bluuebunny/crossref_metadata_2025 huggingface dataset:
The qualitative research interview
Authors: Qu Sandy Q. , Dumay John
Published: September 2011

Purpose

Despite the growing pressure to encourage new ways of thinking about research methodology, only recently have interview methodologists begun to realize that “we cannot lift the results of interviewing out of the contexts in which they were gathered and claim them as objective data with no strings attached”. The purpose of this paper is to provide additional insight based on a critical reflection of the interview as a research method drawing upon Alvesson's discussion from the neopositivist, romanticist and localist interview perspectives. Specifically, the authors focus on critical reflections of three broad categories of a continuum of interview methods: structured, semi‐structured and unstructured interviews.

Design/methodology/approach

The authors adopt a critical and reflexive approach to understanding the literature on interviews to develop alternative insights about the use of interviews as a qualitative research method.

Findings

After examining the neopositivist (interview as a “tool”) and romanticist (interview as “human encounter”) perspectives on the use of the research interview, the authors adopt a localist perspective towards interviews and argue that the localist approach opens up alternative understanding of the interview process and the accounts produced provide additional insights. The insights are used to outline the skills researchers need to develop in applying the localist perspective to interviews.

Originality/value

The paper provides an alternative perspective on the practice of conducting interviews, recognizing interviews as complex social and organizational phenomena rather than just a research method.
Cultural and Race Issues in Sexuality Work with People with Learning Difficulties
Authors: Malhotra Seema , Mellan Bryan
Published: September 2011

The aim of this paper is to highlight some of the complexities involved in undertaking sexuality work and attempting to address the differing cultural needs of service users. It is primarily based on the direct work experiences of the authors but is reinforced by the broader experiences of colleagues.The paper is not written with the intention of giving answers but rather to explore the responsibility of services, as well as the practical implications of carrying out sexuality work with service users from a range of cultural backgrounds within an equal opportunities framework.
Sexuality and Profound and Multiple Impairment
Authors: Downs Caroline , Craft Ann
Published: September 2011

This paper addresses issues of concerns relating to the group whose needs in relation to sexuality have for too long been ignored, namely those with profound and multiple disabilities. The development of a specialist project to meet those needs is outlined, along with some of the difficulties and dilemmas faced along the way. The importance of staff training and support for staff to explore their own values and feelings towards the sexuality of this client group is emphasised.
Stress & Stress Management Among Residential Care Staff
Authors: Rose John
Published: September 2011

Evidence is mounting to suggest that stress not only influences an individual's well‐being, but can also have an impact on the quality of work they perform. This paper starts with a consideration of some important issues relating to stress in staff who work with people who have learning disabilities, particularly those who work in community group homes. Current research indicates a number of common themes. A model is presented that attempts to summarise some of these. However, it is also clear that there is considerable variability between organisations. This variability must be assessed when considering the needs of individuals and groups of staff. Some groups of staff seem to Report higher levels of stress and can benefit from stress management interventions. For stress management to be effective, assessments that take into account individual and organisational issues are necessary. An example of a successful intervention package is provided. This is based on the assessment of staff teams and implemented within a problem‐solving framework.
Joint Commissioning: Searching for Stability in an Unstable World
Authors: Greig Rob
Published: September 2011

Learning disability services have been at the forefront of attempts to develop effective joint working between health and local authority agencies. There is now an emergent framework for commissioners to work together and some, albeit patchy, experience of doing so. Joint commissioning has demonstrated potential benefits for service users, though there is still considerable scope for widening the range of stakeholders and more firmly establishing it in the host organisations.
Assessing the Capacity of People with Learning Disabilities to Make Decisions About Treatment
Authors: Arscott Kate
Published: September 2011

Assessing the capacity of individuals with learning disabilities to make decisions about treatment is problematic. This field has received little attention in the United Kingdom, the concept of capacity proving difficult to define. There are no commonly agreed standards, English law in this area is still developing and there are few guidelines to instruct health professionals. This paper reviews the diagnostic, outcome and functional approaches to examining the issue of capacity and outlines a number of tests that have been developed for use in the clinical setting, though not adapted for use with people with a learning disability. Issues to be addressed in the adaptation of tests are explored and areas for practitioners to consider are discussed.
Procedural Confusion: Challenging the Decisions of the Special Educational Needs Tribunal
Authors: Schwehr Belinda
Published: September 2011

Rights of appeal against decisions of the new Tribunal are not found in the 1993 Education Act. The statute which creates such a right appears to give a choice of appeal route, and does not refer at all to the distinct legal procedure of judicial review. But recent cases have effectively limited rights of appeal from the Tribunal, to an appeal to the High Court on a point of law only, via a particular procedure, and precluded the alternative routes. However, even the way in which the cases are still being indexed and written about, in journals and digests, may perpetuate confusion among practitioners. The writer has heard, anecdotally, that Tribunals themselves are often insisting on being made parties to appeals, and, indeed, SENTs continue to appear in the books as respondents to appeals. The implications for local authority legal and education officers, and for advice workers, particularly as to time limits and legal aid, are considered in this article.
Verbal Communication in People With Learning Difficulties: An Overview
Authors: Remington Bob
Published: September 2011

If people with learning disabilities are to be effective social agents, the capacity to communicate with others through speech, sign or symbol manipulation is of central importance. Unfortunately, severe and profound learning disabilities are frequently associated with very poor communicative skills and remediation is therefore essential. Theories of normal language development may be of value in suggesting remedial strategies but, of these, structural approaches that emphasise language organisation are less helpful than functional accounts of language use. The latter have led to many successful intervention programmes based in the domestic and social environments of learners. Research is continuing to produce rapid progress in communication intervention but the application of scientific findings is critically dependent on high levels of understanding by, and co‐operation between, professionals in such disciplines as nursing, clinical psychology, speech therapy, teaching and management.
Understanding and Responding to Challenging Behaviour: a Service Provider's Experience
Authors: Ashman Beverley
Published: September 2011

Many services struggle with the dilemma of providing quality residential services to people with learning disability who present behaviours which challenge services. In the last year, one such service in North Yorkshire has begun to develop a more systematic and structured way of approaching this. The introduction of a weekly timetable which incorporates all the service and service user requirements, backed up by training, external professional help and management attention, has seen a decrease in behaviours which challenge, increases in team members' skills and confidence, and increased service user participation both in the house and in the community. This paper describes how this process began and the results for service users, staff and the organisation.
Competence and Quality in the Lives of People with Profound and Multiple Learning Disabilities: Some Recent Research
Authors: Hogg James
Published: September 2011

While the right to life, ‘personhood’, and the educability of people with profound and multiple learning disabilities are still under‐debated, service providers and research workers continue to extend the boundaries of expectation with respect to what such people can achieve. In this paper the messages of recent research are summarised and key references for fuller information suggested. The need to bring together such specialised knowledge in the framework of an ordinary life aimed at enhancing competence and quality of life is urged.
Getting a Foot in the Door: the Strategic Significance of Supported Living
Authors: Simons Ken
Published: September 2011

The central argument of this paper is that supported living — enabling people with learning disabilities to live in their own homes, with appropriate support — has a potential strategic role in addressing some of the current shortcomings in community‐based residential services. These shortcomings are described, along with the possible contribution of an approach in which housing and support are separated. Finally some of the current concerns about supported living are briefly addressed.
Monitoring Contracts for Residential Care: a Case Study
Authors: Miles Marilyn
Published: September 2011

This paper reviews how social care contracting in learning disability services has developed in the UK, making use of experience in Berkshire. The monitoring of block contracts for residential care is explored from the perspectives of the keyworker in the home and the purchaser who is monitoring the contract. An action research approach was used to develop monitoring and change subsequent practice in contracting. Particular areas identified as needing improvement were staff induction and training, care planning and review, meeting health needs, and building the setting and measuring of individual service outcomes into all areas of practice, especially provider internal quality‐assurance. The limited role of the service user in the process is highlighted.
Assessment and Service Provision for Children with Autism
Authors: Christie Phil
Published: September 2011

This paper considers issues to do with the assessment of, and provision made for, children with autism. Reference is made to some of the key principles of current legislation and guidance, together with developments in the voluntary sector. These are discussed in the context of personal experience of managing a school for children with autism and diagnostic and assessment services for children with disorders of development and communication. Greater awareness has led to an expansion of services, often in response to pressure from parent organisations, but careful attention needs to be given to ensuring that continued development meets the very complex and specific needs of children with autism.
Self‐Injurious Behaviour: What do we Know and Where are we Going?
Authors: Murphy Glynis
Published: September 2011

Self‐injurious behaviour can become an intransigent difficulty, reduce people's quality of life and lead to hospital admissions or other restrictive outcomes (such as the wearing of protective devices to prevent serious injury). Over the last 15 years there have been some important developments in the treatment of severe self‐injury, but the evidence is that these are making little impact on most people's lives. The reasons why this might be are discussed, and it is proposed that it is time for a radical new approach to interventions for self‐injurious behaviour.
Active Support: Getting it Working Within an Organisation
Authors: Tindall Bob
Published: September 2011

This article describes the implementation of ‘active support’ in United Response, a national voluntary organisation which provides services to people with learning disabilities. The learning process in implementing active support demonstrates that effective leadership by service managers and area managers is very important. It is also important to recognise the scale of change when introducing active support, and that managers may have difficulty with being given a very specific practice focus which they are required to model for other staff members. Leadership, perseverance and coaching may be necessary to convince some service staff that the quality of their service could be improved by the introduction of active support.
Assessment of Mental Health Problems
Authors: Moss Steve
Published: September 2011

This paper examines the process of assessing mental health needs for people with learning disabilities, considering questions of targeting, mental illness and challenging behaviour, diagnostic assessment and quality of life. It recommends comprehensive assessment within an integrated care approach.
Treatment and Therapeutic Interventions: Psychological Approaches
Authors: Collins Suzanne
Published: September 2011

People with learning disabilities are subject to the same range of psychological disorders as non‐learning‐disabled groups. Although in the 1970s and 1980s many therapeutic interventions were based on psychological theories of learning, there has recently been a large expansion in the types of therapy on offer. They have included increasingly sophisticated use of models based on learning theory and the incorporation of a diverse range of other therapeutic models. Although Reports in the literature of successful therapeutic intervention are becoming more common, they largely fail to address the reality of clinical work, which may require a multi‐level approach, for extended periods of time.
Mental Health and Challenging Behaviour Services
Authors: Holt Geraldine , Joyce Theresa
Published: September 2011

Changes have occurred in the pattern of services for people with learning disabilities and mental illness and/or challenging behaviour over recent years, with the development of a variety of service models across the UK. In SE London, residential services are based predominantly on a supported housing model and the strong philosophical premise that people should not be excluded from a community residential service because they have complex physical, behavioural or mental health needs. Local services, therefore, are supporting individuals with a wide range of need. This paper describes the development of specialist mental health and challenging needs services in support of this model. The issues raised are outlined, together with a list for action and priorities to overcome the difficulties encountered, including the maintenance of an effective infrastructure.
My Son with Learning Disabilities and Challenging Behaviour: Adapting to Meet his Needs
Authors: Cooper Vivien
Published: September 2011

Daniel was born on the 6th August 1985. Approximately two weeks later he was diagnosed as having cri du chat syndrome, a relatively rare genetic condition arising from the partial deletion of the short arm of chromosome 5. We were told that he would have severe learning difficulties, and we were handed a photocopied page of a reference book referring to a study carried out on institutionalised individuals with the syndrome, which painted a very bleak picture of his future. This paper is the story of what followed.
Services for People with Challenging Behaviour and Mental Health Needs at Risk of Offending
Authors: Murphy Glynis , Fernando Suman
Published: September 2011

The closure of long‐stay hospitals and the emphasis on community living have highlighted the challenges services face in meeting the needs of some individuals. Government reports since 1990 on services for people with mental health needs, learning disabilities, challenging behaviour and/or criminal offending have recommended community living whenever possible, outlined the characteristics of good services and made suggestions about how these might be achieved (Department of Health, 1992; Department of Health, 1993; Royal College of Psychiatrists, 1996; NHS Executive, 1998). Nevertheless, most health and social service providers still find it difficult to attain the kinds of service proposed and Bouras (1999) recently concluded that this was partly a result of the separation of services for people with learning disabilities from mainstream mental health services. This paper reports the experience of a local service development intervention designed around the needs of this client group.
The Quality and Costs of Village Communities, Residential Campuses and Community‐Based Residential Supports for People with Learning Disabilities
Authors: Emerson Eric , Robertson Janet , Gregory Nicky , Hatton Chris , Kessissoglou Sophia , Hallam Angela , Knapp Martin , Järbrink Krister , Netten Ann , Walsh Patricia
Published: September 2011

This paper provides an overview of the main results of a Department of Health‐funded research project which investigated the quality and costs of residential supports for people with learning disabilities. The main findings were that the adjusted costs of community‐based supports were higher than residential campuses and village communities; within community‐based provision there were no statistically significant differences between the adjusted costs of supported living, small group homes and group homes for 4‐6 people; community‐based provision and village communities offered better care than residential campuses; there appeared to be distinct benefits associated with community‐based provision and village communities; within community‐based provision there were benefits associated with smaller size and supported living arrangements.
A Total Communication Approach Towards Meeting the Communication Needs of People with Learning Disabilities
Authors: Jones Jane
Published: September 2011

The early moves out of long‐stay hospitals into the community for people with learning disabilities in Somerset (started in 1987) required O'Brien's five accomplishments to be put into practice. Since communication is fundamental to achieving such inclusive aims, there was an urgent need to find alternative and effective ways for individuals to understand and express themselves in their new environment(s), and for all those they were to have contact with to have access to the necessary training and resources to make it work. The resulting process subsequently became known as the Somerset Total Communication project. This paper describes the process as it has evolved, and identifies key elements, outcomes and lessons learnt to date.
Managing the Development of Somerset's Services for People with Learning Disabilities
Authors: Dixon Dave
Published: September 2011

The development and review of Somerset Social Services' learning disability services have presented a series of management challenges. Many will be familiar to managers in other parts of Britain. Considering the current policy theme of partnership working, this article identifies and discusses some of the management issues in Somerset that have arisen from joint working between health and social services: the commissioning of singly‐managed community teams and the provision of acute health care.
Policy and Service Development Trends: Forensic Mental Health and Social Care Services
Authors: Markham Glynis
Published: September 2011

This paper discusses the current trends in provision of forensic mental health and social care services in the context of past and current international experience and national strategy development. The introduction reviews the policy framework which has informed national strategy development, followed by a discussion of the paradox or challenge in the gap between policy and public opinion and the contradictory views expressed in public opinion itself. The paper then identifies the characteristics of current trends in forensic service development, moving on to examine how forensic mental health services can be reshaped and the implications for mental health and social care professionals.
Modernising Social Services: Implications for the Development of Staff Training in Learning Disability Services
Authors: Brand Don
Published: September 2011

This paper looks at the Government's agenda for social care, and assesses its implications for managers developing staff training in learning disability services. The first part of the paper sets out the principles and proposals in Modernising Social Services and describes the Government's early steps to implement change and outlines the main features of the new regulatory framework for social care contained in the Care Standards Bill. The second part considers the implications for staff training in learning disability services, drawing on TOPSS England's draft National Training Strategy, and identifies areas for consideration by local managers and education and training providers.
Ten Years of Providing Intensive Support Services for People with Learning Disabilities and Challenging Behaviour: A Brief Service Description and Review
Authors: Toogood Sandy
Published: September 2011

This article describes the development of a specialist peripatetic support service for people with learning disabilities whose behaviour is challenging. It addresses service goals, working methods and development objectives, reviews selected aspects of service process and client outcome, and comments on the impact of changing demand on the service environment.
Achieving Positive Change in People's Lives Through the National Learning Disabilities Strategy: Lessons from an American Experience
Authors: Towell David
Published: September 2011

In 1999, a team from England, comprising self‐advocates, family members, leading professionals and policy‐makers, participated in the annual ‘Collaborative Academy’ of the US President's Committee on Mental Retardation. Fundamental to the Academy method is the commitment to work inclusively across different interests and engage directly with experiences. This paper identifies 41 lessons drawn by the team from US experience, including research‐ and practice‐based perspectives relevant to maximising progress in the context of the forthcoming national learning disability strategy in England. Focusing on the four main themes of learning from good stories, strengthening effective leadership, establishing inclusive policies and building better partnerships in policy‐making, action points are identified at local, regional and national levels. The paper also promotes the value of the Academy method itself as a vehicle for promoting strategy implementation, describing an enhanced role for selected universities in supporting informed change.
All Students Belong: Inclusive Education for Students with Severe Learning Disabilities
Authors: Jenkinson Josephine
Published: September 2011

Attempts to include students with severe disabilities in mainstream classes are comparatively recent in the history of special education. A major motive for inclusion is recognition of the right of all individuals to community membership. However, views differ on the extent to which the goals of inclusive education should emphasise the acquisition of the skills needed to function as contributing members of the community. Inclusion of students with severe disabilities involves changes in teacher roles and responsibilities and flexible approaches to class organisation. The move from an emphasis on functional curriculum to participation in core curriculum with non‐disabled students requires creative adaptations of both curriculum and instructional strategies, including strategies that foster class membership. Challenging behaviour is a potential barrier to successful inclusion, and new approaches that enable both class and specialist teachers to minimise its occurrence need to be developed. Although barriers still exist to inclusion of students with severe disabilities, there is evidence that inclusion can work successfully.
Collective Responsibilities, Fragmented Systems: Transition to Adulthood for Young People with Learning Disabilities
Authors: Routledge Martin
Published: September 2011

This paper explores the obstacles to the provision of effective support for young people with learning disabilities and their families as they leave school and take up adult opportunities and services. Despite often disappointing experiences, there are encouraging developments that local agencies can build on in order to offer supportive and creative assistance during this crucial period for young people.
Women with Learning Disabilities — Experiencing their Sexuality in a Healthy Way
Authors: McCarthy Michelle
Published: September 2011

This paper outlines some of the factors which are important in helping or hindering women with learning disabilities to experience their sexuality in a positive and healthy way. Based on direct experience, the paper presents the factors which must be present for women with learning disabilities to enjoy their sexuality: making choices, giving consent, receiving information, experiencing mutuality, experiencing pleasure, having self‐esteem and having recourse to the law if abused. Conversely, the factors which need to be absent are coercion, oppression, guilt and shame, and unwanted physical consequences. The paper emphasises how important it is that women with learning disabilities and their supporters understand these factors.
The Experience and Management of Menstruation for Women with Learning Disabilities
Authors: Rodgers Jackie
Published: September 2011

This paper describes a three‐phase study to investigate the experience and management of menstruation for women with learning disabilities. It focuses on the findings of the second phase of the study, which looked at the experiences of carers and health professionals. It describes the difficult issues that can arise when providing assistance around menstruation. The findings are discussed in relation to ideologies and sensitivities that exist around gender, sexuality and menstruation.
A Review of the Curriculum for Pupils with Profound and Multiple Learning Disabilities
Authors: Mallett Angela , Naylor John
Published: September 2011

The education of pupils with profound and multiple learning disabilities (PMLD) has gradually improved, due to a range of new initiatives and the introduction of the national curriculum. However, it is widely recognised that some pupils have a wide range of early specific and complex needs that are not always met. This paper describes a new early curriculum for self‐development being implemented at the Shepherd School, which is unanimously supported by therapists, parents and teachers. It is suggested that, for pupils with PMLD, the new revised framework could provide a more relevant broad and balanced curriculum, fulfilling individual needs, and ultimately lead to effective access to the national curriculum.
Prevalence, Disability and Need in Adults with Severe Learning Disability
Authors: McGrother Cath , Thorp Cathy , Taub Nick , Machado Orlando
Published: September 2011

Evidence from a variety of sources suggests that there has been an increase of around 1% per annum in the prevalence of learning disability (LD) in adults over the last 35 years, due mainly to increases in survival. This trend is likely to continue for at least another ten years. Ninety‐six percent of adults notified to the Leicestershire LD register have an estimated IQ below 50 or need supervision every day to remain safe. Three‐quarters have additional significant disabilities including behaviour problems, psychological symptoms, physical dependencies or epilepsy. In one quarter the behaviour problem poses a major challenge to the achievement of an ordinary life. Two‐thirds indicate a need for help from one or other specialist. Informal carers are actively providing care for nearly half the adults, but a quarter are not content with care‐giving. Carers Report 40% more limiting health problems than their counterparts in the general population, in particular depression in women and cardiovascular problems in men. The specific areas of unmet need among carers Reporting depression are for financial help, long‐term social support and medical advice. Resource allocation for this client group needs to be reviewed in the light of substantial and unrecognised increases in prevalence which are continuing to occur, and the need for long‐term support.
Primary Care and Mental Health Needs
Authors: Brooks David
Published: September 2011

There is evidence that the mental health needs of people with learning disabilities are not adequately met. Primary health care is seen as the way forward to ensure full consideration of psychosocial factors in the promotion of health care. The agenda for action includes improving mental health through general health promotion, surveillance and care. This paper explores how this evidence is being translated through professional and national policy initiatives into innovative mental health of learning disability services that build bridges between primary and specialist services and ensure a comprehensive strategy to meet the mental health needs of people with learning disabilities.
The Subscriber Network
Authors: Marks Bob
Published: September 2011

This article discusses the work of the Subscriber Network. The network is open to providers of services for people with learning disabilities in the East Kent area of England and is part of the University Affiliated Programme (UAP) established jointly by the Tizard Centre and East Kent Health Authority. The network's role within the overall UAP is to disseminate information on best practice to as wide a group of service providers as possible. The article discusses the way that this is done and the response of service providers to the network at the end of its first year. The results of a member satisfaction survey are presented, demonstrating positive views on the usefulness of network membership among those taking part.
Developing Friendships and Social Integration through Leisure for People with Moderate, Severe and Profound Learning Disabilities Transferred from Hospital to Community Care
Authors: Srivastava Angela
Published: September 2011

This paper looks at the quality and value of leisure and friendships that people with learning disabilities experience in the community. It provides an overview of the problems in developing friendships for people with moderate, severe and profound learning disabilities transferred from hospital to community care and identifies recommendations for commissioners, providers, staff and carers for the development of friendships through leisure in the community.
Managing Learning Disability Services in the United States
Authors: Castellani Paul
Published: September 2011

The effects of privatisation, public work force downsizing and schemes to re‐invent government have eroded the middle management capacity that is crucial to the success of many community development programmes and complex public and private partnerships for learning disability services in the US. The impact of these factors has been accelerated by reform proposals from within the learning disability field that associate government and management with the perceived ills of traditional specialised service agencies and assume that market and other approaches to providing services will be superior. In addition, the consolidation of learning disability within broader health and human services, at state and local levels, along with large losses in the number of managers in learning disability services, has added to the problems of managing community services. Managing community services is therefore an important challenge in the US, and attention needs to be paid to the unique problems in this environment, with the roles middle managers play in the large and complex organisational environment of community services crucial to their stability and success. Managers more than management frameworks are especially important in the US, as comprehensive administrative arrangements at local level are unlikely to emerge. Disappointment about traditional approaches in specialised provision should not lead to uncritical assumptions about the superiority of alternative arrangements for managing learning disability services.
Responses to Women with Learning Disabilities as they go Through the Menopause
Authors: McCarthy Michelle
Published: September 2011

The research investigated how women with learning disabilities understand and experience the menopause, and the support available. This paper Reports the experiences and attitudes of those people to whom women with learning disabilities might turn for support. GPs generally Reported relatively little experience in treating women with learning disabilities for menopause‐related symptoms and some recognised the need for pro‐active work. Carers played a key role in facilitating women's access to primary health care. Staff in residential and day services recognised the role they played in supporting women through the menopause, but were hampered by lack of time and resources. Mothers of middle‐aged women with learning disabilities who still lived at home felt well‐placed to support their daughters through the menopause and viewed this transition positively. The need for specialist educational materials was emphasised by all those who took part in this research.
Falling Through the Net: Young People who are Homeless and have Mild Learning Disabilities or Other Additional Special Needs
Authors: Leedham Ian
Published: September 2011

Young people with multiple social problems, especially if compounded by additional needs such as those associated with mild learning disabilities or mental health problems, are in particular danger of being excluded from society. Homelessness is one of the most extreme manifestations of such exclusion.
Growing Older with Learning Disabilities: The GOLD Programme
Authors: Thompson David
Published: September 2011

This paper provides an overview of the GOLD programme at the Foundation for People with Learning Disabilities. It describes the work of the 13 funded projects in a context of wider research concerning ageing and learning disabilities. Particular attention is given to those people living with older family carers and those living in residential services for older people. The picture is of services that offer little confidence for the future, as people with learning disabilities grow older.
Ethics Committees in Human Service Organisations for People with Learning Disabilities in the Netherlands
Authors: Meininger Herman
Published: September 2011

This paper describes the aims, roles and functions of ethics committees in Dutch service organisations for people with learning disabilities. The significance of ethical advice for professional practice depends not only on the role of an ethics committee, but also, and primarily, on the theoretical frameworks used. Ethics committees can be important partners for professionals in their search for responsible practice and a well‐considered moral response. Such a partnership has the potential to inspire new ways of showing respect to service users.
Ethics Committees in Human Service Organisations for People with Learning Disabilities in the Netherlands
Authors: Clegg Jennifer
Published: September 2011

This commentary outlines research in the UK, briefly counterpointed against approaches used in the USA and Italy, to show how the Dutch position is distinct. Potential hurdles to translating Dutch ideas to the UK include the discomfort many staff express when invited to consider how they relate to clients and an increasingly legalistic culture which encourages people to want more certainty than an ethics committee can properly deliver. It concludes by identifying two issues that practice ethics committees might also consider: preventative work at a societal level, and going beyond residential situations to consider the complex ethical issues encountered in service relationships with people who live at home with their families.
Joining Forces: Supporting Individuals with Profound Multiple Learning Disabilities
Authors: Nakken Han , Vlaskamp Carla
Published: September 2011

Since 1999, one of the Special Interest Research Groups within the International Association for the Scientific Study of Intellectual Disabilities (IASSID) has been on profound multiple disabilities (PMD). This group has stimulated a world‐wide discussion on education and support for such individuals. However, it is evident that there is some disagreement about who is included in this category. There has also been a debate about the applicability of various policy changes for people with PMD. A third topic of discussion has been the need for more research related to this target group and the related research priorities. This paper profiles and discusses these questions.
Professional Attitudes to Supporting Parents with Learning Disabilities
Authors: McBrien Judith , Power Michael
Published: September 2011

Adults with learning disabilities who become parents and need support evoke a range of responses from health and social care professionals. Providing effective support while safeguarding the welfare of the children is one of the more complex challenges facing practitioners. The article describes an audit, training and evaluation that throws light on some of the underlying difficulties, particularly differences in attitudes and approach between health and social services staff that can obstruct joint working and effective practice. Attention to this area is important in the light of the drive towards integrated health and social care provision.
Twelve Years On: The Long‐term Outcomes and Costs of Deinstitutionalisation and Community Care for People with Learning Disabilities
Authors: Cambridge Paul , Carpenter John , Beecham Jennifer , Hallam Angela , Knapp Martin , Forrester‐Jones Rachel , Tate Alison
Published: September 2011

This paper reports on the key findings of a study into the outcomes and costs of community care for a large cohort of people with learning disabilities, supported in 12 study sites across England, who left various long‐stay hospital 12 years ago as part of a centrally monitored and evaluated government policy initiative on deinstitutionalisation. It represents the last follow‐up of a raft of linked longitudinal evaluations, conducted at four time points over a twelve‐year period. The paper identifies the findings from the last follow‐up and interprets and presents them as summary observations and trends in relation to the findings in learning disability, briefly reviewing them in relation to wider evidence on deinstitutionalisation and community care in England.
Direct Payments for People with Severe Learning Disabilities: A Service Case Study and Implications for Policy
Authors: Beadle‐Brown Julie
Published: September 2011

The paper uses a case study to illustrate the difficulties experienced by those trying to access direct payments for people with learning disabilities, and considers the reasons why such difficulties exist. It proposes measures needed to ensure that people with learning disabilities have equal access to this form of funding.
Spirituality and the Lives of People with Learning Disabilities
Authors: Swinton John
Published: September 2011

The spirituality of people with learning disabilities is under‐researched and frequently misunderstood. Despite evidence to suggest that a focus on the spiritual aspect of the lives of people with learning disabilities can be health‐bringing and life‐enhancing, this dimension of people's lives is often overlooked or considered irrelevant. This paper seeks to explore some significant aspects of the ‘forgotten dimension’ of spirituality and to show that both the available research evidence and the experiences of people with learning disabilities suggest that it is an aspect of life which should be taken seriously. Neglect of this dimension has significant moral, legal and interpersonal consequences, which service providers are often unaware of but which are central to genuinely person‐centred and holistic support. The paper offers some insights and pointers that will enable service providers to begin to understand and incorporate spirituality into the lives of people with learning disabilities.
Progress with Learning Disability Hospital Closures in Scotland
Authors: Whoriskey Margaret
Published: September 2011

Since the late 1950s the focus of UK policy for people with learning disabilities has been on deinstitutionalisation and care in the community. In the last decade policy focus has shifted towards individualised support and community membership. Deinstitutionalisation in Scotland started later than in England, and still has some way to go. This article considers four aspects of the current hospital closure programme in Scotland: involving people with a learning disability and families, managing hospital closure, service reprovisioning, and strategic planning.
Inclusion in Scotland: Progress and Prospects
Authors: Allan Julie
Published: September 2011

Considerable progress has been made in the inclusion of children with special educational needs within mainstream schools over the last 25 years but inclusion remains a major source of concern and confusion for policy makers and practitioners and of dissatisfaction for children and their parents. This paper explores some of the conceptual confusion surrounding inclusion and examines the impact of policy and legislative developments on support for children with special needs in mainstream schools. The paper draws on findings from a recent Scottish Parliamentary Inquiry into special educational needs, to which the author was Adviser, and on recent research.
Developing Inclusive Practice: North Lanarkshire's Approach
Authors: Vassie Christine , Currie Laura‐Ann
Published: September 2011

North Lanarkshire Council is developing inclusive practice in all its schools through a number of imaginative initiatives. These initiatives are firmly rooted in an educational philosophy of multiple intelligences, a social policy of raising achievement for all children, and a theory of change which emphasises the importance of evidence and evaluation.
Independent Advocacy in Scotland
Authors: Rattray Tony
Published: September 2011

The need to support independent advocacy at a national level has been officially recognised in Scotland by the creation of two new agencies. The Advocacy Safeguards Agency has five core functions: independent evaluation, policy development and implementation, technical support for commissioners, research, and dispute resolution. The Scottish Independent Advocacy Alliance will be a membership body providing information, networking and training services to its members and helping the sector to organise collectively when needed.
Modern Therapeutic Approaches in Learning Disability Services
Authors: Frankish Pat , Terry Sue
Published: September 2011

This paper summarises the main areas of therapeutic developments in recent years in the field of learning disability. There has been a growing interest in alternative ways of helping learning‐disabled people live with themselves and the world in a socially acceptable way. Most such approaches are person‐centred, even if provided in a group setting. The range and types of therapies are illustrated and the advances in humanistic approaches highlighted. Cognitive, psychodynamic and creative therapies have been added to behaviour therapy, with good results, indicating the potential of learning‐disabled people to benefit from the same sorts of therapy as other people.
Criminal Law, Sexuality and Men and Women with Learning Disabilities: Protection v. Empowerment
Authors: Wheeler Paul
Published: September 2011

Sexuality is complex, concerning concepts such as power relations, sensuality, personal integrity, capacity to consent, decision making, identity and self‐awareness, intimacy and relationships. Despite this complexity, it is an integral part of every human being, affected by race, socio‐economic status and intellectual ability. However, the expression of the sexuality of people with learning disabilities is denied and rarely facilitated. Often the importance of gender identity is ignored and this is reflected, for example, in how women with learning disabilities see their own bodies. Explanations include historical beliefs like eugenics, service principles such as normalisation, economics and an over‐riding concern to protect women and men with learning disabilities from abuse. Acknowledging that such factors play an important role in preventing the facilitation or expression of sexuality by men and women with learning disabilities, this paper focuses on the development of the criminal law, the role and potential of current sexual offences and the Home Office Report Setting the Boundaries.
Supported to be Sexual? Developing Sexual Rights for People with Learning Disabilities
Authors: Keywood Kirsty
Published: September 2011

This article explores criminal law reform proposals on the law relating to sexual offences, scheduled for debate in the current parliamentary session, in order to illustrate the current tension between sexual empowerment and protection of people with learning disabilities from sexual violence. It suggests that law's response to the sexuality of people with learning disabilities, evidenced by the Sexual Offences Bill now before Parliament, will be inadequate as long as it is characterised as choosing between protection and empowerment. An alternative conception of sexual rights can provide a fuller and more persuasive account of the sexuality of men and women with learning disabilities.
Germany
Authors: Schädler Johannes , Schwarte Norbert , Wissel Timo , Aselmeier Laurenz
Published: September 2011

This article gives an overview of the services provided for people with intellectual disabilities in Germany. On principle we assume that the field of services in this country, its problems, strengths and opportunities for development, can be understood only if one is familiar with the development pathways and specific historical experiences. Church welfare and powerful voluntary welfare organisations, traditional psychiatry and its ‘oligophrenic’ ideal, the division of state funding competencies into local and centralised levels and the commitments of a new generation of parents organised in the association Lebenshilfe were important factors for the development of the current structures. These can be characterised by the persistence of residential facilities, although it has been the legal mission of the social administration since 1984 to give priority to the expansion of non‐residential services. Specific financial mechanisms promote institutionalisation from the perspective of the local authorities and impede the implementation of integrative approaches in the community.
Greece
Authors: Padeliadu Susana
Published: September 2011

Services for people with intellectual disabilities in Greece can be described as versatile and based on both old and new structures, old, over‐crowded institutions co‐existing with new, alternative structures for independent living. Distinguishing features of the support system are limited financial resources, a strong orientation to medical categories in psychiatry and lack of specific services. There are still many people with intellectual disabilities being treated in mental health services. The gap in services is filled by informal networks, which face a crisis because of the increasing participation of women in the labour market. One of the major deficiencies of the present system is the lack of any sound knowledge of how many people with intellectual disabilities there are, who they are, how they cope with their disabilities and what services they use. This article gives an overview of the current situation.