Association between Down's Syndrome and Alzheimer's Disease: Review of the Literature

In recent years, advances in medical, surgical and nursing care have resulted in a dramatic increase in the life expectancy of children born with Down's syndrome (DS), giving rise to an older population of people with DS not previously seen. It has become clear from the study of the ageing DS population that an association exists between DS and Alzheimer's disease (AD). This paper reviews neuropathological and clinical evidence of an association between DS and AD. The clinical features of AD in people with DS and apparent differences between the signs and symptoms of AD seen in individuals with DS and older people with AD in the general population are discussed. Issues pertaining to the diagnosis of AD in people with DS, such as diagnostic criteria, the process of diagnosis, and specific problems of diagnosing AD in people with DS are also discussed. The therapeutic needs of individuals with DS who are diagnosed as having AD are considered and the necessity to strive to make the diagnostic procedure as valid as possible is expressed. The paper concludes that neuropsychological testing has an important role to play in the diagnostic process.

Involving Service Users in Professional Nurse Education in Wales

A small scale survey was conducted among nurse educationalists within Wales as part of the ongoing monitoring of Welsh Office targets for learning disability nursing. This survey showed that there has been very little service user involvement in professional nurse education in Wales. The authors discuss the possible reasons for such low level involvement. Examples of involvement of people with learning disabilities are compared to the much more favourable situation within the mental health field. Possible reasons for the barriers to progress in this area are discussed. The history of service user involvement and the development of advocacy both within the UK and other countries is also highlighted. The impact of various government initiatives on this situation is considered.

Perceptions of Registered Nurses on the Use of Psychotropic Medication for People with Learning Disabilities

The research literature showed an absence of data on the perceptions of professionals about the use of psychotropic medication for people with learning disabilities within the UK. Registered Learning Disability Nurses in a single hospital ( n = 106) and six community support teams ( n = 36) were asked their views on psychotropic medication for people with learning disabilities using a questionnaire derived from Singh and colleagues in 1996. The 112 (78.8%) respondents indicated that doctors had the greatest influence on initiating or discontinuing medication. Marked differences were evident between hospital and community nurses about the type of behaviour most likely to lead to drug treatment. Behaviour modification was viewed as an alternative treatment for acting out1, self-injury and aggression and behavioural assessment was seen to be the most influential assessment technique. More interprofessional education and training about the use of psychotropic medication were recommended. 1Acting out meaning irritability, shouting, temper tantrums.

Participatory Research with People who have a Earning Difficulty: Journeys without a Map

Emancipatory research has become a focus of interest in the field of disability studies. Despite concerns over its methodological and epistemological position it continues to stimulate debate. Widely adopted by those concerned with social inequity it has become influential in the arena of researching the lives of people who have learning difficulties. Some recent commentators have attempted to use a collaborative approach in conducting their research and in doing so have discovered problems in trying to make the process truly participative. Are these problems inherent in the research design or are they contingent upon the nature of the relationship between the researcher and the researched? This paper considers the theoretical background and the practical problems in the light of the author's experiences of collaborating on a small-scale presentational project with a young man who has a learning difficulty. It is suggested that the purpose of emancipatory research must be made transparent if the intentions are to be translated into a reality. This honesty is necessary in order to appreciate the difference in intention and outcome which will necessarily be shared by parties who approach a ‘common problem’ from different perspectives.

An Abuse of Disability? Assessing Treatment Outcome in Sexual Offenders with Learning Disabilities

There is growing recognition that, of the small proportion of people with learning disabilities who do offend, a disproportionate number are likely to have committed offences of a sexual nature. Perhaps of greater concern is the lack of empirical data to support the diversity of clinical interventions employed with this client group, and an absence of objective criteria for determining the outcome of such interventions. This paper describes initial findings of a study designed to assess treatment outcomes in eight male sexual offenders with learning disabilities currently detained in a special hospital. Data were collected through a range of quantitative research instruments in order to establish the utility of various assessment methods. Results obtained demonstrate positive shifts in several of the areas targeted during treatment. However, difficulties in the use of quantitative instruments with such inherently small samples are highlighted and discussed, and the paper, therefore, concludes by outlining how the research will develop hereafter through the development of a more qualitatively oriented, ordinal assessment instrument.