Information was collected on the social networks of 500 adults with mental retardation receiving different types of residential supports. Results indicated that (a) the reported median size of participants' social networks (excluding staff) was 2 people; (b) 83% of participants were reported to have a staff member; 72%, a member of their family; 54%, another person with mental retardation; and 30%, a person who did not fit into any of these categories in their social network; (c) variation in the size and composition of participants' social networks was associated with a range of variables, including the personal characteristics of residents (age, autism, ability, and challenging behavior), the type of previous and current accommodation, staffing ratios, institutional climate, and the implementation of "active support."
Developmental prosopagnosia (DP) is a cognitive condition characterised by a severe deficit in face recognition. Few investigations have examined whether impairments at the early stages of processing may underpin the condition, and it is also unknown whether DP is simply the "bottom end" of the typical face-processing spectrum. To address these issues, we monitored the eye-movements of DPs, typical perceivers and "super recognizers" (SRs) while they viewed a set of static images displaying people engaged in naturalistic social scenarios.Three key findings emerged: (1) individuals with more severe prosopagnosia spent less time examining the internal facial region, (2) as observed in acquired prosopagnosia, some DPs spent less time examining the eyes and more time examining the mouth than controls, and (3) SRs spent more time examining the nose -a measure that also correlated with face recognition ability in controls. These findings support previous suggestions that DP is a heterogeneous condition, but suggest that at least the most severe cases represent a group of individuals that qualitatively differ from the typical population. While SRs seem to merely be those at the "top end" of normal, this work identifies the nose as a critical region for successful face recognition.Keywords: prosopagnosia, super recognizers, face recognition, eye movements, individual differences. Eye Movements and Face Recognition 3Eye-Movement Strategies in Developmental Prosopagnosia and "Super" Face Recognition Prosopagnosia is a neuropsychological disorder characterized by a failure to recognize familiar faces. While some individuals acquire the condition following neurological trauma (e.g. Damasio, Damasio, & Von Hoesen, 1982), it is thought that approximately two per cent of the population have developmental prosopagnosia (DP: Bennetts, Murray, Boyce, & Bate, under review for this review; Bowles et al., 2009). This form of the disorder has been attributed to a failure to develop the visual recognition mechanisms necessary for successful face recognition, despite intact low-level visual and intellectual functions (Susilo & Duchaine, 2013). Interestingly, there also appears to be a genetic component to the condition in at least some individuals (Duchaine, Germine, & Nakayama, 2007; Grueter et al., 2007).Due to considerable difficulties hindering early diagnosis of face recognition difficulties, it is essentially impossible to distinguish the former, developmental, from the latter, congenital, form of prosopagnosia. For the purpose of this paper we are thus referring to all types of prosopagnosia unrelated to known neurological trauma and without concomitant disorders known to affect face processing as "developmental".A multitude of work with both healthy and impaired participants has contributed to cognitive neuropsychological theories of face recognition, such that it is generally accepted that the process consists of a series of sequential stages that can selectively be damaged by neurological trauma (e.g. Bruce & Young, ...
Aspects of the treatment and management of challenging behaviour were investigated among 500 adults with intellectual disabilities receiving various forms of residential supports. The present results indicated that: (1) 53% of participants were reported to have shown at least one ‘moderately serious’ or ‘severe’ form of challenging behaviour in the previous month; (2) the most commonly employed management strategies were physical restraint (used with 44% of people showing challenging behaviour), sedation (35%), seclusion (20%) and mechanical restraint (3%); (3) the most commonly employed ‘treatment strategies’ were goal setting within individual programme plans (used with 62% of people showing challenging behaviour), antipsychotic medication (49%), written intervention programmes (23%) and written behaviourally orientated intervention programmes (15%); and (4) factors identified through logistic regression analyses to be associated with the use of specific treatment and management strategies included personal characteristics of the person with intellectual disabilities (e.g. age and diagnosis of autism), resources (e.g. type of accommodation, cost of provision and staffing levels), the organization of resources (e.g, planning of support to residents) and the nature of the challenging behaviour (e.g. more sustained episodes of challenging behaviour).
Information was collected on 63 adults in supported living residences, 55 adults in small group homes, and 152 adults in large group homes. Results indicated that (a) there were no statistically significant differences in service costs once these had been adjusted to take account of participant characteristics; (b) compared with participants living in small group homes, those in supported living residences had greater choice, participated in more community-based activities, experienced fewer scheduled activities, were more likely to have had their home vandalized, and were considered at greater risk of exploitation; (c) compared with participants living in large group homes, those in small group homes had larger social networks, more people in their social networks who were not staff, not family, and did not have mental retardation. These residents were considered at less risk of abuse.
Background Non-suicidal self-injury (NSSI) describes a phenomenon where individuals inflict deliberate pain and tissue damage to their bodies. Self-injurious behaviour is especially prevalent across the autism spectrum, but little is understood about the features and functions of self-injury for autistic individuals without intellectual disability, or about the risk factors that might be valuable for clinical usage in this group. Methods One hundred and three autistic adults who responded to an online advertisement were classified as current, historic or non-self-harmers in accordance with responses to the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT). Multinomial regression aimed to predict categorisation of participants in accordance with scores on tests of autistic traits, alexithymia, depression, anxiety, mentalising and sensory sensitivity. Linear regression examined relationships between these predictors and the range, frequency, lifetime occurrence and functional purposes of NSSI. Qualitative analysis explored the therapeutic interventions that participants had found helpful, and what they wished people understood about self-injury. Results Current, historic and non-self-harming participants did not differ in age, age at diagnosis, male-to-female ratio, level of employment or education (the majority qualified to at least degree level). The most common function of NSSI was the regulation of low-energy affective states (depression, dissociation), followed by the regulation of high-energy states such as anger and anxiety. Alexithymia significantly predicted the categorisation of participants as current, historic or non-self-harmers, and predicted use of NSSI for regulating high-energy states and communicating distress to others. Depression, anxiety and sensory-sensitivity also differentiated participant groups, and sensory differences also predicted the range of bodily areas targeted, lifetime incidence and frequency of NSSI. Sensory differences, difficulty expressing and identifying emotions also emerged as problematic in the qualitative analysis, where participants expressed the need for compassion, patience, non-judgement and the need to recognise diversity between self-harmers, with some participants perceiving NSSI as a practical, non-problematic coping strategy. Conclusions Alexithymia, depression, anxiety and sensory differences may place some autistic individuals at especial risk of self-injury. Investigating the involvement of these variables and their utility for identification and treatment is of high importance, and the voices of participants offer guidance to practitioners confronted with NSSI in their autistic clients. Electronic supplementary material The online version of this article (10.1186/s13229-019-0267-3) contains supplementary material, which is available to authorized users.
Previous studies have reported that the rate of prescription of antipsychotic medication for people with intellectual disability is far in excess of the expected prevalence of psychoses for this population. Recent research identifying factors which predict the use of psychotropic medication suggests that challenging behaviour may play a key role in determining the receipt of antipsychotic medication. The present study reports the prevalence of psychoactive medication receipt for 500 people with intellectual disability living in different forms of residential provision in the UK. Variables which predict the receipt of psychotropic medication are also identified. The results show differences between forms of residential provision in rates of medication receipt. Analyses of predictors of psychotropic medication receipt suggest that, whilst the receipt of antidepressants is predicted by symptoms of mental ill health, the receipt of both antipsychotics and hypnotics/anxiolytics is predicted by variables related to challenging behaviour.
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