabilities (IDD).\ud Method: Six months were spent volunteering within each service and a mixed-methods approach was utilised including applied and ethnographic methods to explore and describe if and how spirituality was embedded within the two services. \ud Results: Themes found included community of value; homely functional care; and barriers to spiritual care. GL staff tended to provide what we termed “religious spiritual care” whilst AH staff administered both “religious” and “non-religious spiritual” based support. This difference may be related to the type of training found only at AH which included spiritual dimensions. \ud Conclusion: Services could benefit from acknowledging the importance and significance of spiritual care training and education for effective and varied spiritual care for people with IDD who desire such support.

Background People with intellectual disabilities, if convicted of offences, may be sentenced to prison, but little is known about their life when they are released. Method This study followed up men with intellectual disabilities who were leaving prisons in England. Results The men were hard to contact, but 38 men were interviewed, on average 10 weeks after leaving prison. The men were living in a variety of situations and often were very under-occupied, with limited social networks. A total of 70% were above the clinical cut-off for anxiety, and 59.5% were above the clinical cut-off for depression. The men were receiving little support in the community, and many had been reinterviewed by police. Conclusions Community teams need to provide better support to this very vulnerable group.

Courts in England, Wales and Northern Ireland have identified children and adults with intellectual disabilities (ID) as vulnerable witnesses. The call from the English Court of Appeal is for advocates to adjust questioning during cross-examination according to individual needs. This review systematically examined previous empirical studies with the aim of delineating the particular communication needs of children and adults with ID during cross-examination. Studies utilising experimental methodology similar to examination/cross-examination processes, or which assessed the communication of actual cross-examinations in court were included. A range of communication challenges were highlighted, including: suggestibility to leading questions and negative feedback; acquiescence; accuracy; memory and understanding of court language. In addition, a number of influencing factors were identified, including: age; IQ level; question styles used. This review highlights the need for further research using cross-examination methodology and live practice, that take into consideration the impact on communication of the unique environment and situation of the cross-examination process.

Background: population‐based data are presented on the nature of dying in intellectual disability services.Methods: a retrospective survey was conducted over 18 months with a sample of UK‐based intellectual disability service providers that supported over 12,000. Core data were obtained for 222 deaths within this population. For 158 (71%) deaths, respondents returned a supplemented and modified version of VOICES‐SF.Results: the observed death was 12.2 deaths per 1,000 people supported per year, but just over a third deaths had been deaths anticipated by care staff. Mortality patterns, place of usual care and availability of external support exerted considerable influence over outcomes at the end of life.Conclusion: death is not a common event in intellectual disability services. A major disadvantage experienced by people with intellectual disabilities was that their deaths were relatively unanticipated. People with intellectual disabilities living in supported living settings, even when their dying was anticipated, experienced poorer outcomes.

Research suggests that adults with Tourette’s syndrome (TS) may face unique challenges in their everyday life due to their condition. To date, however, only a limited number of studies exist in relation to their life experiences and conception of identity. This study, which we believe to be the first of its kind, aimed to expand the literature by ‘giving voice’ to this population, and to evaluate the social and personal cost of living with TS during adulthood. Semi-structured interviews were conducted with sixteen adults with Tourette’s that focused on how they negotiated their identity and experiences. Transcripts of recorded interviews were subjected to interpretative phenomenological analysis. Three superordinate themes emerged: a) “Incorporating Tourette’s syndrome into self” revealed two divergent ways in which TS was merged into the participants’ self-identity, either by reconciling with it or fighting against it; b) “Interpersonal interaction” covered issues relating to negative and supportive ties as a result of their condition; and finally, c) “The solitude of Tourette’s syndrome” described the loneliness that stems from the condition. The current findings suggest that the experience of the participants is a multidimensional one related to self-identity threat, social withdraw, and self-stigma. Implications for clinical practice on the topic are discussed.

Background This small, qualitative study sought to develop a richer understanding of the way in which the deprivation of liberty safeguards (DOLS) were being used for people with intellectual disabilities. It is important to note that this study was completed prior to the changes resulting from the P v Cheshire West and Chester Council judgement. Method Six DOLS cases were identified and two people involved in each case were interviewed (care home managers, key workers, social workers, specialist nurses or psychologists), using semi-structured interviews. The data were analysed using grounded theory techniques. Results The interviewees described DOLS as providing a framework leading to positive outcomes for the people they supported, in some cases avoiding inpatient stays. However, they had a number of concerns including lack of knowledge and training, potential under use of DOLS and disappointment with case law. Conclusion Overall, these findings are encouraging in regard to the specific individuals for whom DOLS applications were made; however, they also highlight the need for a stronger agenda regarding wider dissemination of information, and training about DOLS, as well as some reform.

Background: Social media is a growing phenomenon, yet people with intellectual disability (ID) may not experience comparable access to this communication technology. Adolescents with ID may benefit from e-inclusion, especially as individuals with ID are at risk of having smaller social networks. Materials and Methods: The Social Network Guide was adapted to measure social media usage and used to examine the interpersonal relationships of adolescents with and without ID. Results: Adolescents with ID held smaller social networks with less developed informal relationships. However, friendship quality was comparable or superior to typically developing peers. Adolescents with ID interacted with a smaller percentage of contacts using social media. Social media use was predictive of the number of reported friendships and did not significantly predict critical comments. Conclusions: Findings suggest that adolescents with ID have comparable access to social media but use these sites to interact with a smaller number of social contacts.

The Financial Crisis of 2008 resulted in many western economies implementing cuts in health and social care. This systematic review provides a holistic picture of the impact of austerity policy on the lives of people with learning disabilities (LD) and the collateral effects on the people who support them. Our review suggests that in the current climate of economic austerity, available funding to support people with LD is no longer aligned to their care needs. Cuts in disability services have adversely affected the well-being both of people with LD and their informal carers. Individuals with LD have lost social support and are experiencing increased social isolation. Heightened demands on family carers’ time have negatively influenced their wider roles, including parental functioning, and labour market participation. Our review provides the foundations for further discourse and research on the effects of austerity on people with LD and their family carers.

Training in research ethics in higher education institutions tends to be increasingly focussed on operational instruction and how to navigate review processes. This has largely come about as a result of the gradual extension of the ‘medical model’ of prospective ethics review to all research involving human participants over the last few decades. Often devolved to an administrator, the purpose of instruction in research ethics is sometimes reduced to form-filling techniques. While this may serve to facilitate researchers’ compliance with ‘auditable’ regulatory requirements, and to reassure risk-averse universities that they can demonstrate rigorous oversight, it does nothing to skill researchers in assessing the ethical implications of their own research. Mastering the skills to address and mitigate the moral dilemmas that can emerge during a research project involves more than having a pre-determined set of options for research practice. Changing their perception means enabling researchers to view themselves as ethical practitioners within a broader community of researchers. In this chapter we discuss the implementation of a university training programme that has been designed to improve both the moral character, and thus the moral competence of researchers. Using a virtue ethics approach, we employed case studies and discussion, backed up by provision of individualised advice, to help researchers to consider the moral implications of research and to improve their moral decision-making skills. Attendees reported greater engagement with the issues and increased confidence in facing ethical dilemmas in their own research.

Spirituality as a dimension of quality of life and well-being has recently begun to be more valued within person-centred treatment approaches to mental health in the UK. The aim of this paper is to provide indicators of the extent to which accessing a spiritual support group may be useful within mental health recovery from the view point of those in receipt of it. The study design was a small-scale exploratory study utilising mixed methods. Quantitative methods were used to map the mental health, general well-being and social networks of the group. These were complimented by a semi-structured open-ended interview which allowed for Interpretative Phenomenological Analysis (IPA) of the life-history accounts of nine individuals with mental health problems who attended a 'spirituality support group'. Data from unstructured open-ended interviews with five faith chaplains and a mental health day centre manager were also analysed using thematic analysis. The views of 15 participants are therefore recounted. Participants reported that the group offered them: an alternative to more formal religious organisations, and an opportunity to settle spiritual confusions/fears. The 'group' was also reported to generally help individual's subjective feelings of mental wellness through social support. Whilst the merits of spiritual care are appealing, convincing services to include it within treatment may still be difficult.

Over the past two decades research on religion/spirituality has begun to gain momentum. Nevertheless, to our knowledge, a systematic review of empirical research in the field of intellectual and developmental disabilities (IDD), social care services, and spirituality has not been carried out in the last 20 years. Six psychology, IDD, religion, and health related journals were searched in addition to two data bases. Published empirical papers on religion, religiosity, spirituality, spiritual and/or religious care and people with IDD and related terms between 1990 and 2015 were identified and examined. Of the 57 publications identified, only 8.9% met the inclusion criteria and were reviewed. The five empirical papers included in this review were thematically analysed, yielding four main themes in relation to spiritual/religious care: ‘understanding of spiritual/religious concepts’; ‘support to participate in spiritual/religious activities’; ‘spiritual/religious practices in relation to self-identity’; and ‘barriers to spiritual/religious care provision’. This paper concludes that more empirical and original research in relation to the spiritual care of people with IDD residing in IDD care services is needed.

Background Researchers contend that religious and spiritual communities may provide a conduit to friendship for people with IDD. This research explored the interface between social networks and spirituality for individuals with IDD living in either a faith or non-faith based service. Method A mixed-methods approach was used including semi-structured interviews, the Social Network Guide and the Spiritual Belief Inventory-15R with individuals with IDD (or staff members who provided their opinions of what individuals who lacked capacity to consent would say if they had capacity). These findings were corroborated with extensive field notes generated from participant observation. Results The faith-based group had a higher network size (m = 78) compared to the non-faith based group (m = 44). Those with larger social networks also reported higher SBI-15R scores. Conclusion Findings highlight the possible role of social, religious and spiritual activities for expanding individuals’ social networks.

Background Little research exists comparing the social networks of people with intellectual disability (ID) from South Asian and White backgrounds. This UK study reports on the barriers that South Asian people with intellectual disability face in relation to social inclusion compared to their White counterparts. Materials and methods A mixed-methods research design was adopted to explore the social lives of 27 men (15 White; 12 South Asian) and 20 women (10 White; 10 South Asian with intellectual disability). Descriptive and parametric tests were used to analyse the quantitative data. Results The average network size of the whole group was 32 members. South Asian participants had more family members whilst White participants had more service users and staff in their networks; 96% network members from White intellectual disability group were also of White background, whilst the South Asian group had mixed ethnic network members. Conclusions Social networks of individuals with intellectual disability in this study were found to be larger overall in comparison with previous studies, whilst network structure differed between the White and South Asian population. These differences have implications relating to future service planning and appropriateness of available facilities.

Purpose – Despite spirituality being a key aspect of quality of life, it appears to remain a low-priority area for social and health care government policy. The purpose of this paper is to identify and describe what, if at all, UK policy says about spirituality in relation to the care of people with learning disabilities (LD). Design/methodology/approach – A systematic policy review using three government databases: legislation.gov.uk; Department of Health and Directgov (now known as gov.uk) was carried out. Findings – The review identified policy gaps and a general lack of government directives in relation to the spiritual care of people with LD. Whilst research in this area is gathering momentum, practical implementation which makes a real difference to the spiritual experiences of people with LD appears to be sparse. Originality/value – To the authors’ knowledge, this is the first systematic policy review on this subject area, highlighting the need for spirituality to become a more supported aspect of social care within LD services.

Purpose – The purpose of this paper is to analyse the reflective journals kept by 62 students researching and interviewing people with learning disabilities. The aim was to explore the content and discover any themes that were generated throughout the journals as a result of the pre-, during- and post-interview process. Design/methodology/approach – The method used to analyse the journals was Interpretative Phenomenological Analysis (Smith and Osborn, 2008). Findings – The results showed that there was a shift from negative to positive reflections as the frequency of contact with people with learning disabilities increased and that the majority of students reported a change in attitude towards this group of individuals after experiencing direct contact (two to three meetings over a period of two months). Research limitations/implications – Implications of the findings are for government policies, promoting social inclusion through education, to offer the opportunity for direct contact with people with learning disabilities, (in keeping with Allport's, 1954 Contact Theory) at an earlier stage in education, fostering an environment for earlier attitude change and increased social inclusion. Social implications – Changing society's attitude through our education system may decrease marginalisation by the public as well as discriminatory and abusive behaviour found in some social and community care settings. Originality/value – This piece of research may add value to social, government and educational policies. Finding an evidence base to continue to build policies for decreasing marginalisation and promoting social inclusion for people with learning disabilities.

Accessible Summary Many people with learning disabilities want to work. The Sustainable Hub of Innovative Employment for people with Complex needs (SHIEC) project is about supporting people with complex needs to find work. This study interviewed staff members who are part of SHIEC. Staff said it can be difficult to help people with complex needs to find work and this often made them worried. Staff also said that when people with complex needs found work, it was very rewarding. Staff said being part of SHIEC helped them do this. Summary Whilst the value of supported employment for people with learning disabilities is well substantiated, the experiences of supporting individuals into work are less well documented. The Sustainable Hub of Innovative Employment for people with Complex needs aims to support people with learning disabilities and complex needs to find paid employment. Sixteen semi-structured interviews administered to staff members of Sustainable Hub of Innovative Employment for people with Complex needs revealed seven core themes concerning their experiences of helping people with complex needs into work. This included the practical and emotional reality of facilitating supported employment and a reflection on those factors that influenced success. This article discusses how findings relate more broadly to work in this area, and the vital roles frontline staff play in making employment happen for people with learning disabilities.

Background The topic of funerals within the life cycle approach to care in the UK remains largely absent. This small exploratory study sought to investigate how practitioners deal with this sensitive issue and to capture the views of older people with and without intellectual disabilities about funerals. Methods A semi-structured questionnaire was administered to 40 service managers, and five focus groups for 26 people with and without intellectual disabilities were facilitated. Questionnaires were subjected to thematic content analysis; focus group data were analysed using a grounded theory approach. Results Managers demonstrated confusion about organizing the funerals of people with intellectual disabilities. Few differences existed between the views of people with and without intellectual disabilities in relation to funerals and a number of core themes were identified including the lack of opportunities to attend funerals. Conclusions More thought and practical interventions are needed to support vulnerable people to participate in the funerals of people they know.

Background\ud People with intellectual disabilities are more vulnerable to sexual abuse and are more disadvantaged in the criminal justice system than the general population. However, little is known about the experiences of people with intellectual disabilities who have allegedly been victims of sexual abuse and also been witnesses in court.\ud \ud Materials and Methods: This study used semi-structured interviews and a Grounded Theory approach to examine the experiences of four people with intellectual disabilities and four carers/supporters who had all attended trials.\ud \ud Results: Findings showed that after the traumatic incident of abuse, a court experience could become a secondary source of trauma. Experience of this trauma was dependent on the quality and quantity of support people received and the understanding of intellectual disabilities amongst the legal participants.\ud \ud Conclusion: The findings argue for better training for legal participants who are in contact with vulnerable witnesses and better support structures for alleged victims.

Background: Tourette’s syndrome (TS) is a highly stigmatised condition, and typically developing adolescents’ motives and reason for excluding individuals with TS have not been examined. \ud Aims: The aim of the study was to understand how TS is conceptualised by adolescents and explore how individuals with TS are perceived by their typically developing peers. \ud Method: Free text writing and focus groups were used to elicit the views of twenty-two year ten students from a secondary school in South East England. Grounded theory was used to develop an analytical framework. \ud Result: Participants’ understanding about the condition was construed from misconceptions, unfamiliarity and unanswered questions. Adolescents who conceived TS as a disorder beyond the individual’s control perceived their peers as being deprived of agency and strength and as straying from the boundaries of normalcy. People with TS were viewed as individuals deserving pity, and in need of support. Although participants maintained they had feelings of social politeness towards those with TS, they would avoid initiating meaningful social relationships with them due to fear of “social contamination”. Intergroup anxiety would also inhibit a close degree of social contact. Participants that viewed those with TS as responsible for their condition expressed a plenary desire for social distance. However, these behavioural intentions were not limited to adolescents that elicited inferences of responsibility to people with TS, indicating that attributional models of stigmatisation may be of secondary importance in the case of TS. \ud Implications for interventions to improve school belonging among youths with TS are discussed.

Research has consistently shown that young people with Asperger’s Syndrome (AS) are likely to experience increased anxiety during new social situations; yet, studies have been regionally and culturally bound. The aim of this study was to explore how higher education students with AS experienced attending university in two European countries: the UK and Spain. The objective was to find out if experiences differed between the two countries in relation to contrasting support arrangements and what kinds of interventions might aid students’ social well-being at university, an important learning outcome for future practice. This small-scale comparative exploratory study incorporated life-history interviews with nine students with AS. The interviews were transcribed verbatim and subjected to Interpretative Phenomenological Analysis. Four superordinate themes significant to both groups of students in Spain and the UK emerged from the data: social relationships, ‘special interests’, ‘environment’ and ‘support mechanisms’. Students with AS need and want clear, unambiguous and structured information from academics; support to get to know others in ‘small special interest groups’; more designated ‘quiet zones’ across campuses; and above all, a move away from ableist notions of AS. To our knowledge, this is the only Spanish–UK comparative study of university students with AS.