The Inventory of Legal Knowledge (ILK) and adults with intellectual disabilities

2017 ◽  
Vol 8 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Malorie E. Watson ◽  
Aaron J. Kivisto
Keyword(s):  
Intellectual Disabilities ◽  
Convergent Validity ◽  
Area Under The Curve ◽  
Legal Knowledge ◽  
Simulation Design ◽  
Cut Scores ◽  
Psychiatric Symptomatology ◽  
Content Type ◽  
The Usa ◽  
Adults With Intellectual Disabilities

Purpose Adults with intellectual disabilities (ID) entering the legal system in the USA are at heightened risk of being incorrectly labeled as malingering. The Inventory of Legal Knowledge (ILK) was recently developed to assess response style of individuals undergoing competency to stand trial (CST) evaluations. The purpose of this paper is to present preliminary data on the utility of the ILK with adults with ID. Design/methodology/approach In total, 32 adults were recruited from an American day program for adults with ID. Using a simulation design, the first 24 participants were assigned to the honest responding group and the remaining eight were assigned to the fake bad group. The normative performance of the honest responding group was compared to established norms for adults without ID, the most efficient ILK cut-off score was examined, and convergent validity of the ILK and other malingering measures tested. Findings Compared to the established mean score, the recommended cut-off score, and two independent published samples of non-ID adults, the normative performance of the honest responding ID group was significantly lower. Analyses of area under the curve revealed that the ILK lacked sufficient ability to discriminate adults with ID instructed to respond honestly from those instructed to feign incompetence, and correlational analyses failed to support the convergent validity of the ILK in this sample. Research limitations/implications The present findings do not support the use of the ILK with adults with ID, even with adjusted cut scores. The development of novel malingering measures that can be used in the context of CST evaluations with adults with ID is needed. Originality/value The present study is the first to examine the psychometric properties of the ILK with adults diagnosed with ID and without concomitant psychiatric symptomatology.

A practical example of an open disclosure process for people with intellectual disabilities in the Republic of Ireland

2021 ◽  
pp. 174462952110189
Author(s):  
Feabhra Mullally ◽  
Deirdre Corby
Keyword(s):  
Intellectual Disabilities ◽  
Service Providers ◽  
Republic Of Ireland ◽  
Open Disclosure ◽  
The Usa ◽  
People With Intellectual Disabilities ◽  
Adults With Intellectual Disabilities ◽  
The Republic ◽  
Communication Needs ◽  
The Uk

Literature pertaining to open disclosure predominantly refers to acute care settings; this is the case in, for example, the UK, Republic of Ireland, Australia, Korea and the USA. There is, however, a dearth of literature regarding open disclosure related to people with intellectual disabilities. A practice example of open disclosure is presented here, following a serious adverse event in an organisation supporting adults with intellectual disabilities. The aim of the process was to openly disclose in a meaningful way to adults with significant intellectual disabilities and communication difficulties. An apology pathway was developed by a multidisciplinary team based on individual communication needs. A suite of resources was developed including easy read-picture agendas and sign language to support increased understanding of the apology. Service users received the apology first, followed by meetings with their families. This practice example has positive implications for service providers for people with intellectual disabilities.

Teaching playground behavioural expectations to secondary age students with intellectual disabilities attending a special school

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
David Simó-Pinatella ◽  
Marisa Carvalho
Keyword(s):  
Intellectual Disabilities ◽  
Secondary Students ◽  
School Setting ◽  
Special School ◽  
Content Type ◽  
Students With Intellectual Disabilities ◽  
Special Education School ◽  
Adults With Intellectual Disabilities ◽  
Materials Used

Purpose School-wide positive behaviour support (SWPBS) is a proactive behavioural support system that fosters behaviour change in individuals in a school setting. This article aims to present a case example of teaching and reinforcing behavioural expectations in a special school. Design/methodology/approach This case study reflects different steps and materials used before and during the intervention in a special education school with 61 secondary students with intellectual disabilities. An AB design (A – baseline; B – intervention) was used to collect and analyze data. Findings Results suggest that teaching behavioural expectations as a universal measure may be feasible and positively impact school climate. Suggestions and recommendations for implementing SWPBS within a school are provided. Originality/value This case study provides a step-by-step guide illustrating the process of teaching and reinforcing behavioural playground expectations to young adults with intellectual disabilities attending a special school.

Identification of PTSD in adults with intellectual disabilities in five patients in a specialised psychiatric inpatient unit

2014 ◽  
Vol 8 (2) ◽  
pp. 91-102 ◽  
Author(s):  
Trine Lise Bakken ◽  
Arvid Nikolai Kildahl ◽  
Vibeke Gjersøe ◽  
Espen Matre ◽  
Tone Kristiansen ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Practical Implication ◽  
Case Reports ◽  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Traumatic Experiences ◽  
Content Type ◽  
Psychiatric Inpatient Unit ◽  
Severe Intellectual Disabilities ◽  
Adults With Intellectual Disabilities

Purpose – The purpose of this paper is to describe and discuss assessment of post-traumatic stress disorder (PTSD) in adults with intellectual disabilities. Existing research in this area encompasses case studies, and includes, for the most part, persons with mild intellectual disabilities. Design/methodology/approach – The aim of this study is to investigate symptom presentation and subsequent identification of PTSD in persons with more severe intellectual disabilities; i.e. persons with moderate or severe intellectual disabilities. Five patients in a specialised psychiatric inpatient unit for patients with intellectual disabilities were included. Information about the patients was collected through case files and interviews with key informants: family, milieu therapists, and caregivers in community settings, and observations through inpatient admission. The authors of this paper followed a training programme for trauma therapists in addition to the inpatient treatment of the five patients. The five patients all met criteria for PTSD according to the Diagnostic Manual – Intellectual Disability. Findings – Previously, it was not suspected that the five patients suffered from PTSD, although they had experienced terrifying incidents. All patients displayed severe changes in behaviour, which may have overshadowed symptoms of PTSD. PTSD in persons with more severe intellectual disabilities may be interpreted as challenging behaviour, or other psychiatric disorders such as psychosis. Research limitations/implications – The limitation of the study is the small number of participants. Practical implications – Practical implication is linked to clinical practice related to identification of PTSD in persons with intellectual disabilities. Originality/value – The paper may encourage more research into how PTSD can be identified in persons with moderate and severe intellectual disabilities. The case reports may help clinicians to look for traumatic experiences in persons with intellectual disabilities who have experienced terrifying incidents.

Short communication: reliability and validity of the UKU Side Effect Rating Scale for adults with intellectual disabilities

2016 ◽  
Vol 10 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Anne Louise Tveter ◽  
Trine Lise Bakken ◽  
Jan Ivar Røssberg ◽  
Egon Bech-Pedersen ◽  
Jørgen G. Bramness
Keyword(s):  
Side Effects ◽  
Focus Group ◽  
Intellectual Disabilities ◽  
Side Effect ◽  
Rating Scale ◽  
Reliability And Validity ◽  
Medical Doctor ◽  
Face Validity ◽  
Content Type ◽  
Adults With Intellectual Disabilities

Purpose – The UKU side effect rating scale for adults with intellectual disabilities (UKU-SERS-ID) was developed to detect side effects among patients with intellectual disabilities (ID). The purpose of this paper is to examine the reliability and face validity of the UKU-SERS-ID. Design/methodology/approach – UKU-SERS-ID comprises 35 items. In total, 22 patients with ID were included from two specialized services for adults with ID and comorbid mental illness. All patients were rated on three different occasions by three clinicians; two nurses and one medical doctor. Reliability was estimated with Cohen’s κ. A focus group discussed the face validity of the items comprising the UKU-SERS-ID. Findings – Respectively ten (nurse-nurse scores) and eight (nurse-doctor scores) items were considered difficult to score due to low prevalence of the symptoms. For the other items the reliability was acceptable. Through discussion in a focus group, with the reliability scores in mind, only one of the items of the UKU-SERS-ID was discarded. Practical implications – The authors have developed a feasible side effect instrument for clinical practice. It is easy to score and relevant regarding important side effects. Originality/value – The UKU-SERS-ID seems to be a feasible tool. Further investigations are mandatory in order to gain knowledge about distribution and phenomenology of side effects from psychotropic medication for individuals with ID.

Community dialectical behaviour therapy for emotionally dysregulated adults with intellectual disabilities

2014 ◽  
Vol 8 (3) ◽  
pp. 165-173 ◽  
Author(s):  
Aubrey Baillie ◽  
Sean Slater
Keyword(s):  
Intellectual Disabilities ◽  
Detailed Examination ◽  
Outcome Data ◽  
Lessons Learned ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Client Group ◽  
Adults With Intellectual Disabilities

Purpose – The purpose of this paper is to reflexively examine the challenges of implementing a community dialectical behaviour therapy (DBT) service for adults with intellectual disabilities (ID) and describes the practical lessons learned about how to maximise the effectiveness of DBT with this client group. Design/methodology/approach – A brief overview of DBT is provided and reference is made to literature which highlights the potential benefits of providing a DBT service to clients with an ID. This is followed by a discussion of the clinical presentation of the clients receiving DBT in the service that is the focus of this case study. Using a reflexive approach, a detailed discussion follows of the challenges faced in implementing a community DBT service for the clients served. Findings – Solutions to a variety of challenges faced in four years of service delivery are described, key lessons learned are highlighted, together with issues meriting further research. Research limitations/implications – This case study and its implications are limited to community DBT services. Another limitation is that, although outcome data have been collected over the past two years, the dataset is not yet large enough to draw statistical conclusions. Practical implications – The paper describes adaptations to treatment structure and strategy which the authors believe are necessary to improve treatment outcomes in community DBT services for adults with ID. In particular, the practical experience suggests that a didactic approach to teaching DBT skills is not effective and should be replaced by the “community of learners” approach that involves the trainer contingently responding to client input. Pre-set lesson plans inhibit the trainers’ ability to respond contingently. Originality/value – The existing literature on providing a DBT service for people with an ID has principally focused on providing a rationale for providing this type of intervention, and on assessing outcomes. Given that this is still a relatively new type of provision for this client group, a detailed examination of process issues is called for.

The Adult Attachment Projective Picture System: a pilot study of inter-rater reliability and face validity with adults with intellectual disabilities

2018 ◽  
Vol 12 (2) ◽  
pp. 57-66 ◽  
Author(s):  
Deanna Gallichan ◽  
Carol George
Keyword(s):  
Intellectual Disabilities ◽  
Adult Attachment ◽  
Clinical Utility ◽  
Reliability And Validity ◽  
Clinical History ◽  
Face Validity ◽  
Rater Reliability ◽  
Content Type ◽  
Adult Attachment Projective ◽  
Adults With Intellectual Disabilities

Purpose The purpose of this paper is to assess whether the Adult Attachment Projective (AAP) Picture System is a reliable and face valid measure of internal working models of attachment in adults with intellectual disabilities (ID). Design/methodology/approach The AAPs of 20 adults with ID were coded blind by two reliable judges and classified into one of four groups: secure, dismissing, preoccupied, or unresolved. Inter-rater reliability was calculated using κ. Six participants repeated the assessment for test-retest reliability. Two independent experts rated ten cases on the links between the AAP analysis and the clinical history. Findings There was significant agreement between AAP judges, κ=0.677, p<0.001. Five out of six participants showed stability in their classifications over time. The majority of expert ratings were “good” or “excellent”. There was a significant inter-class correlation between raters suggesting good agreement between them r=0.51 (p<0.05). The raters’ feedback suggested that the AAP had good clinical utility. Research limitations/implications The inter-rater reliability, stability, face validity, and clinical utility of the AAP in this population is promising. Further examination of these findings with a larger sample of individuals with ID is needed. Originality/value This is the first study attempting to investigate the reliability and validity of the AAP in this population.

Direct care staff knowledge about medication for individuals with intellectual disabilities

2019 ◽  
Vol 13 (3/4) ◽  
pp. 144-151
Author(s):  
Amanda Sawyer ◽  
Johanna Lake ◽  
Yona Lunsky
Keyword(s):  
Intellectual Disabilities ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Medication Administration ◽  
Psychotropic Medications ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Content Type ◽  
Adults With Intellectual Disabilities

Purpose The majority of adults with intellectual disabilities (ID) are prescribed at least one, if not multiple medications, with psychotropic medications being the most commonly prescribed. Direct care staff play an important role in psychotropic medication administration and monitoring, yet little is known about their knowledge and comfort with medication. The paper aims to discuss this issue. Design/methodology/approach A 15-item survey, focusing on self-reported knowledge and comfort with psychotropic medication, was completed by 152 direct care staff employed at three agencies providing residential services for individuals with ID across Ontario. Findings In total, 62 per cent of staff respondents reported that psychotropic medications were among the top medications regularly taken by the individuals they support, with behaviour listed as the most commonly reported reason for taking this medication. The majority of staff reported monitoring medication, however, the frequency of monitoring varied considerably. Generally, staff reported feeling comfortable and knowledgeable about medication use, but, most reported a desire for additional medication training. Originality/value This is the first Canadian study to examine staff knowledge and comfort regarding medication use, and the first study to assess PRN (“as needed”) as well as regularly administered medications.

scholarly journals Commentary on “Dietitians’ challenges when consulting to adults with intellectual disabilities”

2019 ◽  
Vol 24 (4) ◽  
pp. 163-167
Author(s):  
Paraskevi Triantafyllopoulou
Keyword(s):  
Intellectual Disabilities ◽  
Intervention Studies ◽  
Overweight And Obesity ◽  
Future Research ◽  
Content Type ◽  
Prevalence Studies ◽  
Multiple Components ◽  
Obesity And Overweight ◽  
Randomised Control Trials ◽  
Adults With Intellectual Disabilities

Purpose The purpose of this paper is to consider issues around obesity and overweight for people with intellectual disabilities (IDs). Design/methodology/approach A review of the literature is provided looking at issues around overweight and obesity for adults with IDs. Both prevalence studies and intervention studies were considered. Findings The prevalence of overweight and obesity is considerably higher for adults with IDs when compared to the general population. Intervention studies focusing on multiple components seem to be the most effective. However, future research should focus on randomised control trials taking into consideration the views of people with IDs. Originality/value This paper synthesizes some of the available evidence on obesity and overweight for adults with IDs providing clear recommendations for the future.

Assessing attachment status in adults with intellectual disabilities: the potential of the Adult Attachment Projective Picture System

2014 ◽  
Vol 8 (2) ◽  
pp. 103-119 ◽  
Author(s):  
Deanna J Gallichan ◽  
Carol George
Keyword(s):  
Intellectual Disabilities ◽  
Adult Attachment ◽  
Clinical Work ◽  
Clinical Samples ◽  
Future Research ◽  
Validity And Reliability ◽  
Content Type ◽  
State Of Mind ◽  
Adult Attachment Projective ◽  
Adults With Intellectual Disabilities

Purpose – The purpose of this paper is to explore the potential of the Adult Attachment Projective Picture System (AAP) as a measure of attachment state of mind in adults with intellectual disabilities. The AAP is a free response picture system method of assessing patterns of adult attachment with established validity and reliability in community and clinical samples. Design/methodology/approach – The paper reports on five cases of adults with intellectual disabilities who were administered the AAP as part of routine clinical work. The AAP administration procedure was modified to take account of the participants’ intellectual disabilities. Findings – It was possible to code and classify each AAP using the established coding and classification system. The authors coded four cases blind to each other ' s classification; they agreed on classifications for three cases and reached consensus on the fourth. The AAP analysis showed strong correspondence with case history material. Originality/value – The AAP demonstrates the potential to assess attachment state of mind in adults with intellectual disabilities and is the first developmental measure of attachment status that has shown potential in this population. The paper discusses clinical application of the AAP and directions for future research.

scholarly journals The impact of Covid-19 on access to psychological services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jack Purrington ◽  
Nigel Beail
Keyword(s):  
Psychological Distress ◽  
Intellectual Disabilities ◽  
Effect Size ◽  
Waiting Times ◽  
Psychological Services ◽  
Service Users ◽  
Content Type ◽  
Referral Rates ◽  
Adults With Intellectual Disabilities ◽  
The Impact

Purpose The novel coronavirus and associated mitigation efforts have produced barriers to accessing services for adults with intellectual disabilities. This paper aims to evaluate the impact of Covid-19 on access to psychological services. The paper evaluates monthly referral rates and psychological distress scores for service users awaiting therapy. Design/methodology/approach A quantitative service evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. A single case experimental design was used to examine the impact of events in March 2020 on referral rates. Descriptive statistics and effect size calculations were used to examine the impact of prolonged waiting times on psychological distress scores. Findings Referral rates were examined comparing a 5-year rolling average monthly referral rate for the 12 months prior to March 2020 with the 12 months following. Findings demonstrate that events starting in March 2020 have had a considerable impact on referral rates and rates have not recovered. Eight service users were contacted to determine the impact of prolonged waiting times with results demonstrating increases in psychological distress of large effect size. Originality/value This is the only paper the authors are aware of examining the impact of the coronavirus on access to services and psychological distress for adults with intellectual disabilities. It is hoped that these findings will be able to inform both policy and practice as services continue to navigate the pandemic.

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