BACKGROUND:Policy initiatives emphasise the need for forensic community intellectual disability teams to reduce avoidable admissions and facilitate timely discharges from inpatient forensic services. These teams provide specialist risk assessment, psychiatric management, and rehabilitation for individuals with intellectual disabilities who have offended or are at risk of offending. AIMS:This paper describes the development and initial evaluation of a Forensic Community Intellectual Disability team in Norfolk. METHODS:A retrospective case-note review examined sociodemographic, clinical, and forensic characteristics of 58 patients managed in the first year. A clinical consensus method estimated avoided admissions. RESULTS:Patients were predominantly male, White British, mean age 37, with high rates of autism, mental illness, substance misuse, and self-harm risk. Common offences included violence, property, and sexual offences. Interventions resulted in 15 avoided hospital admissions. CONCLUSIONS:The team demonstrated that tailored community-based care can effectively manage forensic needs and reduce reliance on inpatient services.
The study explored dentists' perspectives and experiences providing dental care for children and adolescents with intellectual and developmental disabilities in India. A descriptive qualitative research approach was employed, utilising semi-structured interviews with dentists practicing in both urban and rural areas. The interviews were audio-recorded, transcribed, coded, and thematically analysed. The analysis resulted in four major themes: 1) the need to improve caregivers' awareness regarding dental care, 2) the need to improve caregiver support regarding dental care, 3) complexity in providing dental care and 4) the need to improve support for dentists. Challenges varied among rural and urban areas with dentists in rural areas facing difficulties due to lack of caregivers' awareness and cultural misconceptions. Raising caregivers' awareness and improving their motivation will go a long way to improve care, especially in rural areas. In addition, there is an urgent need to improve support for dentists and preparedness in terms of training and facilities.
Menopause affects every woman however those with an intellectual disability experience it earlier than the general population. Women with an intellectual disability also experience disparities in health services and information. Despite a recognised need, there are currently no established evidence-based education programmes to support women with an intellectual disability to prepare for menopause. This study aimed to develop, deliver and design a menopause education programme to women with an intellectual disability in the community setting. Additionally, the study aimed to identify any adaptions required within the programme and evaluation methods, to enhance its acceptability from the perspectives of women with an intellectual disability. A rapid review of menopause education programmes, alongside a public and patient involvement exercise informed the initial education programme design. An experimental study was conducted. The co-designed education programme was delivered to 6 groups of women with an intellectual disability. Participants completed a pre and post evaluation of their knowledge of menopause and participated in focused groups to determine the acceptability of the programme and any adaptions needed. Forty-three women participated in the six-week programme within the community setting. Knowledge of menopause was evaluated pre- and post-completion of the education programme and demonstrated improvement. Women reported feeling prepared to navigate menopause and the appreciation of being supported in a group setting. Some adaptions to the programme were noted. Menopause education plays a key role in preparing women with an intellectual disability for going through menopause. Menopause education for women with an intellectual disability is key to reducing the health and wellbeing impacts that menopause has on this population. Provision of education within supportive environments and delivered through active learning approaches has the potential to enhance the confidence and dignity of women with an intellectual disability going through menopause in the short term.
Menstrual hygiene management poses challenges for girls with intellectual disability, particularly when instruction is limited to informal or unsystematic approaches. This study examined the effectiveness of a structured instructional program targeting sanitary pad changing skills for girls with intellectual disability. A multiple-baseline-across-participants single-case design was implemented with three girls with intellectual disability and their mothers. Instruction in sanitary pad changing skills was delivered face-to-face during the intervention phase using Behavioral Skills Training, followed by a generalisation phase in which mothers supported skill implementation in natural settings. Artificial intelligence-generated visual materials were developed to aid instruction. Data were collected using researcher-developed observation forms and analysed through visual inspection of graphed data. Follow-up data were obtained two months following the intervention. Results indicated that all participants acquired the target skill, demonstrated generalisation, and maintained performance over time. Social validity findings indicated that mothers viewed the intervention positively.
This paper examines the experiences of family carers supporting their children and siblings with intellectual disabilities, autism, and co-occurring mental health conditions in, inpatient services. Carers’ relational knowledge of communication, sensory needs, and trauma histories is often excluded from care, reinforcing systemic power imbalances and legitimising coercive practices such as restraint and seclusion. Using four online community focus groups with twenty-seven carers, facilitated by lived experience co-researchers, thematic analysis revealed carers’ dual roles as relatives and advocates navigating institutional exclusion. Participants described how distress was misinterpreted and labelled as ‘ challenging behaviour ’, reinforcing institutional responses that perpetuated harm and cumulative relational trauma for both individuals and their families. Carers called for partnership, trauma-responsive cultures, and policy reform. In response, we propose the Carer-Inclusive Restrictive Practice Reduction (CIRP) Framework: a rights-based model embedding carer authority through recognition, reparation, reconnection, and reform to address epistemic injustice and advance collaborative, ethical mental health care.
Despite widespread recognition of the need for training programs for healthcare professionals on intellectual disability, it remains inconsistently integrated into medical and nursing curricula. This systematic review aims to explore how training programs addressing care for adults with intellectual disabilities are designed and evaluated to promote inclusive healthcare. A total of 19 studies published between 2007 and 2026 were included, mainly mixed-methods and quantitative pre-post intervention studies. Findings highlight a predominance of interventions focusing on knowledge, skills, and attitudes, while also identifying two additional dimensions-affects and vocation-as relevant yet underexplored. A key issue identified is the mismatch between targeted learning outcomes and the variables assessed, along with the limited use of validated evaluation tools. Results also suggest that direct interaction with adults with intellectual disabilities enhances learning outcomes. The study concludes with recommendations to improve the theoretical grounding, methodological rigor, and inclusiveness of future training programs.
Studies of the transition of disabled children to adult services suggest that family involvement is a key factor in promoting positive outcomes. Few studies, however, include parental perspectives on transition, or focus on adults with intellectual disability. This article identifies the preoccupations of a mother of an autistic man with intellectual disability as he moves from the family home to a residential setting. Drawing on an analysis of blog posts made over a period of 100 days, and a review of the wider literature, key challenges and opportunities for the residential setting and person moving from the family home, as well as for the parent, are identified. It is suggested that the effective transition of an autistic adult with intellectual disability to a residential setting is likely to involve support for parents, as well as support from parents. Recommendations for improving the parental experience of transition are made.
Individuals with intellectual disabilities encounter challenges in their sexual development. Addressing these challenges effectively requires comprehensive sexual education. The study aimed to evaluate the effectiveness of the Family Sexual Education Program (MT-ACEP) conducted with parents of adolescent with intellectual disabilities. This study was designed as a quasi-experimental design with pre- and post-test matched with a control group. A total of 20 participants were included in the experimental and 19 in the control group A criterion sampling method was employed. Independent samples t-test results revealed no significant difference between the mean pre-test scores of the experimental group (X̄ = 11.25) and the control group (X̄ = 12.42) on the knowledge level of parents at the pre-test (t = .973, p>.05). At the post-test stage, with the experimental group scoring significantly higher (X̄ = 24.22) compared to the control group (X̄ = 12.64) at the post-test (t = 8.07, p<.05). The effect size was determined as 2.58.
Our objective was to describe how distance to specialty clinics and availability of primary care providers affects health and service use for adults with Down syndrome in the United States. We used 2019 data from a cohort of Medicaid enrollees ≥18 years with Down syndrome. We identified specialty clinics and mapped distance from individual's zip codes. We created quantiles by distance and primary care provider density. Our cohort of 89,382 adults showed differences in health outcomes and costs by their geographic proximity to clinics and their access to primary care providers. After adjustment, mortality rates in Quartile III of distance to the specialty clinics were 1.16 times (95% CI: 1.00, 1.34) and Quartile IV was 1.27 times (95% CI: 1.08, 1.49) that of Quartile I. Hospitalization rates were quantitatively similar across groups. Ensuring equitable access to both primary and specialized care for adults with Down syndrome remains a significant challenge.
This retrospective cohort study assessed the risk of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in individuals with intellectual disabilities compared to those without. Using data from the Korean National Disability Registry and National Health Insurance Service, individuals over 40 who underwent health examinations in 2009 were followed until 2020. Cox proportional hazards models estimated hazard ratios (HRs) for dementia outcomes, adjusting for confounders. Over a mean 8-year follow-up, 161 dementia, 111 AD, and 22 VaD cases occurred among individuals with intellectual disabilities. Adjusted HRs for all-cause dementia, AD, and VaD were 5.75, 5.23, and 4.66, respectively, compared to those without intellectual disabilities. The risk was especially elevated among those aged 40-64 years (P for interaction <0.01). In conclusion, individuals with intellectual disabilities have a significantly higher risk of dementia, particularly at younger ages, highlighting the need for increased awareness and targeted healthcare strategies.
Virtual reality is increasingly recognized as a potential tool for motor rehabilitation in individuals with intellectual disabilities. However, its effectiveness in balance training has not been extensively examined. The current meta-analysis aims to evaluate the impact of virtual reality-based interventions on balance abilities in individuals with intellectual disabilities and examines key moderating factors. Twelve randomized controlled trials comprising 34 effect sizes were analyzed. The results indicate a moderate overall effect size (ES=0.551) of virtual reality training on balance improvement. Specifically, the intervention demonstrated a greater effect on static balance (ES=1.000) compared to dynamic balance (ES=0.380), suggesting that virtual reality interventions may be effective in improving balance ability. Furthermore, subgroup analyses revealed that participant age, intervention length, and frequency significantly influenced the outcomes, highlighting the importance of adapting virtual reality training to individual characteristics to maximize their effectiveness.
