scholarly journals Addressing Aggression in the Residential Setting for Juveniles with Mild Intellectual Disability through Training in Non-Violent Resistance

2020 ◽  
Author(s):  
K. M. Visser ◽  
L. M. C. Jansen ◽  
A. Popma ◽  
R. R. J. M. Vermeiren ◽  
M. C. Kasius
Keyword(s):  
Intellectual Disability ◽  
Behavioral Problems ◽  
Work Performance ◽  
Traumatic Experiences ◽  
Residential Setting ◽  
Negative Consequences ◽  
Mild Intellectual Disability ◽  
Significant Interaction Effect ◽  
Residential Settings ◽  
Quasi Experimental

Abstract Background Levels of aggression are high in residential settings for juveniles with Mild Intellectual Disability (MID). As a result, treatment is less effective, aggression causes injury, traumatic experiences and longer inhabitation for juveniles. Additionally, inpatient aggression has been linked to burnout and stress among group workers, which has negative consequences such as less job satisfaction or poorer work performance Objective Therefore, it is crucial to diminish aggressive incidents in these settings and to find a way for staff how to respond to aggression properly. Methods As there is no intervention method which tackles all of the referred problems efficiently, a new method Non-violent Resistance for MID was introduced into three residential settings for juveniles with MID, in a quasi-experimental stepped wedge design. Reports of aggressive incidents were assessed seven times before, during and after the training in NVR-MID on group level. Multilevel analyses were carried out in order to assess the development of the aggressive incidents over time. Results Aggressive incidents decreased significantly in time during and after training in NVR-MID, this decrease is seen in all three institutions. Thus, regardless of resident’s age, gender or IQ, NVR-MID seemed successful in diminishing aggressive incidents. Furthermore, a significant interaction effect was found between institution and time, indicating that regardless if incidents of aggression were relatively high at baseline, decrease in incidents was similar to institutions where incidents were relatively low on baseline. Conclusions Implementing NVR-MID into residential settings for juveniles with MID and comorbid behavioral problems might help to decrease aggressive incidents.

scholarly journals Not recognized enough: The effects and associations of trauma and intellectual disability in severely mentally ill outpatients

2019 ◽  
Vol 58 ◽  
pp. 63-69 ◽  
Author(s):  
Jeanet Grietje Nieuwenhuis ◽  
Hedwig Johanna Henrica Smits ◽  
Eric Onno Noorthoorn ◽  
Cornelis Lambert Mulder ◽  
Engelbertus Johannes Maria Penterman ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Intellectual Disability ◽  
Patient Characteristics ◽  
Intellectual Functioning ◽  
Cross Sectional Study ◽  
Traumatic Experiences ◽  
Mild Intellectual Disability ◽  
Chi Square ◽  
Cross Sectional ◽  
Severely Mentally Ill

AbstractBackground:Little is known about the association between trauma and intellectual disability in SMI patients.Aim:To establish the prevalence of trauma and its association with intellectual functioning in SMI outpatients.Methods:A cross-sectional study was conducted in two mental health trusts in the Netherlands. We used the Trauma Screening Questionnaire (TSQ) to screen for trauma and PTSD, and the Screener for Intelligence and Learning disabilities (SCIL) for suspected MID/BIF. Chi-square and t-tests were used to test differences in outcome over patient characteristics. Post-hoc analysis was used to investigate gender differences between patients with and without MID/BIF on trauma and sexual trauma.Results:Any trauma was found in 86% of 570 patients and 42% were suspected for PTSD. The SCIL suggested that 40% had Borderline Intellectual Functioning (BIF), half of whom were suspected of having Mild Intellectual Disability (MID). These patients had more traumatic experiences (1.89 in BIF, 1.75 in MID, against 1.41 in SCIL-negative patients). Female MID/BIF patients (61%) had experienced significantly more sexual abuse than male MID/BIF patients (23%).Conclusions:Significantly more SMI outpatients who screened positive for MID/BIF reported having experienced traumatic events than those who screened negative. Rates of all trauma categories were significantly higher in the screen-positive group, who were also more likely to have PTSD. Sexual abuse occurred more in all females but the SCIL positive women are even more often victim. Clinical practice has to pay more attention to all of these issues, especially when they occur together in a single patient.

scholarly journals Family Members of Adults with Intellectual Disability Living in Residential Settings: Roles and Collaboration with Professionals. A Review of the Literature

2021 ◽  
Vol 58 ◽  
pp. 004695802199130
Author(s):  
Natalie Zambrino ◽  
Ingeborg Hedderich
Keyword(s):  
Intellectual Disability ◽  
Challenging Behavior ◽  
Family Members ◽  
Professional Staff ◽  
Care Staff ◽  
Residential Setting ◽  
Hand Search ◽  
Residential Settings ◽  
Regular Open ◽  
Key Terms

The aim of this article is to review the literature concerning the role of family members of adults with an intellectual disability living in diverse residential settings and their collaboration with residential staff. Whenever the scarce literature on the subject allowed, the focus was laid on family members of persons with additional challenging behavior. Electronic databases, reference screening, and hand search of selected journals was employed to collate literature using key terms such as family members, intellectual disability, and residential setting. By extracting relevant data of the eighteen articles that fulfilled all inclusion criteria, the following 3 main themes with each subthemes were identified inductively: roles of family members after the transition, the effects of the transition on family members, and the collaboration between the family members and professional care staff. This review presents the different roles family members partake and highlights the importance of regular open two-sided communication for collaboration with professional staff to be successful. Practical implementations are discussed and the need for further research in the field is indicated.

scholarly journals Valproate Induced Behavioral Dysregulation in an Adolescent with Intellectual Disability: A Case Report

2020 ◽  
Vol 5 (12) ◽  
Keyword(s):  
Intellectual Disability ◽  
Behavioral Problems ◽  
Long Term Care ◽  
Autism Spectrum ◽  
Abnormal Behavior ◽  
Mild Intellectual Disability ◽  
Term Care ◽  
Behavioral Dysregulation ◽  
Emergency Interventions

A 14-year-old with mild intellectual disability and autism spectrum disorder was admitted to a long-term psychiatric hospital with complaints of treatment resistant aggressive behavior. Her psychopharmacologic regime was Depakote 1500mg, Intuniv XR 2mg twice daily, and Inderal 10 mg thrice daily, for her mood and behavior symptoms, and prn Ativan and Benadryl for acute episodes of agitation. Despite multiple medication trials, she was continued on Depakote for seven months prior to her admission to long term care. During the first month in long term care, she had over 20 emergency interventions due to physical aggression. She was also witnessed to exhibit abnormal behavior and self-harm during this time. There were concerns that Depakote may be contributing to her dysregulated behavior, thus the medication was slowly down-titrated while her other scheduled medications and dosages remained the same. The patient started to require fewer emergency interventions with noted improvement in her behavior. After the complete termination of Depakote, clinical observations were remarkable for mitigation of aggressive and abnormal behavior as evidenced by the patient going six weeks without any emergency intervention. Behavioral dysregulation is a possible adverse effect of valproate. Individuals with intellectual disabilities are most vulnerable to polypharmacy for management of aggression, behavioral problems, and other psychiatric comorbidities. There is a need for pharmacovigilance on the negative behavioral effects in patients receiving valproate.

Pathways to Care of Individuals With Mild Intellectual Disability

2012 ◽  
Vol 11 (1) ◽  
pp. 57-78 ◽  
Author(s):  
Sarah Soenen ◽  
Ina Van Berckelaer-Onnes ◽  
Evert Scholte
Keyword(s):  
Intellectual Disability ◽  
Personality Disorders ◽  
Behavioral Problems ◽  
Developmental Disorders ◽  
Service Use ◽  
Communication Disorders ◽  
Pathways To Care ◽  
Mild Intellectual Disability ◽  
Clinical Profiles ◽  
Clinical Records

This study investigated whether clinical profiles in individuals with mild intellectual disability (MID) could be defined in terms of their histories (e.g., behavioral, social-environmental, educational, and service use characteristics). The clinical psychologists administered the Diagnostic Interview for Social and Communication Disorders to the (substitute) parents and analyzed the clinical records of individuals with MID. Four subtypes of individuals with MID with specific clinical profiles participated in this study. The results of this study, which used discriminant analysis of the individuals’ histories, supported two discriminant functions. The first discriminant function differentiated clinical profiles largely based on developmental disorders from clinical profiles based on personality disorders. The second function differentiated clinical profiles based on personality disorders and externalizing behavioral problems from other clinical profiles. The characteristics in the histories of individuals with MID can be very different and need to be assessed for further understanding of their unique needs.

Receipt of psychotropic medication by people with intellectual disability in residential settings

2000 ◽  
Vol 44 (6) ◽  
pp. 666-676 ◽  
Author(s):  
J. Robertson ◽  
E. Emerson ◽  
N. Gregory ◽  
C. Hatton ◽  
S. Kessissoglou ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Psychotropic Medication ◽  
Residential Settings
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