Comprehensive Assessment of Triggers for Behaviours of Concern Scale (CATS): Initial Development

Unwin

Weaver

2022

IJERPH

Self Cite

Behaviours that challenge (BtC), such as aggression and self-injury, are manifested by many people with intellectual disabilities (ID). National and international guidelines recommend non-pharmacological psychosocial intervention before considering medication to address BtC. Support staff play a pivotal role in the prescription process. Using coproduction, we developed a training programme for support staff, called SPECTROM, to give them knowledge and empower them to question inappropriate prescriptions and ask for the discontinuation of medication if appropriate and instead look for ways to help people with ID when they are distressed without relying on medication. We have presented data from two focus groups that we conducted during the development of SPECTROM: one that included support staff, and another that had service managers and trainers. In these focus groups, we explored participants’ views on the use of medication to address BtC with a particular emphasis on the causes of and alternatives to medication for BtC. Along with the participants’ views, we have also presented how we have addressed these issues in the SPECTROM resources.

Section: Causes Of Btc and How Understanding Them Can Help The Person...mentioning

confidence: 99%

Causes of and Alternatives to Medication for Behaviours That Challenge in People with Intellectual Disabilities: Direct Care Providers’ Perspectives

Unwin

Weaver

2022

IJERPH

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“…), (7) Communication needs of the person with intellectual disabilities, (8) Effective engagement with and support for the person with intellectual disabilities, (9) Psychiatric disorders vs. challenging behaviour, (10) Physical disorders vs. challenging behaviour, (11) Autism Spectrum Disorder (ASD), and (12) Attention Deficit Hyperactivity Disorder (ADHD). SPECTROM also include many hyperlinked external resources and internal resources such as accessible psychotropic medication leaflets, Comprehensive Assessment of Triggers for behaviour of concern Scale (CATS) [ 23 ], and the Yellow Book, which is a patient/carer handheld health passport containing all relevant health related information in an accessible format that can be taken to a doctor’s clinics and hospital appointments. The core modules are delivered face-to-face/virtually through which the other modules are introduced.…”

Section: Resultsmentioning

confidence: 99%

Short-Term Psycho-Education for Caregivers to Reduce Overmedication of People with Intellectual Disabilities (SPECTROM): Development and Field Testing

Unwin

Woodcock

et al. 2021

IJERPH

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People with intellectual disabilities (PwID) are at a higher risk of developing challenging behaviours (CB). Despite the poor evidence for the effectiveness of medications in managing CB, they are used widely among PwID (50–63%). The aims of our study were to develop a training programme, SPECTROM for support staff to help reduce overmedication in PwID and carry out field testing of SPECTROM including a process evaluation. We developed SPECTROM using the Experience-based co-design method that included four focus groups and a one-day co-design event. Twenty trainees received SPECTROM training. We used the Management of Aggression and Violence Attitudes Scale-Revised-Intellectual Disabilities (MAVAS-R-ID) and the Psychotropic knowledge questionnaire. A semi-structured interview and a feasibility questionnaire were used for process evaluation. SPECTROM website contains 14 modules, resources, and face-to-face training. MAVAS-R-ID scores showed change in staff attitude to ‘medication management’ domain was statistically significant (p < 0.05). Psychotropic knowledge questionnaire showed statistical post-training improvement in correct responses (p < 0.05). Process evaluation data showed that SPECTROM was acceptable, applicable, practical, and relevant to staff practice, and helped to improve self-reflection, knowledge, and support to PwID. SPECTROM is a useful training that helps to change the support staff’s attitude toward CB and improve their knowledge of psychotropic medications.

“…We developed the Comprehensive Assessment of Triggers for Behaviors of Concern Scale (CATS) within SPEC-TROM (Limbu et al, 2021). CATS has 333 examples of triggers for challenging behavior categorized under five primary contextual categories, (a) external environment, (b) internal environment, (c) expression of volition, (d) characteristics associated with IDD or ASD, and (e) specific activities/ events.…”

Section: Empowering Direct Care Staffmentioning

confidence: 99%

Training Direct Care Staff to Empower Adults with Intellectual Disabilities and Their Families to Reduce Overmedication

2023

Adv Neurodev Disord

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Objectives People with intellectual and developmental disabilities (IDD) and autism are subject to restrictive practices like physical restraint and the overuse of psychotropic medications for challenging behavior. People with disabilities and their families are often not involved in shared decision-making for prescription and other care planning, which may violate the UN Human Rights Charter. Methods One way of reducing overmedication is by empowering adults with IDD and their family caregivers to collaborate in the decision to use medications. SPECTROM (https://spectrom.wixsite.com/project), a training program for direct care workers, was developed to help reduce the overmedication of these people. This article presents ideas on how SPECTROM resources could empower adults with IDD and their families to influence their care decisions, including psychotropic prescribing. Results Information provided in 32 easy-read leaflets in SPECTROM on psychotropic medications can be used to improve shared decision-making involving people with IDD and their families. Similarly, the Yellow Passport, an easy-read health record, could help information sharing among care service providers, thus improving their health care. SPECTROM has one module devoted to effectively engaging with people with IDD to improve their communication and help them with their skills building. Conclusions Currently, very limited evidence exists on the effects of SPECTROM to empower individuals with IDD and their families in reducing psychotropic medications for challenging behaviors. In addition to the two pilot studies on SPECTROM from UK and Australia, further research is needed to explore the evidence supporting the above suggestions.