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Clinical judgement is a crucial part of autism and attention deficit hyperactivity disorder (ADHD) assessments. This study aims to harness insights from psychology and sociology to explore clinical perspectives and assessment practices of autism and attention deficit hyperactivity disorder. Qualitative interviews were conducted with health care professionals (n = 17). Interviews were conducted between January and May 2019. Data were analysed using a thematic approach. Themes were sorted into two interrelated categories (1) approaches to diagnosis (2) elements of diagnosis. Approaches to diagnosis were comprised of the following subthemes: nature of diagnosis, application of diagnosis: natural and pragmatic, revisiting conceptualisations: sub-optimal practice & unhelpful diagnoses, autism and attention deficit hyperactivity disorder. Elements of diagnosis contained three related subthemes: contextualising standardised assessments, triangulating material, organisational factors. There is sometimes a pragmatic as well as nosological dimension to diagnosis. Competing desires for consistency and utility add further complexity to neurodevelopmental assessment.

Background: Staff member's views and attitudes can have a significant impact on people with an intellectual disability. This study explores staff attitudes and experiences of people with an intellectual disability's expression of relationships and sexuality across service providers in Ireland. Methods: Staff (n = 86) from service providers (n = 5) completed the Attitudes to Sexuality Questionnaire-Individuals with an Intellectual Disability (ASQ-ID) and open-ended questions. Results: Multidirectional significant differences were noted on staff attitudes to sexuality based on demographic factors, that is, age, education, as well as non-demographics, for example, attendance at training, and active practising of religion. Qualitatively, three themes emerged: "Unsupported and Frustration"; "Taboo Subject Matter" and "Vulnerability and Access to Education". Staff reported a lack of service supports, dominant conservative cultures and people with an intellectual disability's vulnerability. Conclusion: This study highlights the need for improved service practices and enhanced provisions for staff and the people with an intellectual disability that they support.

This paper describes a study exploring the parental response to the diagnosis of their child's developmental disability. A classic grounded theory methodology was used to analyse data comprising 19 interviews and 11 memoirs written by parents. The theory explains how parents adjust to champion their child, who has been identified as having a developmental challenge. At the heart of becoming a champion is a psychological process in which parents refine their perspectives on disability awareness, their aspirations and parenting capacity as they develop their championing skills. Refining perspectives and championing are influenced by two factors: the nature of the child's challenges and service factors. The theory of Confident Championing offers a multivariant model that explains the dynamic nature of the adjustment process, capturing both the stress and the fulfilment and sense of purpose that parents experience.

Background: Children and young people (CYP) seen by child and adolescent mental health services (CAMHS) often experience safeguarding issues. Yet little is known about the volume and nature of these risks, including how different adversities or risks relate to one another. This exploratory study aims to bridge this gap, examining rates at entry to services and profiles of risk using a latent class analysis. Methods: Data were extracted for CYP who received at least one risk assessment at CAMHs in South London between January 2007 and December 2017. In total, there were 21,688 risk assessments. Latent class analysis was used to identify profiles of risk from the risk assessments. Results: Concerns about parent mental health (n = 5274; 24%), emotional abuse (n = 4487; 21%), violence towards others (n = 4210; 19%), destructive behaviour (n = 4005; 18%), and not attending school (n = 3762; 17%) were the most commonly identified risks. Six distinct profiles of risk were identified from the latent class analyses: (1) maltreatment and externalising behaviours, (2) maltreatment but low risk to self and others, (3) antisocial behaviour, (4) inadequate caregiver supervision and risk to self and others, (5) risk to self but not others, and (6) mental health needs but low risk. Conclusions: These findings provide fresh insights into adverse experiences and risks identified by CAMHS. For professionals, the profiles identified in this study might provide insights into profiles of identified risks, in contrast to traditional cumulative approaches to risk. For researchers, these profiles may be fertile ground for hypothesis‐driven work on the association between adversity and later outcomes. [ABSTRACT FROM AUTHOR]

Research related to parental satisfaction with early intensive behavioral intervention (EIBI) remains limited. A 35-item questionnaire called the parental satisfaction scale--EIBI (PSS-EIBI) was developed with four subdomains (child outcomes, family outcomes, quality of the model, and relationship with the team). Study 1 assessed levels of satisfaction for 48 parents with their child's EIBI program after approximately 1 year of intervention. Study 2 examined the relationship between parental satisfaction, length of child participation in EIBI, and the relationship between parental satisfaction and actual outcomes for their child as assessed by the Verbal Behavior Milestones Assessment and Placement Program after approximately 2 years. Results indicate that parental satisfaction with EIBI was consistently high in all four domains of the PSS-EIBI in both studies. Parental satisfaction was found to be associated with gains in child functioning after 1 year of intervention.

Background: Aquatics is an under-researched but possibly appropriate form of activity for people with severe to profound intellectual disabilities (SPIDs). Aim: The current pilot study investigates the suitability of an aquatics programme for service users with SPIDs. Method: Four service users with SPID completed an 8-12-session aquatics programme. Front-line staff (N = 6) were interviewed after the programme to explore its suitability. A thematic analysis of the interviews was utilized. Results: The thematic analysis unearthed main themes of effects, facilitators, barriers, strengths and needs. Conclusion: Aquatics can be an appropriate and beneficial form of physical activity for people with SPIDs, but there are many barriers to participation. Tailored programmes are required. Further investigation of the experiences of people with SPIDs in relation to physical activity is recommended.

Current national policy in the Republic of Ireland advocates for the inclusion of students with learning difficulties in mainstream schools. With Asperger's syndrome (AS) specifically, it is essential that teachers understand the syndrome and are well versed in appropriate approaches to effectively create an inclusive environment for these students in the mainstream classroom. This paper explores teacher knowledge and understanding of AS while also exploring what affects their confidence in educating students diagnosed with the syndrome. Data collection pre-dated changes to the DSM-V and as such AS is used throughout this paper. A survey was distributed nationally to a random sample of qualified post-primary school teachers. The findings revealed that teachers did not appear to possess an adequate level of knowledge and understanding in relation to the syndrome. Continued professional development programmes in the area appeared to have minimal effect, with those completing programmes scoring only marginally better than those who did not (2.85%). These findings are of concern if these teachers are then expected to foster an inclusive environment, particularly when a high proportion of teachers have previously taught a student diagnosed with the syndrome and their knowledge remains limited.

This research aimed to explore how clinical psychologists respond to child safeguarding dilemmas, with special attention to the role of psychology in child welfare. Transcripts from 20 semi‐structured interviews with clinical psychologists working in Child and Adolescent Mental Health Services in England were analysed using a qualitative framework approach. In these interviews, two family case vignettes were used to examine how psychologists respond to child safeguarding dilemmas. We identified three overarching themes: operating within a system of stretched resources; characterising who is considered 'supportable' by psychological services; and challenges around conceptualising and responding to risk. Clinical psychologists viewed social services as responsible for family cases with safeguarding concerns and were reluctant to engage in high‐risk cases where stability in the home was not yet established. They saw their role in child welfare primarily as sense‐makers for families, by offering a contextualised explanation/formulation for the presenting difficulties. [ABSTRACT FROM AUTHOR]

Psychological distress as experienced by higher education students is of major concern because of its potential to adversely impact academic performance, retention, mental health and lifestyle. This paper reports a mixed method investigation of student self-reported psychological distress and help-seeking behaviour. The sample comprised all students (n = 1557) registered on undergraduate nursing/midwifery and teacher education programmes at an Irish university. Participants (n = 1112) completed the General Health Questionnaire (GHQ) to determine their self-reported psychological distress and the Lifestyle Behaviour Questionnaire to examine sources of distress, lifestyle and demographic variables. Individual interviews (n = 59) explored student experiences of psychological distress and their help-seeking behaviours. Forty two percent of respondents exceeded the GHQ threshold =5, which signifies risk of mental or physical health problems. Sources of distress included academic, financial and psychosocial stressors. Regression analysis identified that demographic, programmatic and lifestyle variables predicted GHQ scores. Despite the distress experienced, students were reluctant users of support services. Many actively avoided seeking help. These findings raise serious concerns about the extent of psychological distress among this population. They also alert education providers to be vigilant for student psychological distress and to provide effective interventions, cognisant of the impact of stigma on help seeking.

Children with autism spectrum disorders (ASDs), attention deficit hyperactivity disorder (ADHD) and disinhibited and reactive attachment disorders (RAD/DAD) often experience socioemotional problems. Elucidating a clear picture of these profiles is essential. Strengths and Difficulties Questionnaires (SDQs) were analysed from cohort of children with ASD (n = 1430), ADHD (n = 1193), and RAD/DAD (n = 39). Kruskal–Wallis Tests and network analytic techniques were used to investigate symptom profiles. Children with ASD experienced more emotional problems, peer problems and fewer prosocial behaviours. Children with ADHD and RAD/DAD had higher levels of hyperactivity and conduct problems. Overall, ASD and ADHD networks were highly correlated (rs = 0.82), and we did not observe a statistically significant difference in terms of global Strength. [ABSTRACT FROM AUTHOR]

The authors conducted a study to address gaps in the literature regarding parents' experiences of the transition of their child from special education to postschool mainstream services. Specifically, this study sought to explore the nature, factors, and psychological impact of their child's transition to post-school services. To achieve these aims, a qualitative, grounded theory approach was employed in which semi-structured interviews were conducted with a small sample of parents of children with mild intellectual disability living in the southern region of Ireland. The results indicated that the transition process was generally experienced as stressful, uncertain, and problematic, particularly in terms of the bureaucratic aspects. The experiential shift from school to vocational training and employment emerged as the most salient in parents' perceptions. Parents also identified a range of factors that served as barriers and supports of the transition process, in which the role of the parent emerged as a key facilitative factor. The findings suggest that considerable gaps remain between policy and service provision in Ireland regarding transition planning and postschool services for young adults with intellectual disabilities and their families, often posing barriers to successful transitions.

Child maltreatment in the family context is a prevalent and pervasive phenomenon in many modern societies. The global perpetration of child abuse and neglect stands in stark contrast to its almost universal condemnation as exemplified in the United Nation's Convention on the Rights of the Child. Much work has been devoted to the task of prevention, yet a grand synthesis of the literature is missing. Focusing on two core elements of prevention, that is, antecedents for maltreatment and the effectiveness of (preventative) interventions, we performed an umbrella review of meta‐analyses published between January 1, 2014, and December 17, 2018. Meta‐analyses were systematically collected, assessed, and integrated following a uniform approach to allow their comparison across domains. From this analysis of thousands of studies including almost 1.5 million participants, the following risk factors were derived: parental experience of maltreatment in his or her own childhood (d =.47), low socioeconomic status of the family (d =.34), dependent and aggressive parental personality (d =.45), intimate partner violence (d =.41), and higher baseline autonomic nervous system activity (d =.24). The effect size for autonomic stress reactivity was not significant (d = −.10). The umbrella review of interventions to prevent or reduce child maltreatment showed modest intervention effectiveness (d =.23 for interventions targeting child abuse potential or families with self‐reported maltreatment and d =.27 for officially reported child maltreatment cases). Despite numerous studies on child maltreatment, some large gaps in our knowledge of antecedents exist. Neurobiological antecedents should receive more research investment. Differential susceptibility theory may shed more light on questions aimed at breaking the intergenerational transmission of maltreatment and on the modest (preventive) intervention effects. In combination with family‐based interaction‐focused interventions, large‐scale socioeconomic experiments such as cash transfer trials and experiments with vouchers to move to a lower‐poverty area might be tested to prevent or reduce child maltreatment. Prevalence, antecedents, and preventive interventions of prenatal maltreatment deserve continuing scientific, clinical, and policy attention. Read the Commentary on this article at doi: 10.1111/jcpp.13175 [ABSTRACT FROM AUTHOR]