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Background: Adults with intellectual disabilities often display behaviour that challenges that is a result of biological differences, psychological challenges, and lack of appropriate social support. Intensive Support Teams (IST) are recommended to support the care needs of this group and avoid hospitalisation. However, little attention has been paid to the perspectives of stakeholders who manage, work in, or use ISTs. Method: Interviews and focus groups were conducted with 50 stakeholders (IST service managers and professionals, adults with intellectual disabilities, and family and paid carers) of ISTs. Services operated according to one of two service models previously identified in ISTs in England (enhanced or independent). Results: Thematic analysis identified accessible and flexible support, individualised care, and the involvement of carers and other relevant agencies in management plans and reviews as features of good IST care highlighted by all stakeholder groups. IST managers and professionals described the key challenges of current IST provision as unclear referral criteria, limited interfaces with other local services, and perceived threats associated with funding and staff retention. Findings were similar between the two IST models. Conclusions: ISTs are able to offer care and specialist support that is valued by families, service users and other care providers. However, they face several operational challenges that should be addressed if ISTs are to reach their potential along with community intellectual disability services in supporting adults with intellectual disabilities who display behaviour that challenges in the community.

Background: Using inclusive research methods with people with intellectual disabilities is increasingly common. A recent consensus statement identified key elements when conducting and reporting inclusive research with people with intellectual disabilities. This review identifies the range of health and social care research topics using inclusive research methodologies, systematically appraises the involvement of researchers with intellectual disabilities, and identifies facilitators and barriers to inclusive research. Researchers' experiences of engaging with inclusive research are synthesised. Method: Seventeen empirical studies focused upon inclusive health and social care research were identified. The associated inclusive research methodologies employed, and the stages in which researchers with intellectual disabilities were involved, along with the experiences of researchers with and without intellectual disabilities were synthesised. Results: Papers focused on a broad range of health and social care topics and largely employed qualitative or mixed-methods designs. Researchers with intellectual disabilities were frequently involved with data collection, analysis and dissemination. Facilitators of inclusive research comprised sharing power, team working, having sufficient resources and making research methodologies accessible. Conclusions: Researchers with intellectual disabilities are involved in a wide range of methodologies and research tasks. How the added value of inclusive research is measured and its impact on outcomes, require consideration.

This study compared two goal-setting approaches found in the Precision Teaching literature, namely the minimum celeration line and the beat your personal best during the mathematical practice of three male students diagnosed with autism, aged 8-9. An adapted alternating treatments design with a control condition was embedded in a concurrent multiple baseline across participants design. Each approach was randomly allocated to either the multiplication/division (×÷) table of 18 or 19, while no approach was allocated to the ×÷14 table that acted as a control. Instruction utilized number families and consisted of (a) untimed practice, (b) frequency-building, (c) performance criteria, (d) graphing, and (e) a token economy. Upon practice completion, an assessment of maintenance, endurance, stability, and application (MESA) was conducted. Participants improved with both conditions and maintained their performance well, while improvements with the control condition were weak. The beat your personal best approach was highlighted as slightly more effective in terms of average performance and more efficient in terms of timings needed to achieve criterion. No differences were identified in terms of learning rate (i.e., celeration) or performance on the MESA. More research is warranted to identify which goal-setting procedure is more appropriate for students in special education.

Precision Teaching is a behavior measurement system that emphasizes the development of behavioral repertoires and utilizes Standard Celeration Charts as its primary tool. This system has been applied across various areas, including mainstream and special education, and has successfully improved academic, motor, communication, and other skills. While previous systematic reviews have highlighted important aspects of Precision Teaching, a more comprehensive evaluation is needed to consider all its different applications and recent developments in conceptualizing it. Therefore, this systematic review and meta-analysis will assess the effectiveness of Precision Teaching in accelerating human behavior, identify all the areas of its application, and review the technical aspects of its implementation. The review aims to provide a comprehensive understanding of the system and its potential benefits for individuals in different settings.

Background: We examined whether a series of variables were related to the number of psychiatric inpatients using publicly available data about English psychiatric bed utilisation and NHS workforce. Method: Using linear regression, with auto-regressive errors, we examined relationships between variables over time using data from December 2013 to March 2021. Results: Over time, the number of inpatients reduced by either 6.58 or 8.07 per month depending upon the dataset utilised, and the number of community nurses and community nursing support staff reduced by 7.43 and 2.14 nurses per month, respectively. Increasing numbers of consultant psychiatrists were associated with fewer inpatients over time. More care and treatment reviews (CTRs) were associated with more admissions over time, while more post-admission CTRs were associated with increased discharges over time. Conclusions: Future studies should examine whether psychiatric bed utilisation elsewhere within the NHS by people with intellectual disabilities has increased.

Social media can lead to rejection, cyber-bullying victimisation, and cyber-aggression, and these experiences are not fully understood as experienced by autistic adults. To investigate this, 78 autistic adults completed self-report measures of social media use, cyber-bullying victimisation, cyber-aggression, and self-esteem. High levels of social media use were found to be associated with an increased risk of cyber-victimisation; whereas self-esteem was positively correlated with feelings of belonging to an online community and negatively correlated with feelings of being ignored on social network sites and chat rooms. Future studies are needed to further investigate the experience of cyber-bullying victimisation of autistic adults.

Learning channels refer to the way students receive instruction and respond to it. We examined the relationship between See-Say and See-Write learning channel sets during the mathematical practice of four male autistic students, aged 8 to 14 years. Participants received practice in the ×7 and ×8 tables across both channel sets. Lessons included untimed practice, timed practice, graphing and goal-setting. A multiple treatments design, embedded in a multiple baseline across participants design, was used. When practice on a set was completed, an assessment of endurance, stability, application, generalisation to the other set and maintenance was conducted. Practice led to improvements that were maintained. Participants achieved learning rates above 30% per week, which is a minimum expectation in Precision Teaching. Practice on one set affected performance on the other, and the order of practice was an important variable. The See-Say channel set led to better generalisation outcomes while performance was stronger on the See-Write.

This study compared two goal-setting approaches found in the Precision Teaching literature, namely the minimum celeration line and the beat your personal best during the mathematical practice of three male students diagnosed with autism, aged 8-9. An adapted alternating treatments design with a control condition was embedded in a concurrent multiple baseline across participants design. Each approach was randomly allocated to either the multiplication/division (x÷) table of 18 or 19, while no approach was allocated to the x÷14 table that acted as a control. Instruction utilized number families and consisted of (a) untimed practice, (b) frequency-building, (c) performance criteria, (d) graphing, and (e) a token economy. Upon practice completion, an assessment of maintenance, endurance, stability, and application (MESA) was conducted. Participants improved with both conditions and maintained their performance well, while improvements with the control condition were weak. The beat your personal best approach was highlighted as slightly more effective in terms of average performance and more efficient in terms of timings needed to achieve criterion. No differences were identified in terms of learning rate (i.e., celeration) or performance on the MESA. More research is warranted to identify which goal-setting procedure is more appropriate for students in special education., Author(s): Athanasios Vostanis [sup.1], Ciara Padden [sup.1], Aoife McTiernan [sup.2], Peter E. Langdon [sup.3] [sup.4] Author Affiliations: (1) grid.9759.2, 0000 0001 2232 2818, Tizard Centre, University of Kent, , Cornwallis [...]

Background: This study outlines how a modified Delphi procedure was used with special educational needs teachers to select skills and behaviours for inclusion in the Assessment of Barriers to Learning in Education-Autism (ABLE-Autism). The ABLE-Autism is a new teacher assessment to show progress in barriers to learning for pupils on the autism spectrum with coexisting intellectual disabilities in special schools. The research aim was to select items for inclusion in the assessment based on teacher ratings of relevance, comprehensibility and comprehensiveness. Method: Following a review of the literature and teacher focus groups, a list of 86 items was developed and a modified two-round Delphi exercise was conducted with special needs teachers. Items were selected for inclusion if at least 80% of teachers agreed that the item was (a) able to be understood, (b) important to assess and (c) the median score associated with whether the item was able to be understood and important to assess was 1 (the highest score possible). Results: In the first round, 56 items met the criteria for inclusion and were retained. Thirty items were amended, and, after three items were amalgamated with other items, 27 amended items were included in the second round. After the second round, 14 additional items met the threshold to be included in the final assessment. Conclusions: After both rounds, 70 items were endorsed by teachers and included in the ABLE-Autism. The input of special needs teachers provided initial face and content validity for the new outcome measure.

Background: Treatment for adults who set fires relies upon valid and reliable assessment. Research is needed to ensure self-report measures are available for adults with neurodevelopmental disabilities and that they are robust. Method: Qualitative and quantitative data from three rounds of a Delphi exercise with practitioners and a focus group discussion with adults with neurodevelopmental disabilities were used to generate consensus about the accessibility of item adaptations made to the Fire Interest Rating Scale, Fire Attitudes Scale, and the Identification with Fire Questionnaire. Results: Findings suggested the accessibility of current measures could be improved to better meet the needs of adults with neurodevelopmental disabilities and adaptations to all questionnaire items were needed. Conclusion: Following feedback, revisions to current measures were implemented leading to the development of the Adapted Firesetting Assessment Scale with improved accessibility for adults with neurodevelopmental disabilities.

Two focus groups were conducted with special needs teachers to: (a) identify barriers to learning for autistic pupils, (b) consider broad assessment domains and specific skills or behaviours which teachers consider important for these pupils, and (c) give their opinions on teacher assessments. Data analysis resulted in six main themes: (a) barriers to learning, (b) teacher priorities for autistic pupils, (c) ways of overcoming barriers, (d) the concept of 'true mastery', (e) assessing the bigger picture, and (f) practicalities of assessment. Results showed that teachers have priorities for the pupils they know well and concerns about the assessments they regularly use. To ensure face and content validity of teacher assessments, and for assessments to be useful to and valued by the teachers who use them, it is recommended that teachers have opportunities to input during various aspects of the assessment development process.

Social media can lead to rejection, cyber-bullying victimisation, and cyber-aggression, and these experiences are not fully understood as experienced by autistic adults. To investigate this, 78 autistic adults completed self-report measures of social media use, cyber-bullying victimisation, cyber-aggression, and self-esteem. High levels of social media use were found to be associated with an increased risk of cyber-victimisation; whereas self-esteem was positively correlated with feelings of belonging to an online community and negatively correlated with feelings of being ignored on social network sites and chat rooms. Future studies are needed to further investigate the experience of cyber-bullying victimisation of autistic adults., Author(s): Paraskevi Triantafyllopoulou [sup.1] , Charlotte Clark-Hughes [sup.1] , Peter E. Langdon [sup.2] [sup.3] [sup.4] Author Affiliations: (1) grid.9759.2, 0000 0001 2232 2818, Tizard Centre, University of Kent, , Cornwallis [...]

Objectives: To characterise the changes at work experienced by psychologists working with people with intellectual disabilities during the pandemic and whether these changes, stressors and aspects of working life were associated with mental wellbeing and occupational stress. Methods: Ninety-seven psychologists completed an online survey. Free text comments were analysed using thematic analysis and triangulated with our quantitative findings. Results: Occupational stress, learning new roles, demands at home, and changes due to COVID-19 were associated with poorer mental wellbeing, while uncertainty about the role, a shortage of personal protective equipment, and poorer mental wellbeing were associated with occupational stress. Two main themes emerged during the thematic analysis: being human and being an employee, and triangulation revealed agreement. Conclusions: The wellbeing and occupational stress of psychologists working with people with intellectual disabilities have been affected during the pandemic. It is of note that almost a quarter of our sample reported having been redeployed.

The aim of this study was to investigate the effect of a precision teaching (PT) framework on the mathematical ability of students with intellectual and developmental disabilities. We also examined if students of moderate mathematical ability could perform as well as their peers with fewer difficulties with their math skills. Sixteen students participated and were divided into three groups. One group engaged in PT, and the other two groups functioned as comparisons. The PT group practiced six skills introduced linearly. An A-B design was used for the five component skills, and a multiple baseline across participants design was used for the composite skill (addition). The intervention led to a significant improvement in all skills, including addition, and this was associated with a large effect size; student performance met or exceeded that of their peers. Overall, the findings suggest that PT is an efficient and effective approach for teaching students with IDDs.

Recent COVID-19 lockdown restrictions resulted in reduced access to educational, professional and social support systems for children with intellectual disabilities and their carers. Aim: The aim of this study was to gain insight into the ways mothers of children with intellectual disabilities coped during the first 2020 lockdown period. Methods: Eight mothers of children with intellectual disabilities were interviewed. The recordings of these interviews were subjected to a thematic analysis. Results: Three main themes were identified: carrying the burden; a time of stress; and embracing change and looking to the future. Conclusions: All mothers experienced increased burden and stress. However, some also described some positive impact of lockdown conditions on them as well as on their child's well-being and behaviour. These findings are discussed in the light of the (Journal of Applied Research in Intellectual Disabilities, 33, 2020, 1523) survey results on parental coping and suggestions for future service provision during pandemic conditions are proposed.

Introduction: The measures implemented to manage the COVID-19 pandemic have been shown to impair mental health. This problem is likely to be exacerbated for carers. Method: Informal carers (mainly parents) of children and adults with intellectual disabilities, and a comparison group of parents of children without disabilities, completed an online questionnaire. Almost all the data were collected while strict lockdown conditions were in place. Results: Relative to carers of children without intellectual disability, carers of both children and adults with intellectual disability had significantly greater levels of a wish fulfilment coping style, defeat/entrapment, anxiety, and depression. Differences were 2-3 times greater than reported in earlier pre-pandemic studies. Positive correlations were found between objective stress scores and all mental health outcomes. Despite their greater mental health needs, carers of those with intellectual disability received less social support from a variety of sources. Conclusions: The greater mental health needs of carers in the context of lesser social support raises serious concerns. We consider the policy implications of these findings.

Background: The aim of this feasibility study was to adapt and model a behavioural intervention for anxiety with autistic adults with moderate to severe intellectual disabilities. Method: Twenty‐eight autistic adults with moderate or severe intellectual disabilities, 37 carers, and 40 therapists took part in this single‐group non‐randomised feasibility study designed to test intervention feasibility and acceptability, outcome measures, and research processes. Results: The intervention was judged as feasible and acceptable by autistic adults with intellectual disabilities, carers, and therapists. Minor intervention revisions were suggested. Carers completed 100% of outcome measures and the missing data rate was low. Complying with legislation governing the inclusion of participants who lack capacity to decide whether they wanted to take part in this study led to an average 5‐week enrolment delay. Conclusion: The intervention and associated study processes were judged to be feasible and acceptable and should now be tested within a larger randomised trial. [ABSTRACT FROM AUTHOR]

It is imperative that we devote resources and research effort to find out what is going on in families where there is a member with Intellectual and Developmental Disabilities (IDD) over the course of the COVID 19 pandemic and how adaptations can be made to provide the most effective help. This article discusses the need for more research to be done in this area. The authors share their current research that they are conducting, and they explain future steps to continue this research.

The aim of this study was to investigate the effect of a precision teaching (PT) framework on the mathematical ability of students with intellectual and developmental disabilities. We also examined if students of moderate mathematical ability could perform as well as their peers with fewer difficulties with their math skills. Sixteen students participated and were divided into three groups. One group engaged in PT, and the other two groups functioned as comparisons. The PT group practiced six skills introduced linearly. An A-B design was used for the five component skills, and a multiple baseline across participants design was used for the composite skill (addition). The intervention led to a significant improvement in all skills, including addition, and this was associated with a large effect size; student performance met or exceeded that of their peers. Overall, the findings suggest that PT is an efficient and effective approach for teaching students with IDDs., Author(s): Athanasios Vostanis [sup.1], Ciara Padden [sup.1], Mecca Chiesa [sup.1], Konstantinos Rizos [sup.2], Peter E. Langdon [sup.3] Author Affiliations: (1) grid.9759.2, 0000 0001 2232 2818, Tizard Centre, University of Kent, [...]

Autistic adults who have a history of committing crimes present a major problem for providers of services in terms of legal disposal options and possible interventions, and greater understanding of this group and their associated needs is required. For this reason, we aimed to investigate the face validity of a proposed sub-typology of autistic adults detained in secure psychiatric hospitals in the United Kingdom. Initially, a focus group was completed with psychiatrists, clinical psychologists, healthcare workers, family members and autistic adults who had been detained in hospital, leading to revisions of the sub-typology. Following this, a consensus rating exercise of 10 clinical vignettes based on this sub-typology with three rounds was completed with 15 psychiatrists and clinical psychologists; revisions to the vignettes to improve clarity were made following each round. The findings indicated that these subtypes possess face validity and raters were able to classify all 10 clinical case vignettes into the sub-typology, and percentage of agreement ranged from 96% to 100% for overall subtype classification. This study suggests that the further validity of the sub-typology should be investigated within a larger study, as these subtypes have the potential to directly inform the hospital care pathway such that length of stay can be minimised.

Background: The cognitive and behavioural profile associated with autism spectrum disorders (ASD) includes difficulties with social interaction, communication and empathy. Each of these may present barriers to effective participation in sexual offending treatment, leading to poorer outcomes. Method: Semi-structured interviews were conducted with 13 men with autism and an intellectual disability (including the borderline range) who had completed an adapted sex offender treatment programme. Grounded Theory was used to explore the men's experiences of treatment and perceptions of risk. Results: The men's perceptions of sexual risk were inextricably linked to constructs of identity and shaped their opinions of treatment effectiveness. Risk of reoffending was conveyed through narratives of changes in self and circumstances and included notions of blame and culpability. Conclusions: The findings illustrated some clear benefits for men with ASD associated with attending adapted sex offender treatment programmes, including delivery of treatment within groups and opportunities for social development. The study supports the view that difficulties with empathy and cognitive flexibility complicates treatment for sexual offending.

Background: This trial aimed to measure the effects of extrinsic and intrinsic factors on users' comprehension of health information provided in adapted written "easy read" material. Method: Sixty adults with intellectual disabilities undertook The Easy Read Task, randomly allocated with stratification by reading ability to one of four conditions (with and without simplified language/with and without mediation). Results: Neither linguistic complexity of the text nor mediation independently or combined made a significant difference to the understanding of information. Post hoc testing revealed that the group who received simplified language with mediation performed significantly better than the group that had complex text with mediation. None of the other differences between the remaining groups were significant. Conclusions: Constructing meaning needs to extend beyond a consideration of form as found in "easy read" documents to recognize the role of individual capacity for language processing.