Making a difference for young people with learning disabilities: A model for inclusive counselling practice

The prevalence of mental health problems in young people with learning disabilities and the disability rights movement provide the background to this paper. The aims are to investigate the inclusivity of counselling; gain insight into inclusive practices; and put forward a model for inclusive counselling practice. Mixed methodology provides quantitative and qualitative data through a survey of counsellors (n = 396) and a series of semi‐structured interviews (n = 15). The results produce six indicators of inclusive counselling, which are used to build a model for inclusive counselling practice: proactive approach to inclusion; focus on building relationships; operationalising equal opportunities policies; inclusive initial assessments; adopting flexible and creative approaches to counselling; and training and awareness raising. The implications for research and practice are to acknowledge the exclusive nature of the profession and address the issue of inclusion through training, professional development and further research in the field. The model for inclusive counselling practice is put forward as a tool for auditing existing counselling provision and as guidance for counsellors and policy makers in increasing inclustion of young people with learning disabilities in mainstream counselling.     

Growing up with severe learning difficulties: A longitudinal study of young people and their families

The paper reports on a longitudinal study of young people with severe learning difficulties. Two types of comparison are made: changes between Time 1 and Time 2, and comparisons with the younger age group in the study. The young adults acquired considerably more self-help and communication skills between Time 1 and Time 2. They were less likely to require help with self care than the younger age group and their carers were less stressed. Parents' needs for additional service provision fell into three categories: information needs, help with communication and other skills, and practical help. The greatest need was for information. The main concerns of the mothers at Time 1 and Time 2 are documented. The young adults' preparation for leaving school, current day placements at Social Education Centres and employment prospects are discussed. It is concluded that there are few opportunities to move on to less sheltered environments.     

On the longevity of behavioral interventions for challenging behavior

The capacity for a treatment to maintain its effects over time may be the most critical component of behavioral interventions for challenging behavior as treatments that fail to persist are likely to be of little value to society. We reviewed the quality and quantity of different types of post-intervention data for the treatment of challenging behavior in studies published over the last 7 years. We found that for the majority of participants at least one measure of maintenance, fading, or follow-up was reported but with limited information regarding the quality of those measures. Reports of secondary variables related to post-intervention data (e.g., latency to measurement) were also uncommon. We discuss possible explanations for the paucity of post-intervention data, barriers to obtaining post-intervention data, strategies for obtaining these data, and implications for the external validity of behavioral interventions for challenging behavior. We provide recommendations for increasing the probability that post-intervention data are included in applied research on challenging behavior.     

Cognitive representation of challenging behaviour among staff working with adults with learning disabilities

Cognitive representations of illness have been identified as a determinant of therapeutic outcomes in a variety of health care settings. This paper describes the development of a Likert-type questionnaire to assess how the concept of challenging behaviour is cognitively represented in staff working with adults with learning disabilities. The Challenging Behaviour Representation Questionnaire (CBRQ) was theoretically derived, drawing on two existing measures: the Illness Perception Questionnaire (IPQ) and the Challenging Behaviour Attributions Scale (CHABA). Items for the questionnaire were generated from responses by 300 direct care staff. The questionnaire shows acceptable levels of internal and external reliability. The questionnaire has face validity and a measure of concurrent validity. There is evidence that challenging behaviour is cognitively represented in care staff in a multi-dimensional way, consistent with other studies in health psychology. This has implications for future staff training in this area.     

Writing program with word prediction for a young man with multiple disabilities: a preliminary assessment

This study assessed a writing program with word prediction, which completed the writing of a word and spoke it out only when there was certainty that such a word was the correct one. The assessment was carried out with a young man with multiple disabilities, who typically used a word-processing program without word prediction. The two programs were compared on the time required by the participant for writing general sentences, through a social validation assessment, and eventually a check on the participant's preference. Analysis showed the program with word prediction was significantly more effective in terms of the writing time, which was halved, and was deemed preferable by 40 raters (psychology students) involved in the social validation assessment and by the participant himself. Implications of the findings are discussed.     

Decreasing problem behavior associated with a walking program for an individual with developmental and physical disabilities

In the current investigation, a functional analysis suggested that positive reinforcement in the form of physical contact maintained the self-injurious behavior of a girl with developmental and physical disabilities. We used the information obtained from the functional analysis to develop a treatment for noncompliance with walking in which a therapist removed physical interaction following inappropriate behavior during walks.     

A developmental study of learning disabilities and memory

Seven-, ten-, and thirteen-year-old learning-disabled (LD) and non-learning-disabled (NORM) children were presented specially structured lists of 38 words each and tested for free recall. Each list contained only four semantically related words. Two of the four related words were presented contiguously (serial positions 9 and 10) and the other two words were spaced (serial positions 20 and 30). All children recalled disproportionately more adjacent words (item 9 or 10) than any other words. Spaced words (items 20 and 30) were less likely to be recalled by the younger children than by the older children and by the LDs than by the NORMS. These findings provided support for the distinction between automatic and purposive semantic processing. NORMs' recall was governed by purposive semantic processing to a greater extent than was LDs' recall. However, no group or age differences were observed in automatic semantic processing.     

The effects of self-monitoring on the procedural integrity of a behavioral intervention for young children with developmental disabilities

The effects of self-monitoring on the procedural integrity of token economy implementation by 3 staff in a special education classroom were evaluated. The subsequent changes in academic readiness behaviors of 2 students with low-incidence disabilities were measured. Multiple baselines across staff and students showed that procedural integrity increased when staff used monitoring checklists, and students' academic readiness behavior also increased. Results are discussed with respect to the use of self-monitoring and the importance of procedural integrity in public school settings.     

Comparison of behavioral intervention and sensory integration therapy on challenging behavior of children with autism

The current study used an AB crossover design to directly compare the effects of sensory integration therapy (SIT) and behavioral intervention (BI) on the challenging behavior of 10 participants with autism spectrum disorder. During the intervention phase, all participants received both treatments. Follow‐up probes were conducted 1 month following intervention for 4 participants implementing the more effective intervention. The results showed that BI successfully reduced challenging behavior to low‐ or near‐zero levels. In contrast, SIT resulted in higher and more variable rates of challenging behavior. One exception was noted for Participant 4 who engaged in a decreased level of challenging behavior during SIT. The findings are discussed in relation to implication for practice and future research.     

A cognitive-behavioral intervention program for students with special reading disabilities

Interaction among cognitive, meta-cognitive, and emotional factors seems to play a determining part in achievement behavior and especially in scholastic performance. In this study some preliminary results are presented of the implementation of a multidimensional cognitive-behavioral psychoeducational program especially designed for students with reading disabilities in which parents and teachers also take part. The aim of the program was to provide students with appropriate emotional and cognitive skills with which to address their learning problems. First results on the efficacy of the implemented program to 20 primary school boys and girls with special reading disabilities encourage research on management of learning problems with focus on cognitive and emotional aspects in which parents and teachers contribute. Research including a control group is necessary.     

Nonverbal learning disabilities: The syndrome and a case study

Presents the syndrome of nonverbal learning disabilities (NLD) and the model developed to encompass its complex manifestations. Included are the history of the development of the syndrome, the types of children in whom its principal features are manifest, the hypothesized neurological bases of the syndrome, and a test of its developmental dimensions. A case study with assessment results and treatment implications illustrates the clinical dimensions of the syndrome. General developmental and treatment implications of the NLD syndrome and the NLD model are also included.     

The effects of reinforcer choice on rates of challenging behavior and free operant responding in individuals with severe disabilities

A multielement design was used to evaluate the effects of three reinforcement conditions on the free-operant and challenging responses of two individuals with severe disabilities. Preference assessments identified three stimuli that could function as reinforcers for each participant. Reinforcers were delivered on a variable ratio schedule for a free-operant response. In the participant-selected condition, each reinforcer delivery consisted of placing an array of three different stimuli in front of the participant, who was allowed to select one. In the constant condition, each reinforcer delivery consisted of placing an array of three identical stimuli in front of the participant. Within each session the three stimuli were held constant, but varied across sessions. In the experimenter-selected condition, each reinforcer delivery consisted of an array of three identical stimuli being placed in front of the participant. Within each session, the three stimuli were presented in an order predetermined by the experimenter such that, on average, each stimulus was available every third reinforcer delivery. For both individuals, the participant-selected condition resulted in lower average rates of challenging responses and slightly higher average free-operant response rates. No differences in responding were noted between the constant condition and the experimenter-selected condition. © 1998 John Wiley & Sons, Ltd.     

Collateral effects of behavioral parent training on families of children with developmental disabilities and behavior disorders

We evaluated collateral effects of behavioral parent training (BPT) on families with children who have developmental disabilities and behavior disorders. We compared 18 BPT graduates to 18 similar families waiting for service. The BPT graduates reported significantly less (i) child behavior problems, (ii) disruption to child and family quality of life due to child problem behavior, and (iii) stress related to limits on family opportunities and child physical limitations, up to 5 years after discharge. On a self‐efficacy scale, the graduates reported being more effective child behavior change agents in not only stopping child problem behavior, but also in preventing new occurrences and teaching the child appropriate behavior. These results suggest that BPT has persistent beneficial effects on children and parents. The findings reflect the program's focus on teaching parents how to use functional assessment derived positive teaching strategies to replace child problem behavior. Copyright © 2002 John Wiley & Sons, Ltd.