It is suggested that impaired executive function in Down's syndrome is due to abnormal development of the prefrontal cortex in Down's syndrome. Tests of executive function may be sensitive to cognitive changes with the onset of dementia in people with Down's syndrome. Longitudinal studies examining changes in executive function in people with Down's syndrome are recommended.

This paper reports the results of the largest survey to date of the sexual abuse of adults with learning disabilities. Existing knowledge is reviewed in the light of complex methodological and definition issues that exist and limit any work undertaken. The few existing studies of sexual abuse of adults with learning disabilities are described. Details of the current survey of sexual abuse carried out by the University of Kent and funded by the Rowntree Foundation are then provided. Detailed results of the survey are presented followed by a discussion of their implications and comparability with previous research. 0952-9608/93/03 0193 -24 $1.80/0 MENTAL HANDICAP RESEARCH 0

This paper reports the results of the second part of the largest UK incidence survey to date of the sexual abuse of adults with learning disabilities. A mandate was sought from the relevant statutory agencies and a standard questionnaire filled in by service managers or practitioners for each casehncident reported which fitted the definitions and parameters of the survey. The results confirm the pattern of abuse which emerged from the earlier study, i.e. that both women and men are at risk, that perpetrators are predominantly men and usually known rather than strangers. One important difference was a significant increase in the proportion of cases, of abuse of men with learning disabilities reported. Despite the increase in awareness and sources of information about adult abuse, service agencies have not developed coordinated systems for reporting or recording instances of sexual abuse. Data collection continues to be patchy and ad hoc. The level of reporting has not changed but there is some evidence that people who had been victimised received more appropriate help. Devolution of services within a new mixed market of care requires that additional safeguards are put in place to protect vulnerable adults.

Background Personal health records were implemented with adults with learning disabilities (AWLD) to try to improve their health-care. Materials and Method Forty GP practices were randomized to the Personal Health Profile (PHP) implementation or control group. Two hundred and one AWLD were interviewed at baseline and 163 followed up after 12 months intervention (PHP group). AWLD and carers of AWLD were employed as research interviewers. AWLD were full research participants. Results Annual consultation rates in the intervention and control groups at baseline were low (2.3 and 2.6 visits respectively). A slightly greater increase occurred over the year in the intervention group 0.6 ()0.4 to 1.6) visits ⁄ year compared with controls. AWLD in PHP group reported more health problems at follow-up 0.9 (0.0 to 1.8). AWLD liked their PHP (92%) but only 63% AWLD and 55% carers reported PHP usage. Carers had high turnover (34%). Conclusions No significant outcomes were achieved by the intervention.

This paper aims to clarify the basis upon which sexual activity involving people with learning disabilities might be deemed to be abusive. It examines the acts which are committed, explores consent issues, looks at evidence and suggests a scheme for assessing potentially abusive relationships. Such a scheme is necessary for both researchers and practitioners if they are to report consistently and act to protect and support people with learning difficulties who have been the victim of sexual assaults. 0