Edith Matheson

An Evaluation of the Impact of a One-Day Challenging Behaviour Course on the Knowledge of Health and Social Care Staff Working in Learning Disability Services

The present study evaluates the impact of a one-day challenging behaviour course on the knowledge of59 staff (20 health, 20 social care, 19 day care) as compared with a control group (n = 73). The study found that training led to a significant increase in knowledge in the trained group on all factors but one. This was the identification of the main factors important in responding to challenging behaviour. In relation to this, staff appeared to identify only those factors either which would clearly be within their remit or which they would be more likely to use in their daily work, e.g. health staff identifying psychological approaches, day care and residential staff identifying reactive strategies. Gains in knowledge were found to be similar in those groups followed up immediately, 3–6 months and6–12 months after training. No significant differences in scores between baseline and follow-up were found for the group who had not received training.

An Examination of the Severe Impairment Battery as a Measure of Cognitive Decline in Clients with Down's Syndrome

The present study examined the validity of the Severe Impairment Battery (SIB) as a tool for measuring cognitive decline in clients with Downs syndrome. Two groups participated: 10 clients who showed behavioural decline over at least a 2 year period as measured by the Vineland Adaptive Behaviour Scales, and 14 clients who showed no decline on this measure over the same period. No differences were found between the two groups in relation to health or life factors which may have impacted on functional and cognitive decline. The deteriorating group were found to be significantly older than the non-deteriorating group. The comparison of the SIB scores indicated that the deteriorating group showed a significant decline between baseline and 12 months and baseline and 24 months on the orientation factor. By contrast, for the non-deteriorating group, significant increases were found for praxis, orientating to name and total scores.

Health and social care staff responses to working with people with a learning disability who display sexual offending type behaviours

Abstract This study found that 59% of social care staff were currently supporting a client with a learning disability who had offended or displayed an offending type behaviour. The range of behaviours was similar to that displayed by clients in a secure health facility and included rape, sexual assault and exposure. Only 22.9% of social care staff had received training in this area, while none of the health staff had. Both groups expressed low levels of confidence in supporting this client group. The areas of difficulty were common to both groups and included personal attitudes and attitudes of others to the behaviour, and concerns over risk, responsibility and safety. In respect of attitudes, social care staff were found to be significantly more likely to hold negative attitudes towards the persons behaviour, while health staff were significantly more likely to feel negatively towards the person. Health staff were significantly more likely to identify training as a means of further support, while social care staff identified professional input. Both groups identified the need for theoretical training about working with this client group. Despite this no significant differences were found between those who had and had not received training and confidence, attitudes and the need for further support.

Health and social care workers' knowledge and application of the concept of duty of care

This study used vignettes to examine the understanding and application of the concept of duty of care by health and social care staff working in learning disability services, and the relationship of this to promoting client choice. The study found that health care staff had a significantly broader understanding of the concept of duty of care than social care staff, and were significantly more likely to emphasise client safety. Implications of the findings are discussed.

Knowledge of learning disabilities: the relationship with choice, duty of care and non-aversive approaches

The present study examines the relationship between the knowledge of the diagnostic criteria for a learning disability (based on DSM IV criteria), care practices and experience in health care and social care staff. Responses to a questionnaire were analysed in terms of participants emphasis on: recognizing duty of care; enabling choice; non-aversive and aversive strategies. Results indicated that the knowledge of the criteria for a learning disability was limited, with only I6% of the sample correctly identifying all three criteria. There were no significant differences between the two groups in relation to experience or level of knowledge. No clear cut differences were found between the groups in relation to tendency to emphasize a particular management approach, with the strategies adopted appearing to be influenced by vignettes used in this study. Participants tended to give responses that identified both a recognition of their duty of care to clients and the need to enable choice. Limitations of this study are discussed.