Journal of Intellectual Disabilities current issue

Learning disability nurse education: An opportunity to contribute to shaping the future?

Barr, O. — 2009-09-28

Service users leading the way: Focus group methodology in developing accessible information DVDs with people with learning disabilities

Boyden, P., Esscopri, N., Ogi, L., Brennan, A., Kalsy-Lillico, S. — 2009-09-28

The English government sees it important to view service users as active partners in the delivery of accessible resources. The current article follows a brief report which described an innovative project on developing an accessible DVD explaining the Birmingham Clinical Psychology Service to people with learning disabilities. The article describes three focus groups involving adults with learning disabilities that met to reflect and evaluate the accessibility of the DVD. This process formed the evaluative phase of the DVD development project where people with learning disabilities evaluated the accessibility, level of understanding, and clarity of the DVD content. The DVD was rated positively by the focus groups, and minor changes were made to the final version of the DVD. The article also reflects upon the use of focus groups as a methodological approach in researching the views of people with learning disabilities.

Acceptance and Commitment Therapy (ACT) with a learning disabled young person experiencing anxious and obsessive thoughts

Brown, F. J., Hooper, S. — 2009-09-28

This case study describes how the ACT model was adapted to treat anxious and obsessive thoughts in a young person with moderate/severe learning disabilities. Using mindfulness and ACT-based experiential activities, the client learned to notice her thoughts and distance herself from their literal content. The negative impact that the client’s anxious thoughts had on her life was reduced and she was able to return to a part-time college course. The article describes how the client engaged with some ACT-based activities, such as mindfulness and defusion exercises. The outcome suggests that the experiential, activity-based nature of ACT may offer a more accessible intervention model for learning disabled people than traditional CBT models based on verbal reasoning skills. However, the intervention also required considerable individual adaptation and it is likely that this will be the case in work with people with learning disabilities.

Patient satisfaction with a hepatitis B vaccination programme among persons with an intellectual disability

Cooney, F. — 2009-09-28

This article demonstrates that a patient satisfaction survey can be carried out to evaluate the acceptability of a hepatitis B vaccination programme among persons with an intellectual disability. In this exploratory study, involving six clients, 41 care staff and three managers of intellectual disability services, core themes were identified on the acceptability of the programme. The following recommendations are made: a respectful attitude should be shown to all clients by the healthcare providers; appropriate information about the programme should be provided that is tailored to the needs and receptive capability of all recipients and their carers; the intervention should be delivered in an environment, and by healthcare personnel, familiar to clients; carers should be attentive to the possibility of adverse effects; and explicit, ethically stringent policies should be in place on the use of physical restraint. The article makes suggestions regarding future work in assessing patient satisfaction among this client group.

Learning to take the world seriously: An ethnographic study of the management of knowledge in a special school for children with intellectual disabilities

Todd, S. — 2009-09-28

This article reports on an ethnographic and sociological study of the curriculum inside a special school for students with severe intellectual disabilities in the UK. There are few such studies since it is the routing of children into the special education system that has been sociologically captivating. Bernstein’s analytical approach to the study of curricula is proposed as useful since it draws attention to the structure of the curriculum and is less concerned with assumptions about its content. It also highlights the social messages that are embedded within the curriculum. The data suggest that two codes were in operation within the curriculum. The first was designed to draw the out-of-school experiences of students into the classroom for greater scrutiny. The second involved the strict regulation of ‘dangerous’ knowledge, that is sexual knowledge. The implications of findings are discussed in relation to curriculum development, self-identity and the strength and nature of social boundaries.

Evaluation of clinical checklists for fragile X syndrome screening in Brazilian intellectually disabled males: Proposal for a new screening tool

2009-09-28

Patients with fragile X syndrome present a variable phenotype, which contributes to the underdiagnosing of this condition. The use of clinical checklists in individuals with intellectual disability can help in selecting patients to be given priority in the molecular investigation of the fragile X mutation in the FMR1 gene. Some features included in checklists are better predictors than others, but they can vary among different populations and with patient age. In the present study, we evaluated 20 features listed in four clinical checklists from the literature, using a sample of 192 Brazilian male patients presenting with intellectual disability (30 positive and 162 negative for fragile X mutation). After statistical analysis, 12 out of the 20 items analyzed showed significant differences in their distributions between the two groups. These features were grouped in a new checklist that can help clinicians in their referral for fragile X testing in patients with developmental delay.