bluuebunny/crossref_metadata_2025 huggingface dataset:
‘He Can Hear When He Wants To!’ Assessment of Hearing Function for People with Learning Difficulties
Authors: Murdoch Heather
Published: August 2009

Assessing the hearing of people with learning difficulties, especially those with profound and multiple learning difficulties, is rarely easy. Their use of hearing, furthermore, may be greatly affected by their well‐being and by environmental factors, and it is difficult for clinical assessment to predict these effects. Staff or carers who work with such clients day by day are well placed to carry out ongoing observation, and to interpret clients' responses. This paper suggests an approach to assessment that does not require expert knowledge of the processes involved in hearing: rather, it requires expert knowledge of the individual who is being assessed. It identifies a range of factors which may affect functional hearing, suggests how their effects may be recorded and considers some of the implications for programme and environmental planning.
A Survey of Stereotyped Behaviours Exhibited by Adults with Learning Disability Living in a Residential Centre in the West of Ireland
Authors: Walsh Peter G.
Published: August 2009

This study represents the results of a survey conducted within a residential institution for adults with learning disability. The survey reports prevalence rates of stereotyped behaviours in a population of 112 adults with learning disability who were living in a residential complex in the West of Ireland. Of the total population, 57% were observed to engage in some form of stereotyped behaviours. The greater the degree of disability, the more likely an individual was to exhibit stereotypy and the more likely to exhibit multiple forms of stereotypy. Sixty‐four per cent of the survey population who exibited sterotypy exhibited more than one form of stereotypy and, of those who would be classed as severely disabled and who also engaged in stereotypy, 71% exhibited more than one stereotyped behaviour. The survey also indicated that body rocking and complex hand motions were the most frequently observed stereotypies. These results are in close agreement with earlier prevalence studies.
Sexual Abuse in Adults with Learning Disabilities
Authors: Fenwick Annabelle
Published: August 2009

This article presents a case study of a young man with severe learning difficulties who was presented to the psychology service following an allegation of sexual abuse. It addresses the difficulties in investigating allegations of sexual abuse, particularly in people whose communication skills are very limited. The methodology used and the difficulties in investigating the abuse will be discussed in relation to the research literature reviewed in a previous article (Fenwick, 1994).
Changing Attitudes: A Teaching Initiative in the Medical School
Authors: May David , Phillips Stan , Miller Jenny , Linton Pam , Forbes Jim , Culross Grace
Published: August 2009

In this paper we describe an innovatory teaching programme for medical students which is designed to promote more positive images of people with learning disabilities (L.D.). The programme involves small groups of medical students working in partnership with equal numbers of people with L.D. on a specific task of mutual interest. In educational terms, the programme was highly successful; students enjoyed the experience and found it both interesting and relevant to their medical studies. At the end of the programme students had acquired a greater respect for the abilities of people with L.D. and were more positively inclined towards them and their rights as citizens. However, the evidence also suggested that they continued to regard people with L.D. as somehow qualitatively different from non‐handicapped people — less able, more dependent and child‐like.
Facilitated Communication: Results from a Number of Recently Published Evaluations
Authors: Felce David
Published: August 2009

Facilitated Communication (FC) is a said by its proponents to allow people thought previously to have little or no expressive language to communicate in sometimes sophisticated ways about themselves, their feelings and their views on the world. These claims challenge accepted understandings of intellectual and cognitive disability and language development. They have naturally caused controversy, the more so since FC involves direct physical guidance being given to enable the individual to spell out messages. Such guidance may permit direct facilitator control of the content of what is being communicated. Several research studies investigating the validity of FC and the possibility of facilitator influence have now been published. All of those described here show that individuals could not communicate beyond their previously recognised language abilities when facilitators have been prevented from knowing what response was required. This evidence alone suggests that the facilitators must shape the message being produced during FC. However, most studies also produced direct evidence that they do indeed do so. There is no basis for encouraging more widespread implementation of FC at the moment.
The Stresses and Rewards of Being a Carer in a Family Placement Scheme for People with Learning Disabilities
Authors: Dagnan Dave
Published: August 2009

This study examines some of the stresses, rewards and motivations associated with being a carer in a family placement scheme offering long‐term care to adults with learning disabilities. Semi‐structured interviews were carried out with 20 carers in a family placement scheme in the North of England. The carers reported that the greatest stress is caused by factors such as severe incontinence or challenging or asocial behaviour. The rewards gained from being a carer were both altruistic, for example seeing the clients develop towards greater independence, and personal, for example in fulfilling a need to care described in terms of the general caring roles of a parent, spouse or professional carer. The lack of research into this model of care is highlighted.
A Practice and Policy Agenda for HIV and Learning Difficulties
Authors: Cambridge Paul
Published: August 2009

The aim of this paper is to review how issues around HIV and learning difficulties come together to present a challenge for health promotion/HIV prevention and services for people with learning difficulties. This review will also identify the key practice issues which services for people with learning difficulties need to address in relation to HIV and offer a model for developing policy and resources for carrying forward work in this area. The information and arguments presented in this paper are my personal interpretations based on the experiences and issues generated by two areas of work.

The first is a series of learning sets organised for South East Thames Regional Health Authority (SETRHA) on HIV and HEP B and services for people with learning difficulties. These were open to managers and staff working in learning difficulty services across agencies and sectors, and have recently been completed. (1) SETRHA Learning Sets. Organised by Paul Cambridge and Hilary Brown at The Tizard Centre. Inputs involved SE London Health Promotion Service (James Nichol) and the Sex Education Team (David Thompson). The second is a needs assessment exercise funded by South East London Health Authority (SELHA), covering the special and ordinary needs of men with learning difficulties who have sex with men in public places. (2) SELHA Needs Assessment Exercise. The steering group developed and conducted the study and included Paul Cambridge (Tizard Centre), Simon Davies (Southside Partnership), James Nichol (SELHPS) and David Thompson (Sex Education Team).
An ‘Ordinary’ Life for People with Learning Disability and Severe Sensory Impairment?
Authors: Smith Beryl
Published: August 2009

While life in small, ordinary type homes in the community is seen as desirable for the majority of people with learning disability, it may not serve the special needs of people with more complex impairment, such as those with additional severe sensory impairment. The case is made for retention and development of specialised residential provision for this group of people and for specialised service centres. This is on the condition that, firstly, such services see their function as the provision of intensive specialist help which equips people to make use of community services, as well as that of providing more permanent care for those whose severity of need requires it. Secondly, that they act as resource centres of ideas and practice which provide training for staff who work in a wide variety of situations with people with sensory impairment. Parallels are drawn between meeting children's special educational needs and the special needs of adults with learning disability. A flexible continuum of provision is seen as desirable to meet the diversity of need.
A Survey of Referrals to Specialist Services for People with Learning Disabilities who have a Dual Diagnosis or Challenging Behaviour
Authors: Allen David , Kerr Mike
Published: August 2009

There exists, as yet, no proven service model for people with learning difficulties who are difficult to serve in community settings. This paper describes an initial survey of referrals to separate services for people with a dual diagnosis or behavioural challenges using a structured rating scale. Few significant differences were evident between the populations using the two services, and those which were found related more to the severity of management problems rather than diagnostic criteria. It is suggested that planners and clinicians should avoid producing overlapping services and concentrate instead on unified multidisciplinary assessment and intervention.
Goal Attainment Scaling as a Method of Monitoring the Progress of People with Severe Learning Disabilities
Authors: Glover Susan , Burns Jan , Stanley Brian
Published: August 2009

This paper describes a small pilot project carried out in Bradford in 1991/92, with the aim of assessing the efficacy of goal attainment scaling (GAS) as a tool for setting, monitoring and evaluating goals for people with learning disabilities who attended a day centre. GAS was found to be effective in that service users made good progress towards their goals, and staff found the system simple and quick to use. Since the day centre pilot project the GAS programme has been developed further and introduced into other parts of the learning disabilities service. Following the introduction of a training package aimed at equipping staff with a basic knowledge and understanding of GAS, it is anticipated that staff in both day and residential services will be able to take more of a leading role in the implementation and monitoring of GAS in their own establishments. It is envisaged that the wider implementation of GAS will not only assist in meeting the individual needs of the service's clients, but will also be a valuable quality assurance instrument which will help services evaluate their own performance.
Intensive Community Assessment and Intervention for Challenging Behaviour: A Case Study
Authors: Finlay W. Mick , Duckett Stephane , Eliatamby Anna
Published: August 2009

This paper describes the intensive assessment of a man's challenging behaviour in the community and the interventions developed as a result. There were found to be many contributing factors, and interventions led to a marked improvement in the man's quality of life, communication and behaviour in the community. The process enabled community staff members to develop competence in supporting people who challenge, and allowed the man to remain in his normal environment.
Offenders Referred to a Learning Disability Service: A Retrospective Study from One County
Authors: Thomas D. H. , Singh T. H.
Published: August 2009

A retrospective study of all the offenders with learning disabilities referred to a community based out‐patient clinic serving one county over a seven‐year period was performed. Information was collected regarding degree of learning disability, presence of additional mental disorder, type of offence committed and living conditions at the time of referral. Follow up over a subsequent three‐year period was also performed retrospectively and covered areas such as treatment, reoffending, hospitalisation and present accommodation. Some of the implications of the findings are discussed and it is argued that a community based out‐patient clinic supported by a small in‐patient unit cannot cope with all offenders with learning disabilities.
Community‐based Social Services for People with Learning Disabilities in the People's Republic of China
Authors: Tse John W. L.
Published: August 2009

Since 1954, the People's Republic of China (PRO has set up a vast community network to deliver welfare services at the neighbourhood level. Such institutions called Street Offices and comprised of Residents' Committees are very different from voluntary agencies in the West. Community‐based services for people with learning disabilities, which have gained much popularity in the West in last decades, are described in the Chinese context. This article also examines the functions and roles of the street office in the PRC. Difficulties facing the Street Office are also discussed.
An Observational Case Study of Staring Behaviour
Authors: Fallon John
Published: August 2009

This paper describes the use of empirical data to test a popularly‐held subjective view of the attitude of a man with learning disabilities towards children following incidents involving attacks on children after his resettlement into the community from long‐term institutional care. An heuristic was developed making use of a marked behavioural trait, i.e. his propensity to stare. Relative instances of this behaviour directed towards adults and children respectively were recorded during a sample of twenty‐four, one‐hour sessions. A statistical analysis of the recorded data revealed no significant difference between attention paid to adults and to children. The observers, therefore, concluded that it was unreasonable to assume an unhealthy preoccupation with children.
An Introduction to Aromatherapy for People with Learning Disabilities
Authors: Harrison Jane , Ruddle Judy
Published: August 2009

Aromatherapy is the use of essential oils to promote health and well being and is being used increasingly with children and adults who have severe learning disabilities. Although well known for its relaxing, invigorating and health promoting effects, its use can be further extended to provide sensory stimulation and to help develop communication through a trusting relationship. This article sets out to explore each of these areas and to describe how they have been used with people with severe learning disabilities.
Should We Prevent Down's Syndrome?
Authors: Williams Paul
Published: August 2009

Current policy and practice in relation to the prevention of Down's Syndrome is reviewed in the context of the achievements of people with Down's Syndrome. Parents' views are described and some ethical issues discussed. It is suggested that we each need to decide our answer to the question ‘Should Down's syndrome be prevented?’, lest practice with which we disagree is adopted by default.
Menstruation and Aggression in a Population of Women with Learning Disabilities
Authors: O'Dwyer J. M. , Friedman T.
Published: August 2009

The effects of menstruation have been extensively studied in those with psychiatric disorders. However, there is very little in the literature concerning the effects of menstruation on those with learning disability. We investigated the effects of menstruation on aggressive incidents in women, in a large hospital for people with learning disability. We also considered the effects of medication, epilepsy, and the degree of learning disability. The results suggest that there was no significant increase in aggressive incidents pre‐ or perimenstrually, but that those with primary amenorrhoea have significantly higher rates of aggressive incidents. The possible reasons and implications of these findings are discussed.
Sexual Activity in People with Profound Learning Disabilities
Authors: Reid D. A.
Published: August 2009

Sexual activity in people with profound learning disabilities is relatively under‐researched. This study aimed to measure the proportion of individuals in this group who engage in sexual behaviours and to look for any relationship between this behaviour and intellectual ability within the group. Approximately half of the sample were engaged in some sort of sexual activity but no correlation with intellectual ability was found. The practical and legal implications for carers are discussed briefly.
Vitamin C Status and Dietary Intake In a Long Stay Unit for Clients with Learning Disabilities: Implications for Community Care
Authors: Caudery Alison
Published: August 2009

Vitamin C status was assessed in 23 out of 48 clients living in Farleigh Hospital, Bristol using a simple titration technique on samples of urine collected following a loading dose of Ascorbic acid. A three‐day nutritional assessment was carried out on eight clients using food diaries in order to try and correlate dietary intake with Vitamin C status. The availability of Vitamin C at ward level was examined. The study revealed that despite adequate supplies of Vitamin C‐rich drinks/food at ward level 26% of clients tested had some degree of Vitamin C hypovitaminosis. There did not however appear to be any significant difference in current dietary intake between clients who had a degree of hypovitaminosis and clients who did not, so the implication is that previous dietary intakes were poor and have never been replenished. The limitations of such a small study are acknowledged but the implications for nutrition training and community care are still valid.
Helping People with Learning Disability to Cope with Bereavement
Authors: James Ian A.
Published: August 2009

Emerson (1977) claims that as much as 50% of the emotional and management difficulties of people with learning disabilities, requiring crisis intervention, may be directly or indirectly associated with a death or loss. The current paper attempts to review the recent work on loss in the learning disabled. It uses a 10‐item categorical list adapted from Donnelly's (1990) 10 principles of counselling. The work was initially designed to be a practical guide for carers, following a request for help from nursing staff. As a consequence, this review includes a number of specific suggestions on how to care for people with learning disabilities who have suffered a recent loss.
The Incidence and Importance of Hearing Loss in People with Severe Learning Disability: The Evolution of a Service
Authors: Yeates Sybil
Published: August 2009

This is the third and final report on a study of the hearing of people with severe learning disability in Lewisham and North Southwark. The previous two reports were published in this journal, Volume 17: 33–7 and Volume 20: 126–33. The initial report on a sample of 100 people caused concern by implicating a greater prevalence of hearing loss than most previous work had shown. It was then possible to set up a research project to test the validity of initial results. An intermediate report published after the examination of 300 subjects gave similar results. Approximately 50% of the learning disabled population in Lewisham and North Southwark i.e. 500 people, have now been tested and this paper confirms the findings and stresses the importance of full audiological examination at key ages. In view of this a service has now been established in order to test the remaining people wherever possible, supervise those already found to have a hearing loss and, most importantly, to train all concerned in caring for the learning disabled who also have a hearing loss.
‘Why Parents: How Parents’
Authors: Madden Phil
Published: August 2009

Parents of both children and adults with learning disabilities have an important role in the development of services. Professionals do not always make the best use of parent commitment and insights, or properly respond to their concerns. Yet there are examples of good parent/professional partnership, and successful individual and collective parent empowerment, particularly in the USA. This paper argues that there are opportunities to learn from these developments and to build a new model of partnership.
Living under the Strategy: Do Outcomes for Users of Welsh Community Residential Services Live up to the All Wales Strategy's Underlying Principles?
Authors: Perry Jonathan , Felce David
Published: August 2009

The results of a two‐year study which assessed quality of life outcomes for residents of fourteen small‐scale staffed houses in Wales are discussed in the context of the principles which underlie the All Wales Strategy for the Development of Services for Mentally Handicapped People. Housing quality and location, levels of community participation, individualisation and autonomy were generally found to be reasonably high. In contrast, levels of social participation and support for resident involvement in activity were typically low. Furthermore, it was found that people with more substantial disabilities tended to fair worse than others. These results are compared with outcomes reported for users of earlier ‘demonstration’ projects and brief suggestions for service development are made.
Elderly People with Learning Disability: A Comparison of People Over the Age of 61 in 1984 with Those Over the Age of 61 in 1994
Authors: Rohde Jenifer , Farmer Richard , McCarthy Jane
Published: August 2009

The people with learning disabilities (mental handicap) originating from Westminster, England who were aged over 61 years in 1984 were compared with those in the same age group in 1994. Over the decade there had been a significant change in the nature of the residential provision; the proportion resident in hospitals fell and that in ‘community care’ increased. There was a significant increase in the proportion assessed as having behaviour problems. A significant number of people were less able to feed themselves. Implications for service provision are discussed.
A Double Coming Out: Gay Men with Learning Disabilities
Authors: Davidson‐Paine Chris , Corbett Jenny
Published: August 2009

This paper offers a small‐scale investigation of the experiences of a sample of men with learning disabilities, who are exploring their gay identities. It deals particularly with issues of social acceptance, both generally and within the gay community. In presenting the findings of interviews, drawn from People First Members in the London area, the intention is to raise some key questions relating to potential support strategies for those seeking guidance.
Informal Carers of Former Long‐stay Hospital Residents With Learning Disabilities
Authors: McGilloway Sinead , Donnelly Michael , Mays Nicholas
Published: August 2009

This study set out to describe and analyse the nature and consequences of care for a small number of informal carers (n = 9) providing full‐time care for people with learning disabilities discharged from long‐stay hospitals between 1987 and 1992. The findings showed that these carers, whilst not adversely affected by their caring roles, did experience restrictions on their personal and social lives as well as increased anxiety and physical fatigue. In contrast with findings from other studies of carers of people with learning disabilities, they had more difficulty with practical caring tasks/activities (e.g. providing help with social activities) than with problem behaviour. Although generally satisfied with the professional support received, carers indicated that they would benefit from more support, especially holiday and weekend respite care.
Attitudes of Speech and Language Therapists to Intimate Relationships Among People With Learning Difficulties: An Exploratory Study
Authors: Harris Philip , Brady Carmel
Published: August 2009

This study explored the attitudes of speech and language therapists (SLT) to intimate relationships among people with learning difficulties. A stratified random sample of SLTs (n=66) were sent a short, written scenario concerning two young adults with learning difficulties who were about to set up home together. Half the SLT's received a scenario in which ‘John’ was said to have a severe learning difficulty, the other participants received a scenario in which ‘John’ had a mild learning difficulty. The two scenarios were otherwise identical. All participants were asked to rate the scenario using a semantic differential scale. Forty completed questionnaires were analysed and the results indicated relatively favourable attitudes toward someone with a mild learning difficulty. Attitudes toward a person with severe learning difficulties were significantly less favourable (p<0.001), however, it could not be concluded that the unfavourable attitudes were directly related to engaging in an intimate sexual relationship.
Primary Health Care for People with a Learning Disability
Authors: Kerr Mike , Fraser William , Felce David
Published: August 2009

The delivery of health care to people with a learning disability living in the community has come under increasing scrutiny. Concerns have been raised over both the current quality of this care and its future organisation. In this article we review the evidence on current practice focusing on epidemiology, health status and policy directives affecting primary health care. Four specific areas for service developments are identified: an individual focus within an epidemiological framework, the evaluation of the effectiveness of current therapies, practice organisation and the awareness of health within social care. It is proposed that an effective model of primary health care is possible, supported by research, training, inter‐service collaboration and purchasing guidelines.
Training for Staff Caring for People with Learning Disability
Authors: Smith Beryl , Wun Wai‐Ling , Cumella Stuart
Published: August 2009

This paper considers the training of staff who care for people with learning disability in the community. Details are given of findings from a survey of staff in community units in the West Midlands which suggest that although most staff receive some training, this is largely a mixture of short in‐service courses and there is a lack of consistency across the various agencies. Despite the considerable changes taking place within services for people with learning disability, which require new knowledge and skills, we are still far removed from having an explicit, relevant and agreed strategy for training ‘front‐line carers’. Present approaches are reviewed and recommendations made for future development.
Touch as a Therapeutic Medium for People with Challenging Behaviours
Authors: Hegarty John R. , Gale Evelyn
Published: August 2009

Personal experience suggests that more and more centres are using some form of massage as a therapy approach, but there are few published accounts. In this article, we report a case study with Ms K, a lady who had long displayed severely challenging and disturbed behaviour. A simple form of massage was used as a medium of communicating positive regard with the aim of developing a therapeutic relationship. We believe that Ms K enjoyed this and became more sociable, which led to a change in her lifestyle. More should be done to enable clients with severely problematic behaviour to experience caring relationships, and we believe that a structured approach to using touch therapeutically by appropriately trained professionals is indicated.
Ordinary Women: Issues for Women with Learning Disabilities
Authors: Brown Hilary
Published: August 2009

This paper reviews some key issues for women with learning disabilities and those who work with them arguing that many of these are ‘ordinary’ women's issues which are exacerbated because they often remain unacknowledged. Services ignore gender more than sexuality leading to very atypical lifestyles for women with learning disabilities. The paper explores how women's needs around fitness and appearance, sexuality and sexual abuse, reproductive rights and experiences of motherhood and caring for others could be supported by services which were more willing to acknowledge that women with learning disabilities are ‘women first’.
‘Just When You Think You Got It All Sorted …’: Parental Dilemmas in Relation to the Developing Sexuality of Young Profoundly Disabled People
Authors: Swain John , Thirlaway Carole
Published: August 2009

Sexuality is a neglected topic in the literature focusing on young profoundly disabled people. For parents and formal carers who work with parents and young people themselves, however, sexual development and identity pose fraught and complex challenges in understanding and addressing young people's needs. This paper is based on qualitative research which explored parents' experiences, feelings and understandings and the responses of formal carers to parents' perspectives. The parents faced contradictory pressures to deny and not to deny sexuality. Formal carers drew on beliefs about ‘good parenting’ in reactions to the position of parents. Both groups confronted real dilemmas with young people who are incapable, and may never be capable, of informed consent or self‐determination in sexual relationships.
Group Psychotherapy with Learning Disabled Adults
Authors: Jones Alison M. , Bonnar Sally
Published: August 2009

An account is offered of group psychotherapy with five mildly learning disabled adults with emotional and maturational difficulties. Group content, dynamic process and problems, and evaluation are examined. Psychodynamic group psychotherapy with this client group is a treatment option not often undertaken but it is appropriate and potentially beneficial to this group of people. The task of the therapist is not easy and supervision and support are essential.
Newspaper Portrayal of Disability:
Authors: Jones Robert S. P. , Eayrs Caroline B.
Published: August 2009

Two local newspapers were monitored for a six‐month period and then each received an intervention designed to increase the number of articles which showed people with learning disabilities as active, positive members of local communities and decrease the number of articles which reported fund‐raising events or other ‘special’ activities. Both newspapers were sent a letter reporting the findings of the monitoring exercise plus a copy of National Union of Journalist guidelines on the portrayal of disability. The editor of one newspaper was also visited by a person with learning disabilities who explained how he would like future coverage to proceed. Results of a follow‐up monitoring period snowed that the newspaper which had been visited had positively changed its protrayal of disability issues compared to the other newspaper.
Schizophrenia and Learning Disability
Authors: James David H. , Mukherjee Tapati , Smith Cameron
Published: August 2009

A survey of individuals known to the learning disability service in Cornwall as having a dual diagnosis of schizophrenia and learning disability discovered that very often there can be a long delay between the start of symptoms in schizophrenia in this client group and a diagnosis. This paper seeks to inform staff in learning disability services about the symptoms of schizophrenia, how it presents in people with a learning disability and possibile diagnostic difficulties.
Quality Monitoring in Community Psychiatry of Learning Disabilities Services: Current, Planned and Future Approaches
Authors: Gravestock Shaun , Bouras Nick , Holt Geraldine
Published: August 2009

Trends influencing quality monitoring in psychiatry of learning disabilities services are outlined. The multilevel quality monitoring approaches, selected standards and data from local community specialist psychiatric services illustrate several opportunities and problems. Planned local approaches and future national developments emphasise the importance of defined service objectives and users' outcomes, interagency information systems, user involvement, need assessments, applied research projects and evaluating cost‐effectiveness.
Comparing Quality of Life for People with Learning Disabilities and People who are Unemployed or Retired
Authors: Hughes Andrea , McAuslane Louise , Schur Helen
Published: August 2009

This study investigates the quality of life of people who moved out of a large long‐stay hospital to ‘ordinary housing’ with support staff. A social reference group of unemployed/retired people living in the same urban area was chosen for comparison as they have similar economic status and local opportunities. Ager's Life Experiences Checklist (LEC) was completed by staff for people with learning disabilities and by the researchers in interviews with unemployed/retired people. The rationale for this method is discussed. Findings support the view that the lifestyle of people with learning disabilities, when compared with people of similar socio‐economic status, is enhanced in the domains of Home, Leisure, Opportunities and Freedom, but not in the area of Relationships. Discussion of the need for caution in interpretation is included, especially as the scores of people with learning disabilities are shown to be more like those of Ager's general population. There are pointers to the use of normative data to assist services in monitoring outcomes.
Facilitating a National System of Training in New Zealand
Authors: O'Brien Patricia , Espiner Deborah , Hartnett Frances
Published: August 2009

The structure of a three tiered system of training for human service workers within New Zealand is described as well as the teaching and facilitation methods used to deliver the content of the courses within a tertiary training environment. Underlying the training courses are the three themes of: the creation of valued lifestyles for people with disabilities; a commitment to biculturalism; and the development of effective communication skills. The three levels of training include a certificate, diploma and degree in Human Services. A range of facilitation techniques is illustrated within the context of one elective course.
Promoting Healthy Lifestyles for People with Learning Disabilities: A Survey of Provider Organisations
Authors: Turner Stephen
Published: August 2009

A postal survey of UK provider organisations investigated the nature and organisation of healthy lifestyle initiatives currently being offered to people with learning disabilities. Seventy percent of Social Services or Social Work Departments in England, Scotland and Wales were represented in the survey. One in four respondents said their organisation followed a healthy lifestyles policy for people with learning disabilities. These respondents also reported a wider range of healthy lifestyle initiatives. Weight loss and maintenance were the most commonly reported interventions, along with healthy eating, health education and catering, and health checks. Fitness interventions were less common, especially in NHS provider organisations. Healthy eating and health checks were most often cited as priorities for the future, while weight loss and maintenance interventions were less frequently given, despite the high level of obesity and overweight in this population. Alcohol and smoking‐related interventions were given low priority.
Consumer Audit of Community Learning Disability Teams
Authors: Simon Florence , Roy Meera
Published: August 2009

In 1993, the four Community Learning Disability Teams in Sandwell set up Quality Standards to govern their function. A consumer audit was undertaken to assess views of users and carers on delivery and operation of the service. The results were presented to the teams who modified their practice accordingly. Some of the difficulties encountered in carrying out consumer audit with users who have severe learning disabilities are described.
The Development of a Semi‐Structured Interview to Investigate the Attachment‐Related Experiences of Adults with Learning Disabilities
Authors: Smith Patricia , McCarthy Gerard
Published: August 2009

A procedure was developed by which the attachment‐related experiences of adults with learning disabilities could be explored and the reliability and construct validity of the measure were investigated. Thirty‐one subjects with mild to severe learning disabilities were interviewed using a semi‐structured interview and a third of the subjects were interviewed again three months later. To examine the convergent and discriminant validity of the measure, the relationship between it and measures of self‐esteem, independence and general intelligence was investigated. The reliability of the procedure was found to be high over time (kappa = 0.80) and, as predicted, it was found to be significantly related to self‐esteem and level of independent behaviour in the home. It was not found to be related to general intellectual functioning. Unexpectedly, it was not found to be related to level of independent behaviour outside the home.
Access to Current Genetic Investigations for Children with Special Educational Needs
Authors: Morritt Jennifer , Waterston Tony , Magnay Dorothy
Published: August 2009

The association between chromosome abnormalities and learning disability is well known and the important contribution made by the fragile‐X syndrome is recognised. With the increasingly sensitive tests that are now available, a more precise diagnosis is often possible: yet many individuals with learning difficulties have not had recent investigation. The offer of genetic investigation as a part of the statutory Reassessment of Special Educational Needs in one secondary school in Newcastle‐upon‐Tyne is described. Thirty‐four children were eligible: of the 26 pupils who agreed to be tested, four were found to have a chromosome abnormality. In the three cases where this could account for the child's problems, educational management and family support were facilitated. These findings suggest that the offer of genetic investigation, for the children who remain undiagnosed at this stage, is beneficial and could become a more standard practice.
Involving People with Learning Disabilities in Community Care Planning
Authors: Redworth Mike , Phillips Gary
Published: August 2009

It is now time for people with learning disabilities to become fully involved in community care planning at all levels. This paper highlights some possible reasons (and excuses!) why people have not been accepted as full and equal members of groups serving the planning and commissioning processes. It examines the issues and difficulties around enabling people to become full members and suggests strategies, interventions and good practice guidelines for overcoming those difficulties. Finally, it argues that people with learning disabilities should be key players in the planning of services that directly affect them.
An Anger Management Group for People with a Learning Disability
Authors: Moore Estelle , Adams Richard , Elsworth Julie , Lewis Jessica
Published: August 2009

A course on anger management of eight weeks duration for six people with learning disabilities (in the mild‐moderate range), and their keyworkers, is described. The programme drew on a range of techniques to assist in the exploration and control of difficult emotions, including relaxation, role‐play, problem‐solving and sharing in a group. With reference to the information we received from the participants (clients and staff) about their experience of being in the group, we discuss what appeared to have been helpful to group members in learning how to express angry feelings in appropriate ways, and to keyworkers in supporting clients in the management of aggressive behaviour.
Gender, Race and Sexual Behaviour: Issues in Service Responses to HIV/AIDS
Authors: Senker Jonathan
Published: August 2009

The number of people with learning disabilities who are HIV positive is not known. However, research indicates that there is a significant number of people with learning disabilities at high risk of contracting the virus. Services need to give priority to developing a response to HIV/AIDS. This article argues that notions of HIV as an ‘equal opportunity virus’ are misleading and potentially damaging. Instead, responses need to be rooted in an accurate assessment of the needs and power of service users, together with an understanding of the relationships between race, gender, sexuality and HIV/AIDS. These issues are examined to inform how services should respond in relation to HIV transmission, health promotion initiatives, diagnosis, treatment and support for people with learning disabilities living with HIV/AIDS.
People Living in Community Homes: Their Views
Authors: Holland Angela , Meddis Ray
Published: August 2009

The study investigated the views of people with learning disabilities in community‐based residential services. Six people in different services took part in detailed case studies. Views were assessed using two interview approaches: a Service User's Interview Questionnaire was completed, and secondly, interviews took place on at least six occasions covering selected topics. The use of qualitative analysis is outlined. Four of the six people in the study wanted to leave their residential service. People's views were strongly influenced by the following factors: knowledge of alternative living arrangements, identified friend(s) to live with, dislike of the behaviour of other people in the service, and dislike of a member of staff. Managers and carers in community services may need to give more attention to the interpersonal issues highlighted by the study.
Life Story Work for People with Learning Disabilities
Authors: Hussain Feryad , Raczka Roman
Published: August 2009

The transition from long‐stay hospitals to community residential homes is a difficult period for many people with learning disabilities. Whilst staff ensure a ‘clinical transition’ by forwarding details of the client's history, there is little information from the clients themselves to ensure an ‘emotional transition’. This paper examines ways in which Life Story Work can ameliorate transition stress for clients. The main issues for clients during this time are those of adjustment to the new environment as well as being given the opportunity to deal with the loss and bereavement of their previous lifestyle. It is suggested that we need to look at the clients' needs at this time from a psychological, as well as a practical viewpoint. Life Story Work is a person‐centred approach which enables both staff and clients to focus on particular aspects of their lives. In addition, it allows an opportunity for relevant counselling at a time when staff support and understanding are vital.
Follow the Yellow Brick Road! People with Learning Difficulties as Co‐researchers
Authors: March Justine , Steingold Betty , Justice Susan , Mitchell Paula
Published: August 2009

This article is written by three people with learning difficulties. It is about our experience of doing research. We are all members of Hackney People First and in 1994 we got involved in a project researching self‐advocacy and families. The article describes why we decided to get involved, our feelings about doing research and what we did. It explains the help we had to take part.

Researchers have been talking about disabled people doing research for quite some time, but involving people with learning difficulties as researchers is only just beginning. This article is extremely important, as one of the very few times that people with learning difficulties have written about carrying out research.
Smoking Education for People with Learning Disabilities
Authors: Kelman Lucy V. , Lindsay William R. , McPherson Frank M. , Mathewson Zelda
Published: August 2009

A Health Education Programme for adults with learning difficulties is described. Health Education for this group has often been neglected with limited resources available, especially in relation to tobacco use. The programme described aims to redress this issue by providing a package, which effectively presents information, in a manner which is sensitive to the needs and abilities of this particular group, on the health and social issues of smoking. Two case examples are presented to illustrate how the package is effective in both group and individual settings.
Auditory Integration Training (AIT): Sound Therapy? Case Studies of Three Boys with Autism who Received AIT
Authors: Link Hanna M.
Published: August 2009

Auditory Integration Training (AIT) is an experimental ‘alternative’ therapy aimed at individuals with hypersensitive hearing. Developed by Otorhinolaryngologist Dr. Guy Berard, AIT involves listening to electronically‐processed music through headphones for 20 half‐hour sessions. Berard (1993) believes that many cognitive and behavioural problems, including autism, dyslexia and depression, result partially from distortions in hearing, and thus, that clinical symptoms can be alleviated by use of AIT. For example, Berard (1993) considers autistic behaviours to be largely an avoidance reaction to noises heard too acutely.

The progress of three boys with autism receiving AIT was closely monitored. Few if any beneficial effects on behaviour were observed. Sound hypersensitivity remained unchanged. The paper also questions the validity of the AIT technique used, and highlights a need for an AIT ‘watchdog’ in the UK.
Burnout and Workload in Teachers of Children with Severe Learning Difficulties
Authors: Male D. B. , May D. S.
Published: August 2009

This paper addresses the possibility that teachers of children with severe learning difficulties (SLD) may be especially vulnerable to heightened stress levels. A postal questionnaire posing investigative questions relating to workload and sources and quality of stress was sent to eight SLD schools in inner city, urban and rural areas in the south‐east of England. Fifty‐seven SLD teachers responded. Results indicated that SLD teachers were subject to high workload and long hours of work. High scores were obtained for the variable Emotional Exhaustion as measured by the education version of the Maslach Burnout Inventory. Qualitative data identified workload and challenging behaviour as the most frequently cited sources of intense stress. Results are discussed with reference to the need to develop effective job‐related coping strategies for SLD teachers.
The OK Health Check: A Health Assessment Checklist for People with Learning Disabilities
Authors: Matthews David , Hegarty John
Published: August 2009

This study was instigated in response to the growing awareness that the health care needs of people with learning disabilities are not being adequately met in the evolving community services. This paper describes how a checklist assessment of health needs for people with learning disabilities was developed using a ‘Delphi’ group approach. The paper describes how the health assessment checklist was tested for validity and inter‐rater reliability with qualified and unqualified carers in different settings. The findings demonstrate that it is an effective means of identifying health needs for this client group, and is an appropriate tool for use by staff of all grades.
The Importance of Communication Partnerships: A Study to Investigate the Communicative Exchanges Between Staff and Adults with Learning Disabilities
Authors: Bartlett Claire , Bunning Karen
Published: August 2009

A small‐scale study was conducted to investigate the extent to which the verbal communication skills used by adults with learning disabilities were complemented by those used by their keyworkers during communicative exchanges. The setting was a community‐based day centre. The number of information carrying words (ICWs) used by keyworkers with their clients was measured in two contexts: (A) looking at selected pictures; (B) free conversational exchange. These were compared with the verbal comprehension level of each client, also measured in ICWs, as assessed by the administration of the Derbyshire Language Scheme: Rapid Screening Test of Comprehension (Knowles & Masidlover, 1982). The results revealed that major differences existed between the communication skills used by keyworkers, and the comprehension levels of the participants with learning disabilities under both conditions. The greater mismatch was evident in the second condition of ‘free conversational exchange’. Some limitations of the current study are discussed together with the implications for future investigations and intervention.