scholarly journals Adapting services for autism: Recommendations from a specialist multidisciplinary perspective using freelisting

Author(s):  
Stephanie Petty ◽  
Milja-Leea Bergenheim ◽  
Georgina Mahoney ◽  
Lucy Chamberlain

AbstractThe guidance available for tailoring mental health services for autistic people is limited and dispersed. Practitioners attempting to appropriately adapt mental healthcare and therapy provision report low confidence and inconsistency in their approach. This study contributes to the guidance by providing a shortlist of usable and priority adaptations for diagnostic and therapy services as described by multidisciplinary staff members responsible for the design and delivery of a specialist autism service in the UK. Individual freelisting interviews were conducted with 15 staff, who were asked to list the ways that they adapt their practice individually, within therapy, and collectively as a service. Salience and cultural consensus analyses demonstrated the following agreed priority service adaptations: ensuring the suitability of the service environment with consideration of sensory demands, adapting communication, knowing individual gender identity preferences and minimising client uncertainty. Detailed examples are given for flexibly adapting therapy to individual needs to inform general and specialist services. The findings require replication and evaluation.

Author(s):  
Rachel Forsyth ◽  
Claire Hamshire ◽  
Danny Fontaine-Rainen ◽  
Leza Soldaat

AbstractThe principles of diversity and inclusion are valued across the higher education sector, but the ways in which these principles are translated into pedagogic practice are not always evident. Students who are first in their family to attend university continue to report barriers to full participation in university life. They are more likely to leave their studies early, and to achieve lower grades in their final qualifications, than students whose families have previous experience of higher education. The purpose of this study was to explore whether a mismatch between staff perceptions and students’ experiences might be a possible contributor to these disparities. The study explored and compared staff discourses about the experiences of first generation students at two universities, one in the United Kingdom (UK), and the other in South Africa (SA). One-to-one interviews were carried out with 40 staff members (20 at each institution) to explore their views about first generation students. The results showed that staff were well aware of challenges faced by first generation students; however, they were unsure of their roles in relation to shaping an inclusive environment, and tended not to consider how to use the assets that they believed first generation students bring with them to higher education. This paper explores these staff discourses; and considers proposals for challenging commonly-voiced assumptions about students and university life in a broader context of diversity and inclusive teaching practice.


2017 ◽  
Vol 11 (3) ◽  
pp. 113-119 ◽  
Author(s):  
Sarah Parsons ◽  
Nicola Yuill ◽  
Mark Brosnan ◽  
Judith Good

Purpose The purpose of this paper is to present an overview of the main messages and key questions for further research arising from the seven-seminar series entitled, “Innovative technologies for autism: critical reflections on digital bubbles”, funded by the Economic and Social Research Council in the UK. Design/methodology/approach A synthesis of the main ideas is presented, drawing on the presentations, discussions, participant feedback, and short papers from across the seminar series, which took place between November 2014-2016. Findings There were many positive examples where technologies were positioned and used as facilitative “bridges” between ideas, communities, understanding, and experiences. Researchers and community stakeholders also emphasised the importance of taking different perspectives and working in stronger partnerships with each other. Four overarching research questions were developed from these themes to provide a roadmap for future research, relating to: responsible innovation, technology-enabled social interaction, learning and pedagogy, and engagement. Originality/value The findings and methodologies produced by the Digital Bubbles seminar series, available on the project website (http://digitalbubbles.org.uk/) and in a series of short papers, provide a rich repository of state-of-the-art thinking in the field of autism and technology that is being utilised nationally and internationally in teaching and learning. This paper suggests some valuable future research directions and highlights the importance of establishing and maintaining multi-disciplinary research teams, with autistic people and their families at their core.


2010 ◽  
Vol 7 (2) ◽  
pp. 36-38 ◽  
Author(s):  
Tamás Kurimay

The Republic of Hungary is a landlocked country of 93000 km2 in central Europe; it is bordered by Austria, Slovakia, Ukraine, Romania, Serbia, Croatia and Slovenia. Its official language is Hungarian. Hungary joined the European Union (EU) in 2004. About 90% of the population of c. 10 million is ethnically Hungarian, with Roma comprising the largest minority population (6–8%). Currently classified as a middle-income country with a gross domestic product (GDP) of $191.7 billion (2007 figure), Hungary's total health spending accounted for 7.4% of GDP in 2007, less than the average of 8.9% among member states of the Organisation for Economic Co-operation and Development (OECD, 2009). The proportion of the total health budget for mental health is 5.1%, which is low when compared with, for instance, the UK (England and Wales 13.8%, Scotland 9.5%) (World Health Organization, 2008, p. 118, Fig. 8.1).


2018 ◽  
Vol 60 (9) ◽  
pp. 1084-1096 ◽  
Author(s):  
Tasawar Nawaz

Purpose Transnational education (TNE), interpreted as the mobility of education programmes and providers between countries, has grown exponentially as a worldwide phenomenon in recent years. Higher education institutions (HEIs) have mainly used such opportunities to internationalise their degrees and programmes, and have paid scant attention on preparing academics to teach cross-culturally. As a result, academics being at the coalface of teaching and learning often feel under-informed, under-supported, underprepared and under-confident when it comes to cross-cultural teaching, suggesting that universities have largely failed to prepare their academic faculty members to face the challenges of internationalisation. This is particularly important for new and young players such as the post-92 universities in the UK. However, such institutions have largely been ignored by the previous research in this area. Reverting the research focus on young HEIs, the purpose of this paper is to highlight the importance of preparing faculty staff members in the context of a post-92 university in the UK, to teach cross-culturally at partner institutions via the TNE route. Design/methodology/approach The paper adopts Deardorff’s intercultural competency process model to develop a framework (focussing on three core elements of knowledge, skills and attitudes) that could help the academic staff members to prepare for teaching internationally. The paper is based on a detailed analysis of university’s internationalisation strategy, policy documents and related reports for the 1999–2016 period. The initial analysis is further supplemented by 11 interviews with the main stakeholders, i.e. academics, educational developers and policy makers. Findings As the post-92 university in focus, like its counterparts, continues to proliferate its degrees and programmes through the TNE route, academics who are tasked with transnational teaching have an increased responsibility to develop the competencies required to work with learners from diversified cultural backgrounds. However, there has been less interest at university or faculty level in ensuring that academic faculty members who teach in transnational context are prepared for the specific rigours of transnational teaching. Research limitations/implications The research findings have broader implications at individual, organisational and industry-level for individual academic faculty members to progress further in their career, HEIs to improve the quality of training programmes and policies and the HE industry to adjust the strategy towards internationalisation. Practical implications In the absence of any formally structured training, the paper proposes pre-departure informal training workshops/seminars conducted by seasoned academics at faculty, school or department level to help new academics transform their knowledge, skills and attitudes in order to facilitate positive interactions with students in a cross-cultural teaching environment. Although the focus is on one post-92 university; however, the proposed framework could be adopted across HEIs worldwide. Originality/value The paper is based on a detailed analysis of university’s internationalisation strategy, policy documents and related reports for the 1999–2016 period. The initial analysis is further supplemented by 11 interviews with the main stakeholders, i.e. academics, educational developers and policy makers. Informed by the best practices, the paper also discusses the implication of intercultural competencies for cross-cultural teaching.


2008 ◽  
Vol 14 (2) ◽  
pp. 84-85 ◽  
Author(s):  
Roger Banks ◽  
Linda Gask

Healthcare provision in the UK is in a process of continual change. The structures and processes by which people with mental health problems and people with learning disabilities receive support from statutory services have been, and continue to be, subject to many and varied strategic, policy and professional influences. Integrated and collaborative ways of working between generalist (‘primary’) and specialist (‘secondary’) care have become eroded over time and yet they may be needed more than ever. In this editorial we encourage a collaborative approach between practitioners in generalist and specialist care in studying and developing three strands of work: policy and strategy; training; and professional behaviour. Above all, we advocate strongly for a renewed and dynamic dialogue between psychiatrists and general practitioners in working together to provide high-quality mental healthcare.


2018 ◽  
Vol 44 (7) ◽  
pp. 471-475 ◽  
Author(s):  
Richard Huxtable

Law’s processes are likely always to be needed when particularly intractable conflicts arise in relation to the care of a critically ill child like Charlie Gard. Recourse to law has its merits, but it also imposes costs, and the courts’ decisions about the best interests of such children appear to suffer from uncertainty, unpredictability and insufficiency. The insufficiency arises from the courts’ apparent reluctance to enter into the ethical dimensions of such cases. Presuming that such reflection is warranted, this article explores alternatives to the courts, and in particular the merits of specialist ethics support services, which appear to be on the rise in the UK. Such specialist services show promise, as they are less formal and adversarial than the courts and they appear capable of offering expert ethical advice. However, further research is needed into such services – and into generalist ethics support services – in order to gauge whether this is indeed a promising development.


2003 ◽  
Vol 183 (6) ◽  
pp. 547-551 ◽  
Author(s):  
Anne O'Herlihy ◽  
Adrian Worrall ◽  
Paul Lelliott ◽  
Tony Jaffa ◽  
Peter Hill ◽  
...  

BackgroundLittle is known about the current state of provision of child and adolescent mental health service in-patient units in the UK.AimsTo describe the full number, distribution and key characteristics of child and adolescent psychiatric in-patient units in England and Wales.MethodFollowing identification of units, data were collected by a postal general survey with telephone follow-up.ResultsEighty units were identified; these provided 900 beds, of which 244 (27%) were managed by the independent sector. Units are unevenly distributed, with a concentration of beds in London and the south-east of England. The independent sector, which manages a high proportion of specialist services and eating disorder units in particular, accentuates this uneven distribution. Nearly two-thirds of units reported that they would not accept emergency admissions.ConclusionsA national approach is needed to the planning and commissioning of this specialist service.


BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e030739 ◽  
Author(s):  
Faraz Ahmed ◽  
Hazel Morbey ◽  
Andrew Harding ◽  
David Reeves ◽  
Caroline Swarbrick ◽  
...  

IntroductionAround 70% of acute hospital beds in the UK are occupied by older people, approximately 40% of whom have dementia. Improving the quality of care in hospitals is a key priority within national dementia strategies. Limited research has been conducted to evaluate dementia training packages for staff, and evaluation of training often focuses on immediate, on-the-day training feedback and effects.ObjectivesOur study aims to answer two research questions: (1) How do variations in content, implementation and intensity of staff dementia training in acute hospitals in England relate to health service outcome/process measures and staff outcomes? and (2) What components of staff dementia training are most strongly related to improved patient and staff outcomes?Methods and analysisUsing the principles of programme theory, a mixed-method study will be used to identify mechanisms and the interactions between them, as well as facilitators and barriers to dementia training in hospitals. We will use existing data, such as Hospital Episode Statistics, alongside two surveys (at hospital and staff level).We will recruit up to 193 acute hospitals in England to participate in the hospital level survey. We aim to recruit up to 30 staff members per hospital, from a random sample of 24 hospitals. In addition, we will explore the cost-effectiveness of dementia training packages and carry out an in-depth case study of up to six hospitals.Ethics and disseminationThe study has been reviewed and approved by the Faculty of Health and Medicine Research Ethics Committee (FHMREC 17056) and Health Research Authority (Integrated Research Approval System (IRAS) ID 242166: REC reference 18/HRA/1198). We plan to develop both standard (eg, academic publications, presentations at conferences) and innovative (eg, citizen scientist web portals, online fora, links with hospitals and third sector organisations) means of ensuring the study findings are accessible and disseminated regionally, nationally and internationally.


2011 ◽  
Vol 71 (6) ◽  
pp. 662-669 ◽  
Author(s):  
Vishal R Aggarwal ◽  
Amy Joughin ◽  
Joanna Zakrzewska ◽  
Priscilla Appelbe ◽  
Martin Tickle

Aim: To explore the diagnosis, treatment and referral patterns of chronic oro-facial pain patients by generalist primary care dentists (GDPs) in the UK. Methods: A cross-sectional survey was conducted using a non-stratified random sample of 500 GDPs who were selected from the General Dental Council register. A self-complete postal questionnaire with four hypothetical clinical case scenarios describing sub-types of chronic oro-facial pain (COFP) was used to investigate diagnosis, treatment and referral options of GDPs. Results: Two hundred and twenty (44%) GDPs responded. The majority correctly diagnosed temporomandibular disorder (TMD; 88%) and burning mouth syndrome (BMS; 92%). There was more variation in the diagnosis of the other cases related to persistent oro-facial pain. For TMD there was a clear preference for treatment with occlusal splint therapy, and referral to a temporomandibular joint (TMJ) specialist. The BMS scenario showed drug therapy and referral to an oral medicine specialist to be most popular. The chronic oro-facial pain cases had greater variation in management and choice of psychotherapy was related to duration of pain symptoms. Conclusions: The greater variation in responses to scenarios based on patients with chronic oro-facial pain may reflect the difficulty clinicians face in diagnosing and treating this condition. Management appears to follow a biomedical model and most clinicians chose to refer patients for treatment. There are few specialist services to cater for such referrals, indicating a need to train primary care practitioners in management of chronic COFP, along with the establishment of evidence-based guidelines.


2020 ◽  
Vol 9 (2) ◽  
pp. 47-55
Author(s):  
Sukina Moosajee ◽  
Sobia Rafique

In an age when people are living longer and medical interventions are continually becoming more advanced, clinicians will need to be aware of systemic disorders and treatments that may cause complications in the dental setting. The Office for National Statistics’ projections state that 26% of the UK population will be aged over 65 years by 2041.1 Therefore, clinicians may often encounter patients who complain of prolonged bleeding following certain procedures, most commonly dental extractions. In the majority of cases, the cause is often a local one, which can be managed using simple local measures. However, poor management can lead to potentially fatal consequences. The aim of this paper is to update clinicians on the dental management of patients with acquired or congenital bleeding disorders, and on how to decide the most appropriate setting for safe dental care. Patient safety in the NHS is a national priority with ever greater measures being put into place to avoid patient harm. Whilst most patients can be successfully treated in primary care, for the provision of safe dental treatment, the clinician may need to make a decision regarding referral to specialist services for all dental treatment, or share care between primary care and specialist services for selected procedures.


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