Knowledge Library

The effect of different types of employment on quality of life

Background
Despite research that has investigated whether the financial benefits of open employment exceed the costs, there has been scant research as to the effect sheltered and open employment have upon the quality of life of participants. The importance of this research is threefold: it investigates outcomes explicitly in terms of quality of life; the sample size is comparatively large; and it uses an established and validated questionnaire.
Method
One hundred and seventeen people with intellectual disability (ID) who were employed in either open or sheltered employment by disability employment agencies were interviewed. Quality of life was assessed using the Quality of Life Questionnaire. After making an initial assessment to see whether the outcomes achieved depended on type of employment, quality of life scores were analyzed
controlling for participants’ level of functional work ability (assessed via the Functional Assessment Inventory).
Results
The results showed that participants placed in open employment reported statistically significant higher quality of life scores. When the sample was split based upon participants’ functional work ability, the type of employment had no effect on the reported quality of life for participants with a low functional work ability. However, for those participants with a high functional work ability, those in open employment reported statistically significantly higher quality of life.
Conclusions
The results of this study support the placement of people with ID with high functional work ability into open employment. However, a degree of caution needs to be taken in interpreting the results presented given the disparity in income levels between the two types of employment.

Towards the Prevention of Behavioural and Psychiatric Disorders in People with Intellectual Disabilities

Intervention for behavioural and psychiatric disorders in people with intellectual disabilities often only takes place once these conditions are well established and more resistant to change. As an alternative, this paper promotes a public health prevention model and maps out opportunities for intervention at primary, secondary and tertiary levels. The resulting model is partly derived from generic research into these issues and partly on specific evidence on interventions for people with intellectual disabilities; it also contains more theoretical considerations. The additional research that is necessary to demonstrate the efficacy of the interventions identified is also considered. Central to this proposal is a greater integration of issues for people with intellectual disabilities within much broader policy and research agendas.

Psychopharmacological treatment of challenging behaviours in adults with autism and intellectual disabilities: A systematic review

Introduction

Autism is a neurodevelopmental disorder with a high co-occurrence with intellectual disability. Adults with Autism and intellectual disability have a high incidence of challenging behaviour, defined as repetitive self injurious or aggressive behaviour. We underwent a systemic review of the evidence for treating challenging behaviours in adults with Autism and intellectual disability.

Methods

A literature search was conducted using three large databases to extract studies on the treatment of challenging behaviour among adults with Autism and intellectual disability. Papers, which met this criterion, were reviewed and analysed to assess study evidence and quality.

Results

Seven articles were selected which included five agents: fluvoxamine, sertraline, clomipramine, risperidone, and ziprasidone. Randomized control studies of fluvoxamine and risperidone, provided efficacy for the treatment of challenging behaviour in adults with Autism and intellectual disability. Open label trials of sertraline, clomipramine and ziprasidone were also effective in treating challenging behaviours for this population.

Discussion

Risperidone and fluvoxamine provided the best evidence for treating challenging behaviour, and risperidone was the only medication with multiple trials showing its efficacy. Further studies are required to demonstrate the efficacy of psychopharmacology in treating challenging behaviours among adults with Autism and intellectual disability.

Toilet training individuals with autism and other developmental disabilities: A critical review

The following article reviews the current literature addressing toilet training individuals with autism and other developmental disabilities. The review addresses programs typical to toilet training the developmental disability population, most of which are modeled after the original Foxx and Azrin [Azrin, N. H., & Foxx, R. M. (1971). A rapid method of toilet training the institutionalized retarded. Journal of Applied Behavior Analysis 4, 89–99; Foxx, R. M., & Azrin, N. H. (1973). Toilet training persons with developmental disabilities: A rapid program for day and nighttime independent toileting. Harrisburg, PA: Help Services Press] rapid toilet training methods. Components of such programs are isolated and described in their contribution to toilet training models. Studies are then reviewed and compared for participant and study characteristics. Individual studies validating toilet training programs are then discussed in light of their program components and efficacy. Shortcomings to currently available programs are highlighted and future areas of study are suggested.

The Benefits of Skinner’s Analysis of Verbal Behavior for Children with Autism

Behavior analysis has already contributed substantially to the treatment of children with autism,
and further gains can result from more use of Skinner’s analysis of language in Verbal Behavior
(1957) and in the resulting conceptual and experimental work. The approach emphasizes a unit
of analysis consisting of the relations between behavior, motivative and discriminative variables,
and consequences. Skinner identifies seven types of verbal operants—echoic, mand, tact,
intraverbal, textual, transcriptive, and copying a text—which function as components of more
advanced forms of language. This approach focuses on the development of each verbal operant
(rather than onwords and their meanings) and on the independent training of speaker and listener
repertoires. Five more specific contributions are described that relate to the importance of (a) an
effective language assessment, (b) mand training in early intervention, (c) establishing operations,
(d) an intraverbal repertoire, and (e) automatic reinforcement.