Multi-agency working in support of people with intellectual disabilities

Acute service and disability service providers experiences of joint working to improve health care experiences of people with an intellectual disability compared to non-joint working: A mixed-method systematic review

Persons with intellectual disabilities require frequent access to acute services. Many also access disability services within the community. Reports and enquiries have highlighted the sub-optimal healthcare provided to this group when accessing healthcare in acute services. Joint working between acute and disability services has been identified as a measure to improve healthcare for this group. A mixed method systematic review was undertaken to explore current evidence of joint working between both service providers. Twelve publications were included, and the data were analysed using thematic analysis. Confusion around responsibility and limited training in acute services prevented joint working from occurring. Information-sharing is pivotal in promoting joint-working, but measures which facilitated it were not always used. Albeit acute services demonstrated a strong commitment to deliver quality care to those with intellectual disabilities. Much of the available research captures the experiences of staff in acute services. There is a paucity of research available exploring experiences of disability service providers.

Generic or specialist profession? Identifying social work in community learning disability teams

Purpose

– Social work is integral to community learning disability teams (CLDTs), however there is little research on how social workers discharge their statutory duties within them. The purpose of this paper is to report a study designed to describe what social workers do within a CLDT (anonymised as Maples). The question addressed is: what is the social work role in CLDTs and how is this accomplished?

Design/methodology/approach

– Ethnographic fieldwork was conducted in a CLDT in London during 2011/2012. This involved interviews of professionals and observations of “everyday” social work practice. Data were analysed using constructivist grounded theory.

Findings

– Social work practice in Maples could be categorised along five domains of practice, namely: case management, safeguarding, assessments, mental health practice, and duty. The accompanying professional activities within these domains are described in Table I, with a subsequent focus on the less researched domains of case management, assessment, and duty.

Originality/value

– This research is one of the few to delineate the professional activities of social workers within CLDT. By showing what professionals do, it has important implications for policy – example personalisation – and role effectiveness.

Supporting children with disabilities at school: implications for the advocate role in professional practice and education

PURPOSE

School settings are a common practice context for rehabilitation professionals; health advocacy is a common and challenging practice role for professionals in this context. This study explored how pediatric practitioners advocate for children with disabilities at school. Specifically, we examined everyday advocacy in the context of school-based support for children with disabilities.

METHOD

Our theoretical framework and methodological approach were informed by institutional ethnography, which maps and makes visible hidden social coordinators of work processes with a view to improving processes and outcomes. We included families, educators, and health/rehabilitation practitioners from Ontario. Of the 37 consented informants, 27 were interviewed and 15 observed. Documents and texts were collected from the micro-level (e.g. clinician reports) and the macro-level (e.g. policies).

RESULTS

Pediatric practitioners' advocacy work included two main work processes: spotlighting invisible disabilities and orienteering the special education terrain. Practitioners advocated indirectly, by proxy, with common proxies being documents and parents. Unintended consequences of advocacy by proxy included conflict and inefficiency, which were often unknown to the practitioner.

CONCLUSIONS

The findings of this study provide practice-based knowledge about advocacy for children with disabilities, which may be used to inform further development of competency frameworks and continuing education for pediatric practitioners. The findings also show how everyday practices are influenced by policies and social discourses and how rehabilitation professionals may enact change. Implications for Rehabilitation Rehabilitation professionals frequently perform advocacy work. They may find it beneficial to perform advocacy work that is informed by overarching professional and ethical guidelines, and a nuanced understanding of local processes and structures. Competency frameworks and education for pediatric rehabilitation professionals may be improved by: encouraging professionals to consider how their practices, including their written documents, may affect parental burden, (mis)interpretation by document recipients, and potential unintended consequences. Policies and texts, e.g. privacy legislation and the Diagnostic and Statistical Manual (DSM), influence rehabilitation professionals' actions and interactions when supporting children with disabilities at school. An awareness of the influence of policies and texts may enable practitioners to work more effectively within current systems when supporting individuals with disabilities.

The Characteristics of Local Support Systems, and the Roles of Professionals, in Supporting Families where a Mother has an Intellectual Disability

BACKGROUND

There might be a need for support for families where the mother has an intellectual disability, in order to counteract the effects of potential parental inadequacy and other detrimental aspects of the family situation. The purpose of this study was to describe how professionals characterized such support and the collaboration required.

MATERIALS AND METHODS

Focus group interviews involving 29 professionals were conducted and analysed using content analysis.

RESULTS

Five themes were identified: The roles and activities of the professionals involved; ways in which needs of support are identified; problems in identifying mothers with an intellectual disability; how professionals coordinate their support and work together; and the dilemma concerning legislative actions.

CONCLUSIONS

By identifying both fruitful and problematic aspects of professional support, the findings may be used to enhance future support. More efficient chains of information and improved inter-sector collaboration between professions may further enhance the support practices.