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Mullins L, Scott V. A model for fostering community capacity to support adults with intellectual disabilities who engage in challenging behaviour: A scoping review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:1085-1106. [PMID: 35848498 DOI: 10.1177/17446295221114619] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Developmental support agencies support many adults with intellectual disabilities in the community. Unfortunately, these adults often exhibit high rates of challenging behaviour, which present significant pressures on these service providers. Agencies need to develop effective means of increasing their capacity to provide quality support. Previous systematic reviews found that training staff in positive behaviour supports can improve outcomes; however, the factors facilitating training's effects, long-term effectiveness, and outcomes for service users have yet to be determined. We conducted a scoping review of 98 journal articles and book chapters to develop a model for fostering capacity development drawing from Organizational Behaviour Management and Knowledge Translation theories. Some relevant factors include features of the inner and outer organizational contexts, training approaches (e.g., behavioural skills training & in-situ coaching), ongoing support and feedback. This model may lead to more effective and enduring treatment programs and improved support for adults with intellectual disabilities.
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Affiliation(s)
- Laura Mullins
- Department of Applied Disability Studies, Brock University, St Catharines, ON, Canada
| | - Victoria Scott
- Department of Applied Disability Studies, Brock University, St Catharines, ON, Canada
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Konstantinidou I, Dillenburger K, Ramey D. Positive behaviour support: a systematic literature review of the effect of staff training and organisational behaviour management. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2023; 69:29-44. [PMID: 36743321 PMCID: PMC9897795 DOI: 10.1080/20473869.2022.2123199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 06/18/2023]
Abstract
Positive Behaviour Support is an applied behaviour analytic system of support that is utilised in schools and in residential care settings for children and adults with disabilities who engage in challenging behaviour. Implementation fidelity depends on appropriate staff training and organisational behaviour management. A systematic literature review is reported that evaluated the evidence in relation to change in staff and service user behaviour and the impact of organisational behaviour management systems on effectiveness, generalization, and maintenance of these outcomes. Nine relevant articles were identified and analysed according to (1) the demographics of staff and residents and methods of staff training; (2) organisational behaviour management systems; (3) staff and service-user behavioural outcome measures; and (4) the methodological quality of the study. A combination of antecedent and consequence-based training strategies was used in the studies. Eight studies reported on the organisational behaviour management systems that were used, with five reporting on the responsibility of trainees to transfer their training to their untrained teams (pyramidal training). Although the studies reported on staff behaviour change following the training, only one of the studies reported significant increases of service user quality of life as a result of staff training and only two studies provided adequate methodological strength.
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Affiliation(s)
| | | | - Devon Ramey
- Centre for Behaviour Analysis, Queen’s University Belfast, Belfast, UK
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Martin A, Tyrrell S, Honey E, Rodgers J, Ingham B. What Promotes Transfer of Staff Training Related to Challenging Behavior Displayed by Adults With Intellectual Disabilities? JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Aisling Martin
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust Newcastle upon Tyne UK
- Newcastle University Newcastle upon Tyne UK
| | - Sophie Tyrrell
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust Newcastle upon Tyne UK
| | - Emma Honey
- Newcastle University Newcastle upon Tyne UK
| | | | - Barry Ingham
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust Newcastle upon Tyne UK
- Newcastle University Newcastle upon Tyne UK
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MacDonald A, McGill P, Murphy G. An evaluation of staff training in positive behavioural support. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:1046-1061. [DOI: 10.1111/jar.12460] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Anne MacDonald
- The Richmond Fellowship Scotland Glasgow & Tizard Centre; University of Kent; Canterbury UK
| | - Peter McGill
- Tizard Centre; University of Kent; Canterbury UK
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Antonsson H, Graneheim UH, Isaksson U, Åström S, Lundström MO. Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design. Issues Ment Health Nurs 2016; 37:734-743. [PMID: 27351080 DOI: 10.1080/01612840.2016.1189636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.
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Affiliation(s)
| | - Ulla Hällgren Graneheim
- b Umeå University , Department of Nursing , Umeå , Sweden , University West , Department of Health Sciences , Trollhättan , Sweden.,c University West , Department of Health Sciences , Trollhättan , Sweden
| | - Ulf Isaksson
- a University of Umeå , Department of Nursing , Umeå , Sweden
| | - Sture Åström
- b Umeå University , Department of Nursing , Umeå , Sweden , University West , Department of Health Sciences , Trollhättan , Sweden.,c University West , Department of Health Sciences , Trollhättan , Sweden
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Cox AD, Dube C, Temple B. The influence of staff training on challenging behaviour in individuals with intellectual disability: a review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2015; 19:69-82. [PMID: 25395332 DOI: 10.1177/1744629514558075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Many individuals with intellectual disability engage in challenging behaviour. This can significantly limit quality of life and also negatively impact caregivers (e.g., direct care staff, family caregivers and teachers). Fortunately, efficacious staff training may alleviate some negative side effects of client challenging behaviour. Currently, a systematic review of studies evaluating whether staff training influences client challenging behaviour has not been conducted. The purpose of this article was to identify emerging patterns, knowledge gaps and make recommendations for future research on this topic. The literature search resulted in a total of 19 studies that met our inclusion criteria. Articles were separated into four staff training categories. Studies varied across sample size, support staff involved in training, study design, training duration and data collection strategy. A small sample size (n = 19) and few replication studies, alongside several other procedural limitations prohibited the identification of a best practice training approach.
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Ntinas KM. Self-injurious behaviour, non-interventionism and practitioners' needs: Implications for training and managerial support. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2014; 18:238-248. [PMID: 24951492 DOI: 10.1177/1744629514538875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of the present article is to critically analyse the literature concerning the factors that lead to non-interventionism towards self-injurious behaviour (SIB) in the field of intellectual disability and to make recommendations for the development of practice. It emerges that the limited behaviour analytic skills of practitioners impede the implementation of behavioural interventions and allow SIB to persist. The implications for the development of in-service training and managerial support that would disseminate the implementation of behavioural interventions are briefly discussed.
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Campbell M, Robertson A, Jahoda A. Psychological therapies for people with intellectual disabilities: comments on a matrix of evidence for interventions in challenging behaviour. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:172-188. [PMID: 23106865 DOI: 10.1111/j.1365-2788.2012.01646.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/15/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Psychological therapies with a proven efficacy in the general population are being adapted for use with people who have intellectual disabilities in community settings. METHODS A systematic review of peer-reviewed literature published between 1980 and 2010 was carried out, to identify the evidence base for effective psychological interventions in challenging behaviour. Relevant databases were searched using applied key terms. Evidence was graded, according to the quality of the research. A best-evidence Matrix was produced to improve guidance for service providers and practitioners in the range, volume and quality of psychological interventions. RESULTS There is a limited amount of efficacy research that meets the most stringent standards of empirical evidence. CONCLUSIONS It is important to broaden the evidence base and consider the context of psychological interventions, alongside the values underpinning care and treatment.
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Affiliation(s)
- M Campbell
- School of Psychology & Neuroscience, University of St. Andrews, St. Andrews, Fife, UK
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Bigby C. Social inclusion and people with intellectual disability and challenging behaviour: a systematic review. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2012; 37:360-374. [PMID: 23002899 DOI: 10.3109/13668250.2012.721878] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Social inclusion is central to disability policies internationally. The high risk of social exclusion for people with intellectual disability is compounded for those with challenging behaviour. METHOD A systematic literature review examined how social inclusion of people with intellectual disability and challenging behaviour has been researched and operationalised in the empirical literature, and aimed to determine what evidence exists about the extent of social inclusion by people with intellectual disability and challenging behaviour. RESULTS A thematic analysis of the 14 papers identified that social inclusion has been poorly defined and measured, and that the little research that has occurred in respect of people with challenging behaviour has demonstrated their potential to be socially included. CONCLUSIONS Clearer conceptualisation of inclusion, and greater understanding of practices that support social inclusion and system level mechanisms, which ensure goals around inclusion gain prominence in funding and support plans, may address the neglect of this critical quality-of-life domain for people with challenging behaviour.
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Affiliation(s)
- Christine Bigby
- Department of Social Work and Social Policy, La Trobe University, Victoria, Australia.
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Power M, Jo Lavelle M. Qualifications of non‐nursing residential care staff in the Republic of Ireland. QUALITY IN AGEING AND OLDER ADULTS 2011. [DOI: 10.1108/14717791111163587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeIn response to the challenge of the ageing of societies and concerns over recruitment and quality of service delivery, many nations have introduced new educational and training pathways, as well as national standards that set a minimum qualification level for residential care staff. In Ireland, national standards were introduced in July 2009 and, against this backdrop this study aimed to explore the level of qualification held or being pursued by non‐nursing care staff.Design/methodology/approachAn email/postal survey was conducted.FindingsThis survey revealed that while vocational qualifications were most common, more than 50 per cent of care staff neither held nor were pursuing the minimum qualification set by the standards.Research limitations/implicationsWhile the introduction of standards may address this situation, the workforce appears currently ill‐prepared for increasing professionalisation. Moreover, given Ireland's poor economic circumstances, training or supports are likely to be limited, with the burden of training liable to fall on staff, undermining morale and increasing already tense industrial relations. Limitations of this study include variations in the roles of non‐nursing care staff, with many staff classified as “multi‐task” staff that perform a range of duties from personal care through to more general domestic duties and, in the context of a mixed economy of provision, the abundance of responses from the public sector relative to the private sector.Originality/valueNonetheless, this study provides a timely snapshot and a reference point for further research around the impact of standards on quality of care or workforce professionalisation and it will be of particular interest to policymakers, regulators, employers and care staff.
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Iacono T. Addressing increasing demands on Australian disability support workers. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2010; 35:290-295. [PMID: 21117885 DOI: 10.3109/13668250.2010.510795] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Teresa Iacono
- La Trobe University, Bendigo, Victoria 5442, Australia.
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Campbell M. Workforce development and challenging behaviour: training staff to treat, to manage or to cope? JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2010; 14:185-196. [PMID: 21062856 DOI: 10.1177/1744629510385624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Staff working directly with adults' challenging behaviours in learning disability services need to be very good at what they do. They also need to want to do the job. A theory-practice gap exists, however, between what is known about effective, evidence-based approaches and whether and how these are used in person-centred community services. Many frontline staff working with people with the most serious challenging behaviours do not have the skills to implement programmes to change behaviour. This discussion article reviews workforce development in the context of clinical and service guidelines and asks whether the legitimate purview of frontline staff is treating challenging behaviour, managing it or simply coping with it on a daily basis, whilst maintaining the best quality of life possible for service users.
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van Oorsouw WMWJ, Embregts PJCM, Bosman AMT, Jahoda A. Training staff serving clients with intellectual disabilities: a meta-analysis of aspects determining effectiveness. RESEARCH IN DEVELOPMENTAL DISABILITIES 2009; 30:503-511. [PMID: 18809296 DOI: 10.1016/j.ridd.2008.07.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Accepted: 07/27/2008] [Indexed: 05/26/2023]
Abstract
The last decades have seen increased emphasis on the quality of training for direct-care staff serving people with intellectual disabilities. Nevertheless, it is unclear what the key aspects of effective training are. Therefore, the aim of the present meta-analysis was to establish the ingredients (i.e., goals, format, and techniques) for staff training that are related to improvements of staff behaviour. Our literature search concentrated on studies that were published in a period of 20 years. Fifty-five studies met the criteria, resulting in 502 single-subject designs and 13 n>1 designs. Results revealed important information relevant to further improvement of clinical practice: (a) the combination of in-service with coaching-on-the-job is the most powerful format, (b) in in-service formats, one should use multiple techniques, and verbal feedback is particularly recommended, and (c) in coaching-on-the-job formats, verbal feedback should be part of the program, as well as praise and correction. To maximize effectiveness, program developers should carefully prepare training goals, training format, and training techniques, which will yield a profit for clinical practice.
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Affiliation(s)
- Wietske M W J van Oorsouw
- Radboud University Nijmegen and Amarant, Behavioral Science Institute, Department of Special Education, PO Box 9104, 6500 HE Nijmegen, The Netherlands.
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Campbell M, Hogg J. Impact of Training on Cognitive Representation of Challenging Behaviour in Staff Working with Adults with Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2008. [DOI: 10.1111/j.1468-3148.2008.00436.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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