This review outlines the nature of autism spectrum disorder (ASD) in childhood and early adolescence, its relationship to the autistic condition, and the disabilities and…
Abstract
This review outlines the nature of autism spectrum disorder (ASD) in childhood and early adolescence, its relationship to the autistic condition, and the disabilities and co‐morbid disorders that accompany it. On this basis it gives an overview of the needs of children and families with ASD and the mental health services that they require.
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Psychiatry in the United Kingdom has overhauled its approach to the provision of services for adults with autism spectrum disorders (ASD). This shift is set out in a new policy…
Abstract
Psychiatry in the United Kingdom has overhauled its approach to the provision of services for adults with autism spectrum disorders (ASD). This shift is set out in a new policy document, Psychiatric Services for Adolescents and Adults with Asperger's Syndrome and other Autistic‐spectrum Disorders (Royal College of Psychiatrists, 2005).
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The author provides a commentary on Services for adults with autism spectrum disorders.
Abstract
The author provides a commentary on Services for adults with autism spectrum disorders.
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Robert L. Harrison, Ann Veeck and James W. Gentry
The purpose of this paper is twofold: to describe and evaluate the life grid as a methodology for historical research; and to provide an example application investigating the…
Abstract
Purpose
The purpose of this paper is twofold: to describe and evaluate the life grid as a methodology for historical research; and to provide an example application investigating the dynamics of family meals over a lifetime by pairing life course theory with the life grid method of obtaining oral histories.
Design/methodology/approach
To explore how the meanings and processes of meals change, the authors conducted interviews with 15 respondents aged 80 years old and over, on the topic of family meals.
Findings
The paper discusses the merits of using the life grid method to analyze lifetime family consumption behavior. The findings of this example study provide insight as to how the roles, responsibilities, and loyalties of our participants had changed through births, deaths, marriages, wars, economic periods, illnesses, and the process of aging, leading to changes in dining.
Originality/value
The benefit of the life grid method described in this paper is its ability to minimize recall bias. In addition, the overt process of cross‐referencing events throughout the course of the interviews via the life grid method proved to be a helpful aid in identifying patterns and symmetries during the interpretation stage.
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Sherva Elizabeth Cooray, Sab Bhaumik, Ashok Roy, John Devapriam, Rahul Rai and Regi Alexander
The 11th revision of the International Classification of diseases which sets global standards for defining, reporting and managing health conditions is under way. The…
Abstract
Purpose
The 11th revision of the International Classification of diseases which sets global standards for defining, reporting and managing health conditions is under way. The International Classification of Diseases (ICD) underpinning principle of clinical utility is currently poor for persons with Disorders of Intellectual Development (DID) and mental disorders. This impedes access to healthcare resources; services and social inclusion thereby further aggravating their vulnerability. The purpose of this paper is to present a critical overview and evidence informed recommendations within the context of an international collaborative programme, undertaken by the Faculty of Psychiatry of Intellectual Disability, Royal College of Psychiatrists, UK with support from the World Health Organisation (WHO).
Design/methodology/approach
The authors carried out: first, a systematic review (SR) of literature, using PRISMA guidelines regarding the reliability, validity and utility of the ICD-10/Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria in people with DID (PWDID); second, a national and international consultation exercise with partners, stakeholders and experts; third, a multicentric survey of problem behaviours in PWDID; and finally, information dissemination/dialogues including presentations and workshops at key scientific events, consultation networking, data gathering and consensus building.
Findings
The SR revealed a dearth of robust studies – most consisting of weak research methodologies. Significant difficulties were highlighted regarding the application of diagnostic criteria in the current classificatory systems – particularly in people with severe/moderate DID. Recommendations supported the introduction WHERE APPROPRIATE of modifications based on observed phenomena (signs) in PWDID in lieu of reported symptoms to facilitate DIAGNOSIS AND better access to healthcare and the community. Heterogeneity precluded quantitative pooling and meta-analysis. The consensus building exercise globally revealed that problem behaviours were the commonest reasons for referral to healthcare services with significant numbers without a diagnosed mental disorder being prescribed psychoactive medication.
Research limitations/implications
The consensus gathering exercise WAS SELECTIVE AND did not cover all of the 194 member states of WHO due to resource and time constraints and this constitutes the main limitation of our study. Based on the SR and expert consensus, the authors submitted evidence informed pragmatic proposals to the WHO aimed at addressing the shortcomings of the ICD-10. The key recommendations focused on improving clinical utility within the context of epistemic iteration which would consolidate and strengthen the future evidence base. It was also recommended that self-injurious behaviour should form a standalone sub category in view of its relevance for healthcare services and resources which underpin clinical utility.
Practical implications
The ICD-11 is a global, multidisciplinary and multilingual development for public health benefit with 70 per cent of the world's health expenditures assigned using this system for resource allocation. Currently mental disorders in PWDID can be misinterpreted, unrecognised and under reported resulting in barriers to access to treatment and healthcare resources. Conversely disorders may be over diagnosed when the inherent discrepancies between the chronological age and the developmental level of functioning are not considered. Conclusions and recommendations from this study will result in better diagnosis of mental disorders and healthcare resources in this population.
Social implications
PWDID are a vulnerable sector of the population with an increased prevalence of mental health problems who are marginalised and discriminated by society. Early detection, treatment and management of these conditions will prevent further decompensation and stigmatisation.
Originality/value
To the best of the authors knowledge this is the first comprehensive, large-scale study which evaluates the ICD classificatory system within the context of clinical utility for PWDID, including experts and stakeholders from both lower/middle- and high-income countries. The international consultation/consensus building process culminating in the formulation of evidence informed recommendations, aimed at improving the clinical utility of the ICD-11 for this population, has the potential to improve access to appropriate healthcare and treatment and consequent enhancement of their quality of life.
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David Murphy and Josephine Grace Broyd
This paper aims to provide a discussion and summary of a clinician survey exploring the experiences of suspected feigned autism.
Abstract
Purpose
This paper aims to provide a discussion and summary of a clinician survey exploring the experiences of suspected feigned autism.
Design/methodology/approach
This study is an online survey targeting a range of autism professionals, with varying levels of experience, working in different clinical settings.
Findings
Approximately half of the professionals who completed the survey reported experiencing situations of suspected feigning of adult autism across a range of clinical contexts and with various motivations. In terms of best indications of potential feigning, most clinicians reported “textbook” self-descriptions of problem behaviours with vague examples, as well as inconsistent presenting problems and mismatch with any known developmental history. Approximately half of clinicians expressed the view that autism was more difficult to feign than a psychiatric disorder and had experienced situations involving differences in professional opinion as to an individual autism diagnosis.
Research limitations/implications
The survey is limited by a potential sample bias and no information regarding the clinical characteristics of those suspected to have feigned autism. However, these initial findings offer further questions for future research to pursue.
Originality/value
As an initial examination of practicing clinicians’ experiences of suspected feigned autism, the survey highlights the complexities of an autism diagnosis and suggests feigning is a potential clinical scenario. Some guidance as to when to suspect possible feigned autism is also offered, as well as a provisional assessment protocol.
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John Shine and Samantha Cooper-Evans
The purpose of this paper is to outline the initial development of a framework to assist in clinical case formulation for individuals diagnosed with autistic spectrum disorder…
Abstract
Purpose
The purpose of this paper is to outline the initial development of a framework to assist in clinical case formulation for individuals diagnosed with autistic spectrum disorder (ASD) who have been convicted of violent and other offences.
Design/methodology/approach
The proposed framework obtains information on the presence of ASD features from an individual’s developmental history, index offence and offence paralleling behaviours. Through obtaining information across these three domains the framework helps the practitioner make an informed assessment of the possible contribution of ASD to offending.
Findings
The framework aims to assist the practitioner to develop a clinical formulation based on hypothesised linkages between these domains for use in forensic assessment reports and to aid treatment planning. The use of the proposed framework is illustrated through a reference formulation based on a fictive case example.
Research limitations/implications
The framework is still in the early stages of development and has not been tested. The next stage is to utilise case information data to assess the validity of the items. This does not preclude the use of the framework by practitioners as an aid to generating clinical hypotheses about the possible link between autism and offending as the development of the tool has been informed by research on ASD and offending.
Practical implications
The framework may be used in conjunction with structured professional judgement tools. For example, the recently published third version of the HCR-20 includes pervasive developmental disorders as a historical risk item. This possible relevance of this item in terms of forensic risk could be presented using information obtained from the framework outlined in this paper. This in turn could be used to inform the formulation section of the HCR-20 and in the generation of treatment plans. In the longer term, the framework may help inform our understanding of possible relationships between violence risk and ASD and therefore aid effective assessment and treatment planning.
Social implications
In the longer term, the framework may help inform our understanding of possible relationships between violence risk and ASD and therefore aid effective assessment and treatment planning.
Originality/value
Although there is an emergent body of research on ASD and offending this has not yet been translated into a tool to help practitioners. This paper sets out an approach to do this and therefore makes an original contribution to the literature.
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THE regular search for the good book for the child will continue so long as there are children's libraries. A recent report on an enquiry has reached us from Bethnal Green and…
Abstract
THE regular search for the good book for the child will continue so long as there are children's libraries. A recent report on an enquiry has reached us from Bethnal Green and follows the familiar lines of getting the children to vote on what they like; with the result that the “William” books, which should be making all concerned in their production a fortune, head the list, and the simple “small”‐child books, the Milly‐Molly, Mandy series, come next. The field surveyed was small, for “William” polled only 34 votes; only 800 of the 6,000 children registered as borrowers participated. It is questionable if such enquiries, however much they interest us as librarians, can effectively help to improve child reading, unless some method of finding and providing high literature in the type the youngsters prefer can be devised. Mr. George F. Vale prefaces his brief list of books chosen with a really interesting discussion on the subject, but a quotation from it indicates part of the problem. He writes, speaking of Tom Sawyer, Alice and The Wafer Babies, “What elements go to make a permanent children's book is one of the mysteries of literature, but evidently these books possess some quality which overrides all the chances and changes of time. It is not merely the appeal of a good story; there are many better stories than The Water Babies. The secret seems to be some mysterious rapport between the author's mind and that of the readers, an ability to see and to think upon the level of the child mind.” All this is true, but it is more than that, we think; it is the power of recording what is, has been or may be, within the child's own range of experience; that is, it is true in that it realises the conditions of the world of childhood. It is curious, and possibly significant, that a book for children in these enquiries means a story. An enquiry is overdue into the type and quality of non‐fiction read by them, the sort of child who reads and in what circumstances: Real information here might reveal gaps and surpluses in book provision that are not now widely recognized!
Nathan Klaus and Ainsworth Anthony Bailey
The aim of the study was to assess the impact of the gender of the celebrity and the gender of the consumer who is exposed to an ad featuring a celebrity on consumer response to…
Abstract
The aim of the study was to assess the impact of the gender of the celebrity and the gender of the consumer who is exposed to an ad featuring a celebrity on consumer response to celebrity endorsements. The hypotheses were tested in an experimental study. The results indicated support for four hypotheses regarding differential response by women to ads featuring celebrity endorsers, differential responses to ads featuring female celebrity endorsers, as well as differential response to female celebrity endorsers. Partial support was found for an interaction effect of gender on response to the gender of celebrity endorsers. The implications of the study results as well as limitations and possible future research avenues are discussed.
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Lorraine Higham, Alessandra Girardi and Holly Victoria Edwards
Autism-specific characteristics have been associated with internet criminal activities. Internet and non-internet offenders differ on a series of demographic, psychological and…
Abstract
Purpose
Autism-specific characteristics have been associated with internet criminal activities. Internet and non-internet offenders differ on a series of demographic, psychological and offending variables. However, the clinical and criminal presentation of individuals with autism spectrum disorder (ASD) in forensic secure care settings has been underexplored. This paper aims to explore the profiles of internet offenders with ASD admitted to a secure psychiatric unit.
Design/methodology/approach
This study provides the results of a service evaluation of individuals with ASD. The demographic, clinical and criminal characteristics of a small sample of internet offenders with ASD admitted to secure care are described and discussed.
Findings
Internet offenders present in secure care with high rates of comorbid disorders, histories of violence and traumatic experiences, mood disorders and difficulties with relationships. Of the 24 internet offenders discussed, 18 of them committed an offence of a sexual nature involving children.
Originality/value
This paper highlights the potential risks for individuals with ASD in using the internet and the possible difficulties associated with detecting this because of rapid advancements in technology.