Accessible summary• We talked to some men with learning disability about sex and relationships. Some people lived in the community, and some people lived in hospital. • The men knew quite a lot about sex. Most people said they got good support from their keyworkers. • Some people were asked for sex when they did not want it. Some people were made to have sex that was not safe. • We have some ideas about how men with learning disabilities can speak up for themselves about sex and relationships. SummaryWe aimed to explore in detail the sexual lives and behaviour of men with mild learning disabilities living both in community and in secure hospital settings. We wanted to generate hypotheses about them and identify potential unmet needs. We used a narrative interview that focused on areas such as relationships, sex education, contraception and the attitudes of others towards the participants' sexual lives and orientation. We used the constant comparative method to analyse transcribed interviews. Several clients reported engaging in unsafe practices despite being aware of the risks. Participants generally felt that services had shifted from a paternalistic to a more supportive approach towards their sexual lives and orientation. Experiences with other men were commonly reported. Several participants reported being pressurised into sex as adults. In our sample, sexual knowledge did not lead to safe sexual practices. The good rapport with services reported by the participants may be utilised to provide further education and empowerment to improve the safety of sexual practices in this group. Other ways of improved service delivery are suggested.
Associations between fetal alcohol syndrome (FAS) and other conditions have been reported, but the links between FAS and autistic spectrum disorders (ASD) remain unclear. This study explored the relationship between FAS and ASD in individuals attending a specialist diagnostic clinic. Consecutive referrals over 24 months to a specialist neurodevelopmental clinic were evaluated using gold standard methods for FAS diagnosis and ASD. The first 18-month cohort who met criteria for ASD were compared with controls attending the same clinic but who had not experienced prenatal alcohol exposure (nested data). Data for the whole group were also collected. Twenty-one fetal alcohol spectrum disorder (FASD) individuals were assessed and 16 (72%) met ICD-10 criteria for childhood autism. Further significant differences between the prenatally exposed and non-exposed group with ASD were found in the nested study. The research shows an association between heavy prenatal alcohol exposure and ASD. As this is a small sample in a specialist clinic, the study suggests that a larger, more population-based study of those exposed to heavy prenatal alcohol is warranted.
Purpose Despite being largely supportive of their sibling with an autism spectrum disorder (ASD), some siblings without ASD also feel the effects of the disorder particularly in relation to challenging behaviour and lack of empathy. The purpose of this paper is to explore the experiences adults who have a sibling with ASD and intellectual disability (ID) with challenging behaviour. Design/methodology/approach Interviews were conducted with 11 capacitous adult siblings of service users who have ASD and ID as well as a history of challenging behaviour. A modified version of the autism Parenting Stress Index was used to assess the impact on those siblings. thematic analysis was utilised to analyse their responses. Findings Four main themes emerged from the interviews, which highlighted that challenging behaviour can cause emotional losses and can impact upbringing and the sibling relationship. Despite the siblings making adjustments, they continue to have concerns for the future. Originality/value Chronic challenging behaviour can impact on siblings, and it is important to support entire families, and not exclusively parents.
Individuals with an intellectual disability form a significant minority in the Irish prison population and worldwide prison populations. There is growing recognition that specialist services for such individuals are in need of development. In this paper, we propose a care pathway for the management of individuals with an intellectual disability who present in prison, based on expert elicitation and consensus. Methods A convenience sample of professionals with a special interest in forensic intellectual disabilities were invited to participate in a Delphi exercise. Twelve agreed to participation and 10 subsequently completed the study (83.3%). Expert views were elicited using a semi-structured questionnaire. Content analysis was completed using NVivo 11 software. A care pathway was subsequently proposed, based on the outcomes of the analysis, and circulated to participants for debate and consensus. A consensus was reached on management considerations. Findings Ten experts across a range of disciplines with a combined experience of 187 years participated in the study. Current provision of care was seen as limited and geographically variable. The vulnerability of prisoners with intellectual disability was
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