Search results

The general public and professionals from a range of backgrounds have increasingly become interested in autism spectrum disorders. This interest is particularly relevant to learning disability practitioners. Both autism and learning disabilities are independently associated with increased risk of mental health problems. Thus, when a person has learning disabilities and an autism spectrum disorder, a comprehensive assessment for mental health problems is of paramount importance. This paper provides an overview of the assessment of mental health problems in adults and children with neurodevelopmental disorders. The general assessment principles are outlined followed by assessment issues related to specific conditions such as psychoses, mood disorders and attention deficit hyperactivity disorder. Finally conclusions on the clinical implications are drawn.

The use of violence risk assessment measures within intellectual disabilities (ID) services is now the norm and a growing target for research. The purpose of this paper is to examine the clinical utility of the historical and clinical factors of the HCR-20 in predicting violence.

The study took place within a national low secure service for adults with ID examining all completed admissions over a six-year period, (N=22). Clinical records covering the first three months of admission were examined along with historical reports and incident data recorded at three, six, nine and 12 months admission using the Modified Overt Aggression Scale (MOAS).

Significant positive relationship between Historical score and total number of incidents was established. Patients with challenging behaviour less likely to have a previous history of violence, and more likely to be older at first violent incident than patients without challenging behaviour. Incidents involving patients with autism were less severe and those with no additional psychiatric diagnosis were significantly more likely to have substance misuse problems than those with a diagnosis.

The study found the Historical section was predictive of violent incidents and whilst the study is too small to draw any firm conclusions, the significant positive relationship between the Historical Score and number of incidents for those without additional diagnosis needs to be investigated further as well as the potential positive clinical impact of using the HCR-20 in routine clinical practice.

Reporting to the police incidents of challenging behaviour displayed by inpatients with autism spectrum disorders (ASD) and learning disability (LD) represents an important but often controversial issue. The purpose of this paper is to contribute to this topic through a brief literature review and the presentation of a clinical case.

Case study and literature review.

The action of reporting to the police can be a useful tool within the therapeutic input provided to patients with ASD and LD who present with challenging behaviour. This can enable staff to feel legally supported, and can promote patients’ learning of social rules, in respect of their rights and duties. The clinical case highlighted that reporting to the police can be effective when it is part of a comprehensive, multi‐professional therapeutic process. This should aim at directing patients towards rehabilitation rather than incarceration. This should also entail the identification of clear pathways and ongoing involvement of patients and families.

Despite the relevance for clinical practice of the above debate, little has been published on this topic. This paper contributes to this discussion through the presentation of a clinical case and by describing how this issue was addressed within a secure inpatient setting.