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People with intellectual disability face extensive health inequality and premature mortality. Medical students have reported that they lack the skills, knowledge and confidence to work with those with intellectual disability and autism. This emphasises the need for tomorrow’s doctors to be adequately trained. This study aims to investigate students’ knowledge, skills and attitudes towards people with intellectual disability and autism, examining whether these outcomes change following curricula re-design and with implementation of an e-learning module.

The university curricula in intellectual disability and autism were re-designed and an e-learning module developed using co-production. This was delivered to fourth-year medical students with a subgroup receiving the additional e-learning. A controlled trial evaluated students’ knowledge, skills and attitudes using pre- and post-questionnaires. Statistical tests of difference were used to the scores obtained.

This study showed an improvement in knowledge, skills and attitudes with intellectual disability and autism after curricula engagement, with an incremental benefit observed for students also completing the e-learning module. There was significant difference in pre-and-post placement scores assessing student attitudes towards intellectual disability and autism teaching.

This study highlights the importance of a multi-faceted, co-produced curricula re-design in intellectual disability and autism. The benefit of the e-learning module holds hope that the newly introduced mandatory Oliver McGowan training will be beneficial in the development of tomorrow’s doctors. Effective training in intellectual disability and autism is vital to improve the care and support delivered and reduce unnecessary deaths.

Individuals with intellectual disability have an increased predisposition to other co-morbid physical health conditions, mental illness and neurodevelopmental conditions including autism spectrum condition. There are challenges in diagnosing autism in adults with intellectual disability, and these are often attributes to the complexities in symptoms. The purpose of this paper is to describe the development of the autism diagnostic aid (ADA) tool and face and content validation of its properties.

The ADA tool was developed following a detailed scoping exercise which included literature reviews, observations and discussion with wider multi-disciplinary team members. A face and content validation after consultation with eight experts who are trained and routinely perform assessments for autism spectrum disorders. The experts also have expertise in working with individuals with intellectual disability.

The experts agreed that the ADA tool is appropriate to the targeted construct and assessment objectives as a diagnostic aid in the assessment of autism in adults with intellectual disability. They also determined that the content of ADA tool was valid for its use as a diagnostic aid in the diagnosis of adults with intellectual disability.

The ADA tool was considered a valid tool from the expert’s perspective. It was identified to have a good face and content validity. To the best of the authors’ knowledge, the ADA is first of its kind tool, developed specifically to aid clinicians with autism assessments in adults with intellectual disability.

This tool could potentially help with timely assessment and help with providing appropriate intervention but would require further exploration.

To the best of the authors’ knowledge, this is the first of its kind tool for the assessment of autism in adults with intellectual disability.

According to NHS statistics, as of July 2023, there were around 2045 people with intellectual disability and autistic people in mental health and specialist hospitals. Details of their inpatient stay were captured through Assuring Transformation data returns (NHS Digital, 2023) and includes data on all types of mental health hospitals. This study aims to understand the characteristics of people with intellectual disability and of autistic adults who are in inpatient settings across north of England in February 2022. It explores the clinical and demographic factors that might have an impact on the length of their inpatient stay.

This is a cross-sectional study using routinely collected demographic and clinical data in 2022 of inpatients across the north of England.

A total of 625 patients were in an inpatient setting across the north of England at the time of the data collection. The results indicate that the underlying diagnostic category, region, nature of inpatient service, legal framework, reason for admission and outcome of Care (Education) and Treatment Reviews are factors that are associated with the person’s length of stay in a hospital.

This study highlighted the need to review the community models of care to meet needs of those with intellectual disability. It further highlighted the need to collect and analyse longitudinal data, address social care needs and further understand the factors linked to regional variations.

To the best of the authors’ knowledge, this is a first study that investigated the factors associated with length of stay using inpatient data from across the north of England. It provides new insights into the factors that affect length of stay.

People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This paper aims to detail the process of developing a risk stratification tool to identify those individuals who are higher risk of premature mortality.

This study used population health management principles to conceptualise a risk stratification tool for avoidable deaths in people with intellectual disability. A review of the literature examined the existing evidence of causes of death in people with intellectual disability. A qualitative methodology using focused groups of specialist clinicians was used to understand the factors that contributed towards avoidable deaths in people with intellectual disability. Delphi groups were used for consensus on the variables for inclusion in the risk stratification tool (Decision Support Tool for Physical Health).

A pilot of the Decision Support Tool for Physical Health within specialist intellectual disability service demonstrated effective utility and acceptability in clinical practice. The tool has also demonstrated good face and construct validity. A further study is currently being completed to examine concurrent and predictive validity of the tool.

To the best of the authors’ knowledge, this is the only study that has used a systematic approach to designing a risk stratification tool for identifying premature mortality in people with intellectual disability. The Decision Support Tool for Physical Health in clinical practice aims to guide clinical responses and prioritise those identified as at higher risk of avoidable deaths.

The purpose of this paper is to outline what early support should be offered to children and young people with neurodevelopmental conditions including those who are autistic or have intellectual disability. A review of all child and adolescent mental health services (CAMHS) services in the Northwest completed by NHS England and Improvement (Doyle and Ryan, 2021) found that there was no clear Tier 2 offer (for mild to moderate mental health issues) for autistic children and young people or for those with intellectual disability. Following this review, a project group that had developed a model for mental health services for autistic children and young people and for those with intellectual disability (Wee et al., 2021) was tasked with articulating the “Getting Help” offer for children and young people with neurodevelopmental conditions, including intellectual disability.

A working group was created consisting of professionals from mental health, education and local authority and lived experience representatives of coproduction partners. A brief review of the background literature was also conducted. Six meetings were held to create a framework for the “Getting Help” offer and to discuss what the offer should be based on professional expertise and lived experience.

Recommendations for the Getting Help multi-agency offer included pre- and post-assessment support as part of a single attention deficit hyperactivity disorder/autism/neurodevelopmental pathway, community support for children with intellectual disability, access to adapted mental health support and the need for early recognition and support for avoidant and restrictive food intake disorder. Key themes from working group discussions included the reduction in the quality of services experienced by children and families due to silo working, which increased the risk of falling between multi-agency services and led to early signs of neurodevelopmental needs, or mental health issues being missed. Another theme was aiming for equity of access and outcomes.

This work is a response to a coproduced review of CAMHS in the Northwest and incorporates the lived experience of young people and families. It also adopts a holistic multi-agency neurodevelopmental approach rather than focusing on a single diagnosis or service.