scholarly journals Clinical and cost effectiveness of staff training in the delivery of Positive Behaviour Support (PBS) for adults with intellectual disabilities, autism spectrum disorder and challenging behaviour - randomised trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andre Strydom ◽  
◽  
Alessandro Bosco ◽  
Victoria Vickerstaff ◽  
Rachael Hunter ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Cost Effectiveness ◽  
Intellectual Disabilities ◽  
Staff Training ◽  
Randomised Trial ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Challenging Behaviour ◽  
Positive Behaviour Support ◽  
Adults With Intellectual Disabilities

scholarly journals Clinical and cost effectiveness of staff training in the delivery of positive behaviour support (PBS) for adults with intellectual disabilities, autism spectrum disorder and challenging behaviour - randomised trial

2020 ◽  
Author(s):  
André Strydom ◽  
Alessandro Bosco ◽  
Victoria Vickerstaff ◽  
Rachael Hunter ◽  
Angela Hassiotis
Keyword(s):  
Autism Spectrum Disorder ◽  
Randomised Trial ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Cluster Randomised Trial ◽  
Challenging Behaviour ◽  
Treatment As Usual ◽  
Life Years ◽  
Health And Social Care ◽  
Positive Behaviour Support

Abstract Background: Although Positive Behaviour Support (PBS) is a widely used intervention for ameliorating challenging behaviour (CB), evidence for its use in adults with intellectual disability (ID) and comorbid autism (ASD) is lacking. We report a planned subsidiary analysis of adults with both ASD and ID who participated in a randomised trial of PBS delivered by health professionals.Methods: The study was a multicentre, cluster randomised trial conducted in 23 community ID services in England, participants were randomly allocated to either the delivery of PBS (n=11 clusters) or to treatment as usual (TAU; n=12). One-hundred and thirteen participants (46% of all participants in the trial) had a diagnosis of ID, autism spectrum disorder and CB (ASD+); (47 allocated to the intervention arm, and 66 to the control). CB (primary outcome) was measured with the Aberrant Behaviour Checklist total score (ABC-CT). Secondary outcomes included mental health status, psychotropic medication use, health and social care costs and quality adjusted life years (QALYs) over 12 months.Results: There were no statistically significant differences in ABC-CT between ASD+ groups randomised to the two arms over 12 months (adjusted mean difference = -2.10, 95% CI: -11.3 7.13, p =0.655) or other measures. The mean incremental cost of the intervention per participant was £628 (95% CI -£1004 to £2013). There was a difference of 0.039 (95% CI -0.028 to 0.103) for QALYs and a cost per QALY gained of £16,080.Conclusions: Results suggest lack of clinical effectiveness for PBS delivered by specialist ID clinical teams. Further evidence is needed from larger trials, and development of improved interventions.Trial registrationClinicalTrials.gov: NCT01680276

scholarly journals Clinical and cost effectiveness of staff training in the delivery of positive behaviour support (PBS) for adults with intellectual disabilities, autism spectrum disorder and challenging behaviour - randomised trial

2020 ◽  
Author(s):  
André Strydom ◽  
Alessandro Bosco ◽  
Victoria Vickerstaff ◽  
Rachael Hunter ◽  
Angela Hassiotis
Keyword(s):  
Autism Spectrum Disorder ◽  
Randomised Trial ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Cluster Randomised Trial ◽  
Challenging Behaviour ◽  
Treatment As Usual ◽  
Life Years ◽  
Health And Social Care ◽  
Positive Behaviour Support

Abstract Background: Although Positive Behaviour Support (PBS) is a widely usedintervention for ameliorating challenging behaviour (CB), evidence for its use in adults with intellectual disability (ID) and comorbid autism (ASD) is lacking. We report a planned subsidiary analysis of adults with both ASD and ID who participated in a randomised trial of PBS delivered by health professionals.Methods: The study was a multicentre, cluster randomised trial conducted in 23 community ID services in England, participants were randomly allocated to either the delivery of PBS (n=11 clusters) or to treatment as usual (TAU; n=12). One-hundred and thirteen participants (46% of all participants in the trial) had a diagnosis of ID, autism spectrum disorder and CB (ASD+); (47 allocated to the intervention arm, and 66 to the control). CB (primary outcome) was measured with the Aberrant Behaviour Checklist total score (ABC-CT). Secondary outcomes included mental health status, psychotropic medication use, health and social care costs and quality adjusted life years (QALYs) over 12 months.Results: There were no statistically significant differences in ABC-CT between ASD+ groups randomised to the two arms over 12 months (adjusted mean difference = -2.10, 95% CI: -11.3 7.13, p =0.655) or other measures. The mean incremental cost of the intervention per participant was £628 (95% CI -£1004 to £2013). There was a difference of 0.039 (95% CI -0.028 to 0.103) for QALYs and a cost per QALY gained of £16,080.Conclusions: Results suggest lack of clinical effectiveness for PBS delivered by specialist ID clinical teams. Further evidence is needed from larger trials, and development of improved interventions.Trial registrationClinicalTrials.gov: NCT01680276

Validity of the Social Communication Questionnaire in Adults With Intellectual Disabilities and Suspected Autism Spectrum Disorder

2015 ◽  
Vol 120 (3) ◽  
pp. 203-214 ◽  
Author(s):  
Tanja Sappok ◽  
Albert Diefenbacher ◽  
Isabell Gaul ◽  
Sven Bölte
Keyword(s):  
Autism Spectrum Disorder ◽  
Intellectual Disabilities ◽  
Social Communication ◽  
Pervasive Developmental Disorders ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Current Version ◽  
Social Communication Questionnaire ◽  
The Social ◽  
Adults With Intellectual Disabilities

Abstract This study examined the validity of the Social Communication Questionnaire (SCQ) to identify autism spectrum disorder (ASD) in 151 adults with intellectual disabilities (ID) in Germany. Sensitivities and specificities for ASD were 98/47% for the SCQ-current version and 92/22% for the SCQ-lifetime version. Sensitivities and specificities were increased to 89/66% and 78/48% by adjusting the recommended cut-points. The SCQ-current score correlated with the Scale for Pervasive Developmental Disorders in Mentally Retarded Persons and the Autism Diagnostic Observation Schedule, whereas the SCQ-lifetime score correlated with the Autism Diagnostic Interview-Revised. Our findings support the use of the SCQ-current version for ASD screening in adults with ID, although the SCQ-lifetime version should be used with caution in this population.

scholarly journals Clinical and cost evaluation of intensive support team (IST) models for adults with intellectual disabilities who display challenging behaviour: a comparative cohort study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043358
Author(s):  
Angela Hassiotis ◽  
Athanasia Kouroupa ◽  
Rebecca Jones ◽  
Nicola Morant ◽  
Ken Courtenay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Intellectual Disabilities ◽  
Online Survey ◽  
Service Use ◽  
Cost Evaluation ◽  
Challenging Behaviour ◽  
Health And Social Care ◽  
Adults With Intellectual Disabilities

IntroductionApproximately 17% of adults with intellectual disabilities (ID) living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy inpatient stays in England. We have identified two models of ISTs (model 1: enhanced provision and model 2: independent provision). This study aims to investigate the clinical and cost-effectiveness of the two models of ISTs.Methods and analysisA cohort of 226 adults with ID displaying behaviour that challenges who receive support from ISTs from each model will be recruited and assessed at baseline and 9 months later to compare the clinical and cost-effectiveness between models. The primary outcome is reduction in challenging behaviour measured by the Aberrant Behaviour Checklist-Community (ABC-C). The mean difference in change in ABC score between the two IST models will be estimated from a multilevel linear regression model. Secondary outcomes include mental health status, clinical risk, quality of life, health-related quality of life, level of functioning and service use. We will undertake a cost-effectiveness analysis taking both a health and social care and wider societal perspective. Semistructured interviews will be conducted with multiple stakeholders (ie, service users, paid/family carers, IST managers/staff) to investigate the experience of IST care as well as an online survey of referrers to capture their contact with the teams.Ethics and disseminationThe study was approved by the London–Bromley Research Ethics Committee (REC reference: 18/LO/0890). Informed consent will be obtained from the person with ID, or a family/nominated consultee for those lacking capacity and from his/her caregivers. The findings of the study will be disseminated to academic audiences, professionals, experts by experience and arm’s-length bodies and policymakers via publications, seminars and digital platforms.Trial registration numberClinicalTrials.gov Registry (NCT03586375).

Erratum: Stanish et al. (2015)

2018 ◽  
Vol 35 (3) ◽  
pp. 326
Keyword(s):  
Physical Activity ◽  
Autism Spectrum Disorder ◽  
Intellectual Disabilities ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Perceived Barriers ◽  
Activity Levels ◽  
Typically Developing ◽  
Link Type ◽  
Activity Enjoyment

In the article Stanish, H., Curtin, C., Must, A., Phillips, S., Maslin, M., and Bandini, L. (2015). Enjoyment, barriers, and beliefs about physical activity in adolescents with and without autism spectrum disorder. Adapted Physical Activity Quarterly, 32(4), 302-317. doi:10.1123/APAQ.2015-0038, the authors omitted acknowledgment that the study was an extension of a larger (parent) study that compared physical activity levels and correlates among adolescents with intellectual disabilities (ID) and typically developing (TD) adolescents. Some of the methods for the study published in this journal are identical to those in the parent study, and the same comparison group of TD adolescents was used for both disability groups (ID and autism spectrum disorder). The online version of the article has been corrected.The parent study was published as Stanish, H.I., Curtin, C., Must, A., Phillips, S., Maslin, M., & Bandini, L. (2016). Physical activity enjoyment, perceived barriers, and beliefs among adolescents with and without intellectual disabilities. Journal of Physical Activity and Health, 13(1), 102–110. doi:10.1123/jpah.2014-0548.

A Viable Option?

2014 ◽  
pp. 143-162
Author(s):  
Julie E. N. Irish
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Skills ◽  
Cost Effectiveness ◽  
Virtual Environments ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Viable Option ◽  
Children With Asd ◽  
Single User

This chapter considers whether a computer-aided technology, single-user virtual environments, can provide a viable option to teach social skills to children with Autism Spectrum Disorder (ASD). Viability is discussed in terms of key themes found in the literature: evidence-basis, generalizability, cost effectiveness, appropriateness for children with ASD, user experience, teacher’s contribution, and usefulness for caregivers. A matrix is developed to provide a viability rating for each theme. The chapter concludes that evidence-basis and generalizability for single-user virtual environments as an intervention to teach social skills to children with autism spectrum disorder is weak but that cost effectiveness, appropriateness to teenage children with ASD, positive experience of the user, and potential usefulness for caregivers is strong, whilst the teacher’s contribution is a mixed rating between ease of use for the teacher and the high one-on-one time commitment required.

Attachment disorder in autism spectrum disorder and intellectual disability

2019 ◽  
Vol 13 (2) ◽  
pp. 57-66 ◽  
Author(s):  
Arvid Nikolai Kildahl ◽  
Maria Hagen Engebretsen ◽  
Sissel Berge Helverschou
Keyword(s):  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Exclusion Criterion ◽  
Challenging Behaviour ◽  
Attachment Disorders ◽  
Attachment Disorder ◽  
Case Study Methodology ◽  
Content Type

PurposeAutism spectrum disorder (ASD) is an exclusion criterion for one of the two attachment disorders in the DSM 5. However, previous findings indicate that ASD and attachment disorder are unrelated conditions and may co-occur. The purpose of this paper is to explore the diagnostic assessment of an adolescent male with ASD, intellectual disability (ID), severe challenging behaviour and a suspected attachment disorder.Design/methodology/approachCase study methodology was chosen because of its suitability in the exploration of complex clinical phenomena where prior knowledge is sparse.FindingsIt was possible to identify symptoms of attachment disorder in a case involving ASD, ID, anxiety and severe challenging behaviour. The Disturbances of Attachment Interview was particularly useful in this assessment, as was assessment of ASD symptoms and developmental history. Differentiating the two attachment disorders proved challenging.Research limitations/implicationsThere is a need for further research in ASD and attachment disorders not limited by current diagnostic categories.Practical implicationsCo-occurring symptoms of attachment disorder may be identified in individuals with ASD and ID, and exploration of these symptoms in assessments of children and adolescents with ASD/ID and challenging behaviour may be beneficial.Originality/valueThe study adds to previous findings on attachment disorder in ASD, demonstrating that identification of attachment disorder is possible even in the presence of a highly complex clinical picture involving severe challenging behaviour. It may also assist other clinicians in identifying and making more accurate assessment of attachment disorder in ASD and ID.

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