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Purpose The purpose of this paper is to provide a commentary on the preceding article describing changing patterns in the provision and take-up of accommodation services for adults with learning disabilities in Ireland, in the context of the types of reductions in funding that have been apparent internationally for some time.Design/methodology/approach The commentary examines some of the implications and discusses some of the underlying quality of life issues implicit in the data presented. It also explores the tensions between owning one’s home and receiving specialist support and examines what supported living might enable services to achieve.Findings The paper concludes that the nature of economic policy and professional practice, alike, have implications for the quality of home life enjoyed by adults with learning disabilities; and that the interplay between them is more complex than is often allowed.Originality/value These issues are not new, but frustratingly enduring. Their fresh consideration might assist the urgent need to achieve a more coherent narrative capable of consistent application for present and future generations. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe and discuss the variables which have contributed to the adoption of positive behaviour support (PBS) and applied behaviour analysis (ABA). Differences and similarities are highlighted, applications to contemporary issues in the UK and Australia are emphasised, and considerations posed for their improved adoption. Design/methodology/approach: A conceptual framework for diffusion of innovations theory is used to guide the analysis of three sets of articles, and application of the framework is guided by narrative analysis. Findings: Eight variables from the conceptual framework were identified, and the communication networks for PBS and ABA are argued to be distinct. There has been a positive change in the perception of PBS by the ABA field, but PBS has leveraged diffusion more successfully. ABA appears to have been separated from PBS in the UK while Australia is yet to fully benefit from the contributions of ABA. Those working in the fields of PBS and ABA should further collaborate for their mutual benefit. Practical implications: Greater attention to the factors which promote diffusion can assist PBS and ABA to improve their adoption. Originality/value: This is the first paper to use diffusion of innovations theory to analyse the adoption of PBS and ABA. [ABSTRACT FROM AUTHOR]

Purpose -- The ability to tell a story, whether personal or fictional, is a skill which can enable people to build a sense of identity, friendship, community and self-advocacy. However, narrative is rarely prioritised in services. The paper aims to discuss these issues. Design/methodology/approach -- This paper describes two approaches to the development of storytelling for people with learning disabilities used by the charity Openstorytellers. Reflections from interviews are used to illustrate how individuals view their experiences as storytellers, and the benefits that come in the wake of learning to tell and listen to stories. Findings -- Storytelling led to an increased sense of purpose, confidence, communication and value. The findings are based on subjective perceptions by the people concerned, and were not obtained through independent research. However, they represent a first step towards evaluating the impact of multidimensional interventions. Practical implications -- Services need to consider how they enable their members to participate actively in the sharing of experience, and imaginative and creative activities. Storytelling, both mythic and personal, can help to develop social relationships and active participation in one's community. Originality/value -- Both of the approaches described here (Learning to Tell; Storysharing™) are innovative approaches which are new in the field of learning disabilities. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to provide a commentary on Shephard's narrative account of one person's experience of Positive Behaviour Support (PBS). Design/methodology/approach – This paper reflects on Shephard's account in the context of the burgeoning literature concerning the effectiveness of PBS and the author's own experiences. Findings – Practitioners of PBS should consider narrative accounts as legitimate data. Originality/value – This commentary welcomes the move toward the inclusion of narrative, or ethnographic, perspectives when evaluating PBS. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to provide a narrative account of one person's experience of Positive Behaviour Support, against a backdrop of serial placement breakdowns. Design/methodology/approach – The paper reflects on the human stories that lie behind the evidence base and presents one such story. Findings – The paper proposes that such stories are as important as the evidence that is gathered around them, and have the power to challenge and to inspire. Originality/value – This paper is celebratory, rather than analytic. It presents a life being lived and attempts to capture the virtues of its ordinariness. [ABSTRACT FROM AUTHOR]

Purpose – This paper seeks to provide a commentary on the previous paper in this issue, "Love is simply not enough". Design/methodology/approach – The commentary draws on research findings and recent policy about personalisation to consider those factors influencing the development of effective family and professional partnerships. Findings – The paper notes the way in which families have often been undermined by those authorities responsible for providing support. While a lifelong caring role will be a positive choice for some families, it should not be a requirement. Originality/value – The commentary draws attention, in particular, to the importance of local authorities working more effectively with family carers. [ABSTRACT FROM AUTHOR]

Purpose - The present qualitative study aims to address the gap in what one knows about the life experiences of adults diagnosed with mild learning disabilities from minority ethnic communities and to generate a deeper understanding of their experiences.Design/methodology/approach - The paper individually interviewed four adults with mild learning disabilities receiving support from an independent living project using semi-structured interviews. The interviews were recorded and transcribed verbatim. The data collected were qualitatively analysed using interpretative phenomenological analysis.Findings - The findings showed that participants felt socially isolated and did not have a wide social network. Participants also reported that they had suffered some form of abuse in the past. Participants also said that they found employment satisfying and finally that they did not receive support with their cultural needs.Originality/value - This paper highlights that greater emphasis should be placed on examining the social support needs of individuals with mild learning disabilities in order for them to live independently without risking social isolation. [ABSTRACT FROM AUTHOR]

Purpose - People with a learning disability remain at increased risk of abuse and neglect due to a number of factors associated with learning disability per se and the culture in which they live. Understanding the prevalence of abuse within this population allows for appropriate planning and service development. Understanding more about the type and frequency of abuse (and the perpetrators) facilitates prevention of abuse. The paper aims to discuss these issues. Design/methodology/approach - All clients allocated to a psychologist between 2009 and 2011 were included in this survey. The psychologist reported whether the client had experienced any abuse over their lifetime. Information regarding the type of abuse experienced, the relationship to the abuser, and the number of different episodes of abuse was recorded. Findings - Of the 695 clients in the survey 25 per cent had experienced abuse. Of this 25 per cent, 46 per cent were men and 54 per cent were women. In all, 23 per cent of the group who had experienced abuse were referred to the service as a direct result of abuse, whilst 77 per cent were referred for another reason. The most prevalent types of abuse were emotional (27 per cent), sexual (24 per cent), physical (20 per cent), and neglect (12 per cent). Originality/value - Prevalence rates within this study are broadly in line with the existing literature. However, differences included high levels of emotional abuse, and high frequency of abuse perpetrated by women, and by family members. Psychology services should routinely screen for abuse experiences and be alert to the possibility of abuse from female caregivers. [ABSTRACT FROM AUTHOR]

Purpose Bowring et al. describe ways of using the Behavior Problems Inventory – Short Form, illustrating how to use clinical norms to evaluate change. This commentary focuses on the importance of considering information gained directly from people with intellectual and developmental disabilities (IDD) during assessment. The paper aims to discuss these issues.Design/methodology/approach A pilot project involved interviews with four children with IDD. A Talking Mats® (TM) framework was used to gather children’s views regarding challenging behaviours (CBs) and variables relevant to a functional behavioural assessment, such as things they found to be reinforcing, things that set the occasion for CB and things that helped prevent this.Findings The children were able to provide information and insight into several areas that are influential in the maintenance of behaviour that challenges. Some of this information may not have been obtainable from other sources or informants using traditional assessment methods alone.Originality/value Gathering the views of people with IDD is important. The Convention on the Rights of Persons with Disabilities (United Nations, 2009) states that people have the right to be heard. Many people with IDD have difficulties communicating. A TM framework is one method by which people may be able to express their views. Taking the views of the individual into account during the process of gathering information about behaviours that challenge should lead to greater understanding of the functions of any behaviours and therefore to more targeted, acceptable and effective forms of support. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to analyse ratings data from the recently developed Learning Disability Needs Assessment Tool (LDNAT) to identify factors associated with specialist intellectual disability (ID) hospital admissions.Design/methodology/approach Ratings from 1,692 individuals were analysed and the LDNAT items differing significantly between inpatients and non-inpatients were identified. Statistical analyses on total scores derived from these items were used to calculate an optimal cut-off. This LDNAT inpatient index score was also confirmed via an alternative statistical technique.Findings On average, 18 of the 23 LDNAT item ratings were significantly higher in people with ID assessed as inpatients compared to those rated in community settings. Using the total of these items, the resulting LDNAT inpatient index was analysed. A cut-off score of 22.5 was calculated to be the optimal balance between sensitivity (0.833) and specificity (0.750). This was confirmed by calculating the Youden index (j=0.583). At this level 68 per cent of inpatients and 81 per cent of non-inpatient cases were correctly identified.Practical implications Currently there is a national (UK) programme to radically reduce the amount of specialist inpatient care for people ID. This will necessitate early identification of individuals most at risk of admission together with investment in improved, proactive community services if admissions to a diminishing bed-base are to remain manageable.Originality/value This study confirms the associations between mental health difficulties, challenging behaviour and specialist hospital admissions for people with ID, extending existing research by translating these findings into a clinically usable risk index. [ABSTRACT FROM AUTHOR]

Purpose Age-related processes are marked by physiological, psychological and social decline, threatening health, quality of life, functional status and the mobility of individuals. As the impact of demographic change also begins to affect persons with intellectual disabilities (ID), issues and needs regarding the aging process are slowly entering the field of ID research. The paper aims to discuss these issues.Design/methodology/approach In the population of older people with ID, important, age-related events such as falls have prompted increasing research. Falls may lead to several negative health outcomes, require that an individual receives higher levels of care sometimes including hospitalisation and, in the worst case, hasten death. Falls also lead to psychological consequences such as fear of falling which fuels a vicious circle in which older persons afraid of falling reduce their physical activity, in turn hastening their functional decline.Findings Fall prevention in persons with ID is just evolving and further research is clearly necessary. This research can draw on the existing evidence from other fall prevention areas, especially the work carried out with the general older population.Originality/value As stated by Finlayson, a useful next step would be the development of a consensus on the definitions and methodology that should underpin future fall prevention research with persons with ID. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to provide a commentary on "The use of cognitive-behaviour therapy to treat depression in people with learning disabilities: a systematic review". Design/methodology/approach -- Drawing on the literature, as well as both clinical and research experience, some reasons are outlined for the lack of attention given to psychological therapies to treat depression amongst people with intellectual disabilities (IDs). Findings -- More research is needed, but existing evidence is promising regarding the effectiveness of adapted cognitive-behaviour therapy for depression amongst people with IDs. Originality/value -- The commentary draws attention to the scope for developing a range of effective cognitive, behavioural and cognitive-behavioural treatments. [ABSTRACT FROM AUTHOR]

Purpose - Deinstitutionalization has impacts also on direct care workers and their work. The purpose of this paper is to analyse the attitudes of direct care workers towards the closure of the institution, and these attitudes' relation to workers' occupational identity. Design/methodology/approach - Data were collected by postal questionnaire before the closure of the institution. The respondents consisted of two groups: direct care workers of the institution (n = 93) and direct care workers of community-based residential units run by the same organization (n = 117). Findings - The results clearly show that direct care workers in the institution, as a group, were against the closure of the institution. This is quite understandable, because the closure will irrevocably affect their work and also private life. Although this opposing is evident, there was also variance in the attitudes within this group: some were more willing to accept the change, some were more against it. Those opposing the closure seemed to be more reluctant in adopting the new kind of identity as supporters of the self-determination o f their clients and also they felt more insecure about their own competence. Originality/value - In deinstitutionalization research a staff perspective has not been very common. To successfully accomplish the change process it is important to take into account also the staff and how they experience the change. It would be far more beneficial to have staff promoting change than resisting it. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to reflect on Vesala et al.'s (2014) findings on the occupational identity of staff and attitudes towards institutional closure. Design/methodoiogy/approach - This commentary reviews some o f the research around staffing, organisational hygiene and sen/ice management in countries that have already implemented deinstitutionalisation, and draws out some key considerations for countries and organisations that are planning the transition from institutions to community-based care. Findings - There is increasing evidence around approaches that are more likely to lead to positive service user and staff outcomes. Particularly person-centred active support and practice leadership have emerged as effective approaches in facilitating organisational change and high-quality services. Originality/value - Some of the experiences and practices in post-deinstitutionalisation countries around active support and practice leadership can provide valuable considerations for planning institutional closure programmes in countries currently implementing deinstitutionalisation. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to analyse the reflective journals kept by 62 students researching and interviewing people with learning disabilities. The aim was to explore the content and discover any themes that were generated throughout the journals as a result of the pre-, during- and post-interview process. Design/methodology/approach - The method used to analyse the journals was Interpretative Phenomenological Analysis (Smith and Osborn, 2008). Findings - The results showed that there was a shift from negative to positive reflections as the frequency of contact with people with learning disabilities increased and that the majority of students reported a change in attitude towards this group of individuals after experiencing direct contact (two to three meetings over a period of two months). Research limitations/implications - Implications of the findings are for government policies, promoting social inclusion through education, to offer the opportunity for direct contact with people with learning disabilities, (in keeping with All port's, 1954 Contact Theory) at an earlier stage in education, fostering an environment for earlier attitude change and increased social inclusion. Social implications - Changing society's attitude through our education system may decrease marginalisation by the public as well as discriminatory and abusive behaviour found in some social and community care settings. Originality/value - This piece of research may add value to social, government and educational policies. Finding an evidence base to continue to build policies for decreasing marginalisation and promoting social inclusion for people with learning disabilities. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to provide some thoughts following on from reading: "Experiential learning: changing student attitudes towards learning disability". Design/methodology/approach - This commentary outlines some considerations for the continued development o f using service users in tertiary education as educators. Findings - The literature is not clear on the involvement of people with more profound and multiple learning disabilities, or for those who do not use much spoken language in tertiary level teaching. Originality/value - A further cultural shift is needed to ensure that all people with learning disabilities regardless of their communication style have the opportunity to share their experiences within a teaching and learning context. [ABSTRACT FROM AUTHOR]

Purpose – People with learning disabilities want and value friendships and close, intimate, or romantic relationships. However, many people with learning disabilities are socially and emotionally lonely. The purpose of this paper is to describe a novel intervention, using a narrative therapy based group approach, which aimed to ameliorate the negative effects of loneliness in adult men with a mild learning disability. Design/methodology/approach – This study explored the group process, examined participants' experiences of the narrative therapy approach, and used an amended version of the UCLA loneliness scale (3rd ed.) to evaluate the effectiveness of a narrative therapy group approach. Findings – The group enabled participants to develop "experience near" descriptions of loneliness and its effects and to identify and strengthen their abilities, strengths, and resources. Qualitative feedback from participants indicated that the group was experienced positively and helped participants to feel less lonely. Quantitative feedback from an adapted version of the UCLA loneliness scale suggested that most participants felt less lonely following the intervention. Research limitations/implications – There are several limitations of the current study. Most importantly, because of the small sample size (n=5), the results of the current study lack generalisability. Future, larger-scale research should be carried out to address these limitations. Originality/value – The current study draws attention to a significant problem experienced by many people with a learning disability. It also adds to the emerging evidence that narrative therapy approaches may be useful within learning disability contexts. [ABSTRACT FROM AUTHOR]