Effective Communication Related to Psychotic Disorganised Behaviour in Adults with Intellectual Disability and Autism

Abstract

Background: Adults with intellectual disability, autism, and psychotic symptoms display severe disorganisation, which affects their ability to communicate and to perform well-known tasks. They display an aggravated loss of ability to initiate interaction with their staff. Aims: The aim was to examine whether a set of chosen staff communication skills was effective related to psychotic disorganised behaviour and initiatives in the patients. Materials and methods: Three hundred and seventy sequences of dyadic staff and patient interactions were analysed. Thirty-four staff and four patients with intellectual disability, autism, and psychoses were included.Staff and patient interaction was observed by video camera in the natural settings. Two independent observers scored each category. Data were analysed using contingency tables and the significance level was computed using Chi-square analysis. Results: The probability of disorganised behaviour in the patients decreases significantly and the amount of initiatives increases significantly when the staff communicates effectively. The four main categories of staff communication have different effects upon the disorganised behaviour and initiatives from patients. Task sustenance was most effective on disorganised behaviour, whereas emotional support encouraged most patients' initiatives.

PTSD in adults with intellectual disabilities: stabilisation during inpatient stay

“…An emotional climate characterised by a low level of anger and aggression, and staff control, has been found to be favourable for psychotic patients in psychiatric ward (Friis, 1986), who are also vulnerable. The results from a previous study by Bakken et al (2008) indicate that the findings related to research on emotional climate are relevant for patients with severely impaired language skills and intellectual disability. On a practical level, it is important that the milieu therapists are able to identify and respond adequately when the patient presents with anxiety symptoms or aggression.…”

“…Effective staff communication may not be a specific intervention, but it is found to be a key element related to symptom relief in people with intellectual disabilities and severe mental illness (Bakken et al, 2008). The staff members caring for the patients in this study aimed at communication with a low level of EE; that is communicating with a low level of hostility, criticism, and emotional over-involvement (Smeby, 1998).…”

Appreciating the work of nurses caring for adults with intellectual disability and mental health issues

“…When nurses work effectively with people with ID and mental health issues they use advanced communication skills to gather the information, make sound clinical decisions and plan care and treatment (Bakken et al . ). Bakken et al.…”

“…Bakken et al. () stressed that ‘communication strategies that are considered effective seem to decrease with disorganised symptoms in intellectual (sic) disabled adults’ (p. 12). As revealed in the present study, nurses have to work hard at times to manage the diverse communication styles and linguistic limitations they are presented with.…”

“…When nurses work effectively with people with ID and mental health issues they use advanced communication skills to gather the information, make sound clinical decisions and plan care and treatment (Bakken et al 2008). Bakken et al (2008) stressed that 'communication strategies that are considered effective seem to decrease with disorganised symptoms in intellectual (sic) disabled adults' (p. 12). As revealed in the present study, nurses have to work hard at times to manage the diverse communication styles and linguistic limitations they are presented with.…”