Associations between mental health problems and challenging behavior in adults with intellectual disabilities: A test of the behavioral equivalents hypothesis

Introduction Current research findings in the field of intellectual disabilities (ID) regarding the relationship between mental health problems and challenging behavior are inconclusive and/or contradictory. The aim of this study was to further investigate the putative association between these two, highly prevalent phenomena, in people with ID and specifically to explore the hypothesis that challenging behaviors may be behavioral equivalents of mental health problems. Methods A sample of 160 adults accessing secondary care ID health services were assessed using five validated measures. These included ratings of severity of disability, mental health problems, Autism behaviors, physical health problems, and four different aspects of challenging behavior. In conjunction with demographic information, four multiple regression analyses were undertaken to examine the interaction between mental health problems (moderated by severity of disability) and ratings of overall challenging behavior, aggression, self-injurious behavior, and stereotypy. In each case; age, gender, Autism, and physical health problems were included as covariates. Results There was a statistically significant association between mental health problems and ratings of overall challenging behavior, as well as the moderating effect of severity of disability. Importantly, the positive association between mental health problems and challenging behavior was only significant at more severe levels of disability. Conclusions These findings support the 'behavioral equivalents' hypothesis for mental health problems and challenging behaviors. However, further longitudinal research is required before this hypothesis can be considered unequivocally supported

The extension of a set of needs-led mental health clusters to accommodate people accessing UK intellectual disability health services

Background: A development of a needs-led mental health classification system based on the Health of the National Outcome Scales (HoNOS) has previously been developed. Aims: To extend the needs-based mental health (MH) clusters to accommodate the additional needs of people accessing UK intellectual disabilities health services. Method: Hierarchical cluster analysis was performed on assessment data from 18 National Health Service (NHS) provider organisations. The statistical results were clinically shaped through multi-disciplinary workshops. The resulting clusters were combined with six independently rated measures for a second data collection exercise. Based on these data, refinements were made before performing internal and external validity checks. Results: Eight additional clusters for people with health needs associated with their intellectual disabilities were produced. Three described primarily physical health (PH) needs, four described needs arising from behaviours which challenged (with/without autism) whilst one described people with generally low needs. Together, these covered 83.4% of cases with only a 10% overlap. The clusters were replicable and had clinical utility and validity. Conclusions: It was possible to extend the needs-led mental health classification system to capture the additional needs of people accessing UK intellectual disability services

Correlates for the risk of specialist ID hospital admission for people with intellectual disabilities: development of the LDNAT inpatient index

Purpose: The aim of this study was to analyse ratings data from the recently developed Learning Disability Needs Assessment Tool (LDNAT) to identify factors associated with specialist intellectual disability (ID) hospital admissions. Design/methodology/approach: Ratings from 1,692 individuals were analysed and the LDNAT items differing significantly between inpatients and non-inpatients were identified. Statistical analyses on total scores derived from these items were used to calculate an optimal cut-off. This LDNAT Inpatient Index score was also confirmed via an alternative statistical technique.. Findings: On average, 18 of the 23 LDNAT item ratings were significantly higher in people with ID assessed as inpatient compared to those rated in community settings. Using the total of these items, the resulting LDNAT Inpatient Index was analysed. A cut-off score of 22.5 was calculated to be the optimal balance between sensitivity (.833) and specificity (.750). This was confirmed by calculating the Youden index (j= .583). At this level 68% of inpatients and 81% of non-inpatient cases were correctly identified. Practical implications: Currently there is a national (UK) programme to radically reduce the amount of specialist inpatient care for people ID. This will necessitate early identification of individuals most at risk of admission together with investment in improved, proactive community services if admissions to a diminishing bed-base are to remain manageable. Originality/value: This study confirms the associations between mental health difficulties, challenging behaviour and specialist hospital admissions for people with ID, extending existing research by translating these findings into a clinically usable risk index

VegMachine.net. Online land cover analysis for the rangelands

VegMachine.net is an online land cover monitoring tool unded by the Fitzroy Basin Association (FBA). The tool focuses primarily on Queensland, but has functionality for much of Australia’s rangelands. The website went live in July 2016 and recently logged the 1000th user session. Users can view seven different seasonal time series of cover products across the landscape and interactively interrogate and graph ground cover change in six different on-the-fly and email delivered reports. Results can then be exported for use in other software. To date, users have generated over 400 VegMachine® FORAGE ground cover reports which provide paddock-by-paddock, landtype-by-landtype analysis of ground cover change from 1990 to the present. Detailed help is available in multiple formats, including website popups and a dedicated YouTube channel. The web application was designed for two main user groups; technically equipped RD&E personnel including those servicing land manager clients, and a subset of the grazier community willing to operate the service themselves. Initial rollout of the application focused primarily on training events for government agency, private consultancy and natural resource management (NRM) staff in regional Queensland. These users form the core of the current user base. In this paper, we outline the development of VegMachine.net. We demonstrate the primary functionality of the website, provide an overview of user experience including a case study and discuss major learnings and future directions

Identifying needs-based groupings among people accessing intellectual disability services

There is increasing emphasis on needs-led service-provision for people with intellectual disability (ID). This study outlines the statistical cluster analysis of clinical data from 1692 individuals accessing UK secondary care ID services. Using objective needs assessment data from a newly developed ID assessment tool, six clusters were identified. These had clinical face validity and were validated using six concurrently (but independently) rated tools. In keeping with previous studies, the clusters varied in terms of overall level of need as well as specific clinical features (autism spectrum disorder, mental health problems, challenging behaviors and physical health conditions). More work is now needed to further develop these clusters and explore their utility for planning, commissioning and optimizing needs-led services

Re-conceptualising the link between research and practice in social work: a literature review on knowledge utilisation

Despite the recent movement towards greater research use in many areas of social work, criticisms persist that decision making in practice is seldom informed by sound research evidence. Discourse about the research-to-practice gap in social work has tended to focus on the feasibility of evidence-based practice for the profession, but has rarely drawn from the broader knowledge utilisation literature. There are important understandings to be gained from the knowledge utilisation field, which spans more than six decades of interdisciplinary research.This article introduces the wider knowledge utilisation literature to a social work audience. It considers the potential of this body of literature to facilitate research use in social work, as well as conceptual issues that may be hindering it from informing improvements to research utilisation in practice

The Theosophical Society and its Subaltern Acolytes (1880-1986)

The Theosophical Society (est. 1875), and its associated texts have sometimes been characterized as counter-Orientalizing or only partially Orientalizing, in the sense of at least departing from "official" British-Indian Orientalism and providing a critique of that discourse. In somewhat the same vein, the society has also been characterized as playful, self-ironic and/or postmodernist, and/or as broadly reformist in not only an anti-colonial but also an anti-patriarchal and pro-or-protofeminist way. These approaches fail to grapple with the nature of the orientalism that was fundamental to the foundation of the TS, as well as the pronounced entrepreneurial and exploitative aspect of the cult, its strategic and emotional structuring, and the significance of its syncretizing and revitalizationist processes

Traditional Faculty: How Can We Help?

This handout is a blog entry by Dr. Alan Trevithick, originally posted on cryingliberalelite.blogspot.co

Traditional Faculty: How Can We Help?

This handout is a blog entry by Dr. Alan Trevithick, originally posted on cryingliberalelite.blogspot.co