• Sex chromosome abnormalities in two state hospitals for patients requiring special security

      Casey, M. D.; Segall, L. J.; Blank, C. E. (1966)
      THE association between sex chromatin abnormality and mental sub-normality is well established. The incidence of sex chromatin abnormality in the new-born male and female population is about 0.2 per cent and 0.08 per cent respectively; in institutionalized mentally sub-normal male and female populations about 1 per cent and 0.4 per cent respectively. Court Brown1 reported that a high proportion of sex chromatin positive males recognized in his unit had been committed to a mental defective institution because of anti-social behaviour. He suggested that an abnormal sex chromosome complement might predispose to delinquency. However, a survey by Wegman and Smith2 on a group of socially disturbed males of relatively normal intelligence failed to show an increase in sex chromatin abnormality.
    • Interactions between adults with profound intellectual disability and staff

      Clegg, Jennifer (1991)
      Studied interaction between adults with intellectual disability and staff of special health service units. Study 1 varied 5 interactive strategies (e.g., talk, choice, social routine) with 9 Ss (aged 17–34 yrs; developmental age 1–9 mo). Results show that increased positive behavior from Ss was associated with staff talking with them and using social routines. No such increase was observed when staff made their responses contingent on Ss, a finding which was supported by the 2nd study carried out with 16 staff–client pairs (Ss aged 16–38 yrs; developmental age 3–25 mo). In this study no correlations were found between behavior during interaction and developmental age. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Friendship among adults who have developmental disabilities

      Clegg, Jennifer (1991)
      Investigated the difference between people with developmental disabilities who did or did not have peer-group friends. 28 adults with developmental disabilities attending day centers were interviewed. Those with a friend were significantly more likely to describe themselves positively on all dimensions and to describe themselves as nondisabled. Ss without a peer-group friend were similar to lonely people without disabilities on 2 of 3 factors explored. Qualitative analysis of Ss' descriptions of their friendships suggested that most Ss had relatively superficial relationships, since Ss used descriptive constructs that ordinarily apply to strangers. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • The analysis of talk sessions between staff and adults with profound intellectual disability

      Clegg, Jennifer (1991)
      Examined interactions between 20 adults (aged 16–38 yrs; developmental age 1–25 mo) with profound intellectual disability and staff of social services day centers, during sessions when the Ss' staff member talked with them. Results show that, in relatively ideal conditions, Ss responded positively during approximately one-third of session time; the staff were very responsive to changes in Ss' behavior; and Ss were most likely to respond negatively to changes in staff behavior, if they responded at all. No evidence of turn-taking between the interactors was found. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Motor disorder in severe mental handicap

      Jones, Jo (1991)
      In response to the D. Rogers et al (see record 1991-21389-001) finding that motor disorder is significantly associated with more severe mental handicap, the present author discusses the appropriateness of using the Dyskinesia Identification System: Condensed User Scale (R. L. Sprague and K. M. Shaw, 1989) with patients with mental handicaps. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Putting people first; a social constructionist approach to learning disability

      Clegg, Jennifer (1993)
      Moving from an individual to a social focus will allow clinical psychologists working with people who have learning disabilities to address a wider range of difficulties experienced by this client group. Social constructionist theory may be a useful framework to facilitate such an approach, and is intellectually compatible with changes occurring in other related disciplines. Research relevant to this perspective is reviewed under four subheadings proposed by Doise. Implications for clinical practice are discussed by reference to two case studies.
    • Epistemology and learning disabilities: Invited commentary on Hastings and Remington

      Clegg, Jennifer (1994)
      The effect on service provision of describing a variety of actions as challenging behaviour is discussed: it is suggested that studying stereotyped, aggressive and self-injurious acts in their own right has yielded more useful psychological debate, and ignoring such conceptual thinking leads to implicit theorizing where assumptions go unquestioned. Evidence for the relevance of staff actions on different topographies of client responses is critically reviewed, alongside discussion of the authors' rhetoric. The importance of adjusting language and frameworks to make room for alternative conceptualizations is discussed. The article concludes by recommending that research into staff attitudes and actions will be better served by reflexive methods and reporting which emphasize mutuality.
    • Attachment and learning disability: A theoretical review informing three clinical interventions

      Clegg, Jennifer (1995)
      Attachment theory makes sense of 2 phenomena observed in some people with learning disabilities: it provides a reason for their limited exploration of the world and it explains discontinuities in the pattern and intensity of their expressions of anger. Applying this framework to 3 enmeshed relationships occurring between an adult with learning disabilities and a member of care staff achieved at least partial resolution of their problems. All of the interventions yielded significant client change in 3 areas: reduction in anger and distress; increased exploration of physical and intellectual environments; and an increase in the range of people to whom the client relates. The following sequence of priorities for intervention are proposed for guidance: working with ambivalent carers, building a secure base, and enabling emotional development within the setting. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Striking the balance: A grounded theory analysis of staff perspectives

      Clegg, Jennifer (1996)
      Studied constraints and enablements experienced by direct care staff working with adults with profound learning disabilities, by means of the grounded theory form of qualitative analysis. Staff from 4 units of 19–49 yr old adults with profound learning disabilities described their relationships with particular clients during individual discussions. Issues arising from discussion were elaborated in subsequent individual and group meetings, evolving into an account of interactional aspects of professional care based on a core typology of relationships (Provider, Meaning-maker, Mutual and Companion). Analysis suggests that stable social environments which support relationship-building and the creation of meaning are important facilitators of staff–client contact. The authors offer 4 propositions about staff–client relationships and discuss their implications for clinical services. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Quality of life measures in a high security environment

      Robinson, David K.; Whyte, Lawrence; Fidler, Ian (1997)
      In 1995, Rampton Hospital was designated as the national centre for people with learning disabilities requiring secure care. Since then, the nursing research unit at Rampton Hospital has examined quality of care and patient satisfaction with some of this client group (Fisher 1994, Robinson 1996, Robinson and Reed 1996). This article reports the findings of an exploratory study to measure the quality of life for people with learning disabilities based on a study carried out at the Elwyn Community Learning Disability Unit in the United States.
    • A comparison of three approaches to delivering a speech and language therapy service to people with learning disabilities

      Money, Della (1997)
      This research aimed to compare three different approaches to delivering a speech and language therapy service to people with learning disabilities, in order to make recommendations for future service delivery. The three approaches all involved working with key communication partners in the environment. They were: (i) working directly on a one-to-one basis with the person and partner; (ii) working indirectly by providing teaching for partners; and (iii) a combination of these two approaches. A teaching course called 'Talkabout' was used. Talkabout aims for staff to reach a recognised level of knowledge and competence in communication skills, thus facilitating the communication skills of their service users. The results indicated that whilst communication changed in all three approaches, overall changes were greater in the combination approach. Only the combination approach demonstrated statistically significant differences following intervention, in terms of staff initiations, service user responses, and their use of additional modalities.;
    • What is 'special' about national health service residences for people with learning disabilities? An audit of residential needs

      Nesbitt, Sophie; Collins, Graham (1998)
      The results of this audit showed that the NHS residents tended to be more able, in terms of level of learning disabilities, however required greater help in managing challenging behaviour and mental health problems; whereas residents living in Partnership Housing Schemes tended to be less able in terms of learning disability, and they appeared to display less challenging behaviour. This study has gone a long way in trying to determine differences between the NHS and partnership scheme service provision. There are important differences, which are fundamental in definition in order to pay full consideration to which service provision benefits which service users most adequately. The establishment of these differences will assist in trying to determine the exact role and function of these units in comparison within the NHS service provision.
    • Sleep studies of adults with severe or profound mental retardation and epilepsy

      Hamilton, David S. (1998)
      Sleep patterns of people with mental retardation have received little research attention. This is an important gap in knowledge because understanding the relation between sleep and wakefulness may be critical to care provision. Descriptive sleep information on 28 people with severe or profound mental retardation and epilepsy was presented here. Sleep EEG data, studied both conventionally and by means of a neural network-based sleep analysis system suggest atypical sleep stages with significant depletion of REM sleep and a predominance of 'indiscriminate' non-REM sleep. Sleep diaries completed by caregivers reveal lengthy sleep period times, especially among those with profound mental retardation. Possible explanations for these results and their implications were discussed.
    • The use of ECT in intellectual disability

      Cutajar, Peter; Wilson, David N. (1999)
      The present survey examines the use of electroconvulsive therapy (ECT) by consultant psychiatrists working with people with intellectual disability in Trent Region, UK, which has a population of 4.7 million people. In the first phase of the study, all consultants in the area were sent a questionnaire to find out how many patients had been given ECT during the previous 5 years. Some 92% of the consultant psychiatrists returned the questionnaires. Eight patients were given a total of 122 ECTs, which is low when compared with the use of ECT by general adult psychiatrists. The second phase of the research involved a study of the individual medical case notes to obtain information about individual indications for ECT, outcome and consent issues. The commonest indication for ECT was depression, and the best response was obtained when the clinical picture was dominated by biological and/or psychotic symptoms.
    • Satisfaction for all: A framework for assessing life satisfaction for all people with learning disabilities

      Money, Della; Collins, Graham (1999)
      Most services for people with learning disabilities are accessed by service users with varying learning disabilities and communication needs. This article presents a framework for assessing life satisfaction for all people with learning disabilities. The framework is designed to be an all-inclusive service evaluation strategy, which embraces all service users, regardless of their abilities. It is a practical tool, for inter-disciplinary use, providing a starting point for service development. The survey is broadly divided into three sections, dependent on service user communication skills. These sections are described and examples discussed. The article concludes with future implications and recommendations for surveying the life satisfaction of people with learning disabilities.
    • Ethics and intellectual disability

      Clegg, Jennifer (1999)
      A shift in accepted practice regarding sharing research led one editor to discuss adopting a legal rather than a moral stance to enforce ethical standards. Familiar ethical concerns regarding consent and balancing individual rights against those of others are considered, alongside lacunae in the field, by drawing on virtue ethics. Reappraisals of quality of life, person-centered planning and normalization are discussed, concluding that developing ethical relationships with people who have intellectual disability takes precedence over client competency.
    • Alcohol problems and intellectual disability

      Wilson, David N. (1999)
      The present paper discusses some of the difficulties in working with people with an intellectual disability and an alcohol problem, and draws on the sparse literature about alcohol problems in people with intellectual disability. Four individuals drawn from the current clinical case loads of medical practitioners in UK community intellectual disability services are described. Some suggestions for staff training, patient education and health promotion, and therapeutic approaches are made.
    • Cognitive functioning in people with epilepsy plus severe learning disabilities: A systematic analysis of predictors of daytime arousal and attention

      Hamilton, David S. (1999)
      In spite of the high prevalence of epilepsy and the importance of preserving cognitive function in people with learning disabilities, this population has received relatively little research attention. This study sets out systematically to investigate possible predictive factors of inter-ictal states of arousal and attention. The daytime function of 28 people with epilepsy and severe learning disabilities was assessed by performance on a two-choice reaction time vigilance task, behavioural analysis of time-sampled video recordings taken in naturalistic settings, and carer ratings on visual analogue scales. This methodology yielded eight discrete functional measures, from which two further index measures were derived after principal components analysis. A range of clinical and psychosocial assessments was completed and subjects had 36 hour ambulatory EEG and sleep EEG monitoring. Regression models identified significant predictors of cognitive function from a range of potential explanatory variables i.e. demographic, clinical, pharmacological, background EEG rhythms and sleep parameters. Results indicated that greater severity of learning disability, longer bedtime periods, poor sleep efficiency, frequent seizures and antiepileptic drug polytherapy were significant predictor variables. Explained variance (adjusted R<sup>2</sup>) was greater than 50% for six of 10 outcome variables (range up to 85%). Furthermore, significant regression equations (P < 0.05) were obtained for all but one variable. Thus, these results appear reasonably robust. Results support an interactional model of daytime arousal and attention in people with epilepsy plus severe learning disabilities. Inter-ictal cognitive function appears to be mediated by a combination of organic, circadian (sleep wake), clinical and pharmacological factors.