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The purpose of this paper is to provide a commentary on Banks et al. and sets the wider context.

It provides a brief narrative review of the literature on the factors that determine the quality of life of people with intellectual disabilities, including the impact of culture.

Key to ensuring good quality of life outcomes is support that is facilitative, enabling and empowering which can compensate for severity of disability and improve people’s experiences. This approach is called Active Support. Improving quality of life is a key part of preventing and responding to behaviours that challenge. Culture is an important factor in ensuring staff are motivated to work in such ways but is likely to be intertwined with many other factors.

This paper summarises the key literature on what is needed to improve outcomes for people with intellectual disabilities. It introduces the importance of exploring how the different dimensions of culture interact and how culture, practice, processes and structures might work in a much more complex and intertwined fashion than previously conceptualised.

The purpose of this paper is to establish the effectiveness of Talking Mats® (TM) in evaluating service users’ experiences, and explore their views of the implementation of person-centred active support (PCAS).

This is a mixed-methods study, employing qualitative interviewing and observational measures.

Both qualitative and quantitative measures indicated inconsistent implementation of PCAS. It was possible to effectively gain participants’ views on positive and negative aspects of quality of support and quality of life, using TM, across three themes, My life, My support and Self-determination.

Generalisability of the research may be limited due to the sample, and the potential for researcher and interviewer bias is acknowledged.

TM provides a mechanism that may facilitate the inclusion of the views and experiences of people with intellectual and developmental disability (PWIDD) who have limited verbal skills. Their views need to be reflected in adaptions made to PCAS.

This study included a population who are often left out of qualitative research because of the methodologies adopted. It also included older PWIDD, where there has been less research about the effectiveness of TM.

The purpose of this paper is to reflect on the difficulties highlighted by Ntinas around supporting change in services for people with intellectual and developmental disabilities.

This commentary examines what is needed for change and reflects on staff culture.

The authors propose that it is not sensible to separate the culture of a service from the implementation of person-centred approaches and attempt to map how the concepts overlap and are interconnected.

Whilst some elements of culture are clearly important in order to start the process of change, other elements will change as an intervention is introduced and embedded.

Previous studies have confirmed the potential benefits of participating in theatrical improvisation, including improved mental health, well-being, skills and strategy development. This study aims to explore the experiences of improv (a subset of theatrical improvisation) for autistic, non-autistic, yet neurodivergent and neurotypical people. In particular, it explores whether participants believe that there have been any benefits from participating in improv.

Twenty adult participants were recruited using snowball sampling. Semi-structured interviews were conducted and analysed using interpretative phenomenological analysis (IPA) and qualitative content analysis (QCA). IPA explored the autistic lived experience during improv participation, while QCA sought to identify the benefits gained.

Implementing IPA allowed for the benefits of improv to be embedded into autistic lived experience. This was aggregated into two themes: “life beyond improv” and “social worlds negative impact”. Findings from QCA found five themes: “creativity and opportunities: the arts and workplace”; “acceptance, cognitive flexibility and rolling with it”; “interpersonal, social and communication skills and human connection”; “gains in mental health, quality of life and wellbeing”; and for just autistic participants, “‘I've gone full autistic’ (and can learn why neurotypicals are like they are)”.

To the best of the authors’ knowledge, this is a novel study area that has not been investigated previously.

Engagement in meaningful active and relationships is important for quality of life but, for those with intellectual and developmental disabilities, engagement depends on the quality of support received from those around them. This paper describes the process of implementing person‐centred active support in the Avenues Trust, and the findings from the evaluation of the implementation in six pilot residential services. Attention was paid both to training staff and to the motivational structures within the organisation. Both the quality of support provided by staff and the level of engagement increased significantly after the introduction of person‐centred active support. In addition, people experienced decreased self‐stimulatory and injurious behaviour, increased opportunities for choice and control, and higher levels of participation in tasks of daily living, without compromising their community involvement. Staff experienced more and better practice leadership, and staff morale improved within the services, with staff generally more positive about management, more satisfied and less likely to leave. Lessons learnt about the implementation are provided.

Grouping people with learning disabilities and challenging behaviour in residential care has been the focus of several recent research studies. This paper describes these studies and what they found. In general, they show negative effects of grouping people with challenging behaviour together in terms of the quality of staff interaction with them and the outcomes they experience.

This mainly conceptual paper summarises the current conceptualisation of personalisation as it applies to people with learning disabilities. It goes on to map out how the drive towards the personalisation of services, its most recent iterations of person‐centred planning, person‐centred funding and person‐centred action, contributes to a better quality of life for people with intellectual disabilities, using the domains and indicators of quality of life set out in the Schalock et al (2002) international consensus. In doing so it describes what you would see in services where person‐centred approaches were being successfully implemented.

The purpose of this paper is to discuss the issue of social inclusion for people with autism spectrum conditions.

Drawing on current policy and good practice guidelines as well as the experience of people with autism and those who support them, this paper considers how well legislation, policy, and good practice are currently implemented with regard to improving the social inclusion of children and adults with autism spectrum conditions.

International and UK policy sets out the rights of children and adults with disabilities to live a good life in the community, with reasonable adjustment to be made by society to ensure this is possible. However, the practical and strategic implementations of policies to ensure these rights for people with autism are still not fully in place.

This discussion takes into consideration the views of carers and support professionals and the direct experiences of those with autism as well as policy and published guidance.