Abstract
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 statistically significant 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.
Highlights
IntroductionIndividuals with intellectual disabilities are at a higher risk of developing behaviours that challenge (challenging behaviours) (18–22%) [1,2] including aggression to others, property, and self [3]
Individuals with intellectual disabilities are at a higher risk of developing behaviours that challenge (18–22%) [1,2] including aggression to others, property, and self [3]
All the relevant stakeholders were involved in the study, which included (a) adults with intellectual disabilities and their families; (b) support staff working with adults with intellectual disabilities in community settings and their service managers; (c) Community
Summary
Individuals with intellectual disabilities are at a higher risk of developing behaviours that challenge (challenging behaviours) (18–22%) [1,2] including aggression to others, property, and self [3]. Challenging behaviour poses a major management problem and is an obstacle to social integration, and it may lead to carer stress, community placement breakdown and hospitalisation, and the use of restrictive practices such as physical restraint and inappropriate use of medication. It is important to understand the reason behind them rather than use medication to sedate. A thorough person-centred assessment with multidisciplinary input is vital for a formulation leading to an appropriate person-centred support package that helps to improve the behaviour and the quality of life of the person with intellectual disabilities [4].
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