Lynne Webber

Assessment of Financial Competence

The decision as to whether an individual requires an administrator to manage some or all of his or her financial affairs is ultimately a legal decision. According to Australian law, this decision must be in the best interests of the individual, and must also be “the least restrictive alternative”. The decision is usually based in part on reports or evidence provided by health-care professionals about the strengths and limitations of the person whose competence is in question. The problem is that currently in Australia there are no universally accepted definitions of financial competence, and no objective, uniform standards for assessing financial competence. The overall goal of the present study was to assess the validity and reliability of a measure of financial competence: the Financial Competence Assessment Inventory (FCAI). The FCAI demonstrated good reliability and validity when used with people with and people without cognitive impairment and was able to distinguish between people with and people without a financial administrator.

Assessing financial competence

Some people have cognitive impairments that may reduce their capacity to manage their own financial affairs. The legal decision to limit a persons right to manage his or her own finances depends, in part, on an assessment of financial competence. Currently, tribunals and courts may receive information from a variety of different sources (e.g., family members, general practitioner, psychologist, social worker etc.) and have to reconcile this information in order to make guardianship decisions. The first aim of this article is to critique contemporary methods, procedures and practices for assessing financial competence. The second aim is to suggest a standard assessment framework that could be employed by tribunals and courts to help them evaluate the status of a persons financial competence.

Dimensions of Financial Competence

Whether or not someone has the ability to look after his or her own financial affairs is one of the most common problems brought before courts and tribunals in Australia. At present, there is no agreed-upon objective standard for assessing financial competency. The aims of this study were twofold: (1) to clarify which financial skills and tasks are considered important to adults in the Australian community when assessing financial competence; and (2) to evaluate a model of financial competence proposed by Webber, Reeve, Kershaw and Charlton. Professional service providers and students judged the importance of 61 skills, tasks and characteristics related to financial competence. The results supported a 6-factor model of financial competence. The findings suggest that it is possible to identify agreed-upon criteria for financial competency and provide a first step towards the development of a valid scale of financial competency.

The Use of Restrictive Interventions in Victoria, Australia: Population Data for 2007-2008.

The once common use of restrictive interventions (the use of restraint and seclusion) for controlling the behaviour of people with an intellectual disability is now coming under greater scrutiny by government and community sector services. Questions are being raised with respect to the clinical efficacy and ethical appropriateness of such interventions (Allen, 2009; McVilly, 2009; Sturmey, 2009). In Victoria, Australia, the Senior Practitioner was established in 2007 by the Disability Act (2006) to protect the rights of people with a disability who are subjected to restrictive interventions or compulsory treatments, and who are in receipt of a disability service funded by the Department of Human Services’ Disability Service. Among other functions, the Senior Practitioner is mandated by the Disability Act (2006) to monitor and review the use of restrictive interventions in Victoria. All disability service providers who use restrictive interventions are required to register with the Senior Practitioner, appoint an Authorised Program Officer (APO) to monitor the use of these practices within their own service, and report the use of chemical and mechanical restraints and seclusion to the Senior Practitioner using the Restrictive Intervention Data System (RIDS). The data included in this paper summarise findings from the first 12 months of operation of the Office of the Senior Practitioner’s RIDS as collated at March 2009. The collection and analyses of these data are important because we know little about the prevalence of the use of restrictive interventions in disability services in Australia and, consequently, have a paucity of evidence to inform the development of policy and monitor practice. If similar data were systematically collected by other jurisdictions and shared in a comparable format, it would be possible to provide national benchmarking around the use of restrictive interventions. This information could assist in promoting and monitoring service quality as well as assist in decision making around the distribution of finite resources to support people who are most at risk of poor outcomes in relation to their health and well-being, and the denial of their human rights. Such crossjurisdictional benchmarking is commonly accepted in other areas of health and community services as an evidence-based mechanism to promote and monitor service quality (e.g., Australasian Rehabilitation Outcomes Centre, http://chsd.uow.edu.au/ aroc/; National Mental Health Seclusion & Restraint Project, http://www.nmhsrp.gov.au/c/mh). However, no such analysis and benchmarking is currently possible across disability services in Australia.

The content validity of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII) and its potential application in accommodation and day-support services for adults with intellectual disability

BACKGROUND The quality of support provided to people with disability who show challenging behaviour could be influenced by the quality of the behaviour support plans (BSPs) on which staff rely for direction. This study investigated the content validity of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII), originally developed to guide the development of BSPs for children in school settings, and evaluated its application for use in accommodation and day-support services for adults with intellectual disability. METHOD A three-round Delphi study involving a purposive sample of experienced behaviour support practitioners (n = 30) was conducted over an 8-week period. The analyses included deductive content analysis and descriptive statistics. RESULTS The 12 quality domains of the BSP-QEII were affirmed as valid for application in adult accommodation and day-support service settings. Two additional quality domains were suggested, relating to the provision of detailed background on the client and the need for plans to reflect contemporary service philosophy. Furthermore, the results suggest that some issues previously identified in the literature as being important for inclusion in BSPs might not currently be a priority for practitioners. These included: the importance of specifying replacement or alternative behaviours to be taught, descriptions of teaching strategies to be used, reinforcers, and the specification of objective goals against which to evaluate the success of the intervention programme. CONCLUSIONS The BSP-QEII provides a potentially useful framework to guide and evaluate the development of BSPs in services for adults with intellectual disability. Further research is warranted to investigate why practitioners are potentially giving greater attention to some areas of intervention practice than others, even where research has demonstrated these others areas of practice could be important to achieving quality outcomes.

Employment and intellectual disability: achieving successful employment outcomes

Publisher Summary This chapter reviews the research that has explored variables that can shape employment outcomes for people with an intellectual disability. The chapter focuses on determining employee success as measured by employer satisfaction and attempts to anchor this against satisfaction with employees without disabilities. The chapter provides an overview of the literature and research of immediate relevance at the macrosystem level, including changes in how “disability” has been understood in relation to the broader ecological context, and the prevailing belief system and culture in which employment, intellectual disability, and other forms of disability are embedded. The chapter focuses on research more directly predictive of successful employment outcomes of people with an intellectual disability, multiple disabilities, and other forms of disability. The chapter discusses the future directions for maximizing successful employment outcomes of people with an intellectual disability.

An Australian validation of the kaufman brief intelligence test (k-bit) with adolescents with an intellectual disability

Abstract The Kaufman Brief Intelligence Test (K-BIT; Kaufman & Kaufman, 1990) provides a relatively quick assessment of intelligence. In this study we assessed the validity and reliability of the K-BIT with an Australian sample of adolescents with an intellectual disability (N = 107). To examine criterion validity, K-BIT scores were correlated with scores on the Coloured Progressive Matrices (CPM; Raven, 1956; r = .52), and the Wechsler Intelligence Test for Children - Revised (WISC-R; Wechsler, 1974; r =.73-75). Test-retest and split-half reliability of the K-BIT were also examined (r = .93 and .88 respectively). Finally, item analyses examined the difficulty and discriminability of individual items. The results revealed that the K-BIT composite score in general provides a valid and reliable estimate of intelligence for Australian adolescents with an intellectual disability, but that a higher standard error estimate should be used in interpreting scores of the overall composite and Matrices scores of the...

Applying the CRPD to Safeguard the Rights of People with a Disability in Contact with the Criminal Justice System

People with disability and those who have complex needs are often at risk of offending. Until recently, there has been a paucity of research on how the rights of people with disabilities are safeguarded when they who come into contact with the criminal justice system, in terms of assessment, intervention and monitoring. Clinical practitioners need to be aware that they have a responsibility to safeguard the rights of people with disabilities. The ratification of the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD) and an associated Optional Protocol provide a way to examine these rights with the view of implementing them in day-to-day clinical practice and service delivery. In this article we use the CRPD framework to apply a human rights perspective to people with disabilities in the criminal justice system and illustrate its potential application on a case study of a person who was incarcerated.

Reliability and utility of the behaviour support plan quality evaluation tool (BSP-QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour

BACKGROUND Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II (BSP-QEII) was developed to monitor and assess BSPs prepared by teachers to support children with disability in the school system. This study investigated the application of the BSP-QEII to the assessment of BSPs for adults with ID in community support services. METHOD The inter-rater reliability of the BSP-QEII was assessed. The utility of the BPS-QEII was then investigated with reference to a time series study of matched pairs of BSPs, developed for the same clients over a period of approximately 3 years. Differences in plan quality measured across a number of service and systemic variables were also investigated. RESULTS The BSP-QEII was found to have good inter-rater reliability and good utility for audit purposes. It was able to discriminate changes in plan quality over time. Differences in plan quality were also evident across different service types, where specialist staff had or had not been involved, and in some instances where a statutory format for the plan had or had not been used. There were no differences between plans developed by government and community sector agencies, nor were there any regional differences across the jurisdiction. CONCLUSIONS The BSP-QEII could usefully be adopted as an audit tool for measuring the quality of BSPs for adults with ID. In addition to being used for research and administrative auditing, the principles underpinning the BSP-QEII could also be useful to guide policy and educational activities for staff in community based services for adults with ID.

Restraint and Seclusion of People on Compulsory Treatment Orders in Victoria, Australia in 2008–2009

In Victoria, people with an intellectual disability who have shown behaviour that is a significant risk of serious harm to others may be detained within government-funded disability accommodation by either a court or civil order. The aim of such orders is both to protect the public and at the same time provide treatment to the person with a disability, so that the person will be able to return to live more independently within the community. Little is known about the characteristics or use of restraint and seclusion with this particular group. Thus, the aim of this study was to examine this groups characteristics and compare the use of restraint and seclusion to other people with an intellectual disability who were subjected to restraint and seclusion, but not detained. The practice and policy implications of the results are discussed from an interdisciplinary perspective with recommendations for professionals working in the field.