Evaluation of a treatment program for individuals with an intellectual disability who have high risk behaviours

In the past two decades numerous programs have emerged to treat individuals with developmental disabilities who have sexual offending behaviours. There has, however been very few studies that systematically examine the effectiveness of long term treatment with this population. The present research examines the therapeutic outcomes of a multi-modal behaviour approach with six individuals with intellectual disabilities previously charged with sexual assault. The participants also exhibited severe behavioural challenges that included verbal aggression, physical aggression, destruction and self-injury. These six participants (5 males, 1 female) were admitted to a Long Term Residential Treatment Program (LTRTP), due to the severity of their behaviours and due to their lack of treatment success in other programs. Individualized treatment plans focused on the reduction of maladaptive behaviours and the enhancing of skills such as positive coping strategies, socio-sexual knowledge, life skills, recreation and leisure skills. The treatment program also included psychiatric, psychological, medical, behavioural and educational interventions. The participants remained in the Long Term Residential Treatment Program (LTRTP) program from 181 to 932 days (average of 1.5 years). Pre and post treatment evaluations were conducted using the following tools: frequency of target behaviours, Psychopathology Inventory for Mentally Retarded Adults (PIMRA), Emotional Problems Scale (EPS), Socio-Sexual Knowledge and Attitudes Assessment Tool (SSKAAT-R) and Quality of Life Questionnaire (QOL-Q). Recidivism rates and the need for re-hospitalization were also noted for each participant. By offering high levels of individualized interventions, all six participants showed a 37 % rate of reduction in maladaptive behaviours with zero to low rates of inappropriate sexualbehaviour, there were no psychiatric hospitalizations, and there was no recidivism for 5 of 6 participants. In addition, medication was reduced. Mental health scores on the PIMRA were reduced across all participants by 25 % and scores on the Quality of Life Questionnaire increased for all participants by an average of 72 %. These findings add to and build upon the existing literature on long term treatment benefits for individuals with a intellectual disability who sexually offend. By utilizing an individualized and multimodal treatment approach to reduce severe behavioural challenges, not only can the maladaptive behaviours be reduced, but adaptive behaviours can be increased, mental health concerns can be managed, and overall quality of life can be improved.

The effects of plants(Typha Latifolia)and root-bed medium on the treatment of domestic sewage within a vertical flow constructed wetland /

The effect that plants {Typha latifolia) as well as root-bed medium physical and chemical characteristics have on the treatment of primary treated domestic wastewater within a vertical flow constructed wetland system was investigated. Five sets of cells, with two cells in each set, were used. Each cell was made of concrete and measured 1 .0 m X 1 .0 m and was 1.3 m deep. Four different root-bed media were tested : Queenston Shale, Fonthill Sand, Niagara Shale and a Michigan Sand. Four of the sets contained plants and a single type of root-bed medium. The influence of plants was tested by operating a Queenston Shale set without plants. Due to budget constraints no replicates were constructed. All of the sets were operated independently and identically for twenty-eight months. Twelve months of data are presented here, collected after 16 months of continuous operation. Root-bed medium type did not influence BOD5 removal. All of the sets consistently met Ontario Ministry of Environment (MOE) requirements (<25 mg/L) for BOD5 throughout the year. The 12 month average BOD5 concentration from all sets with plants was below 2.36 mg/L. All of the sets were within MOE discharge requirements (< 25 mg/L) for suspended solids with set effluent concentrations ranging from 1.53 to 14.80 mg/L. The Queenston Shale and Fonthill Sand media removed the most suspended solids while the Niagara Shale set produced suspended solids. The set containing Fonthill Sand was the only series to meet MOE discharge requirements (< Img/L) for total phosphorus year-round with a twelve month mean effluent concentration of 0.23 mg/L. Year-round all of the root-bed media were well below MOE discharge requirements (< 20mg/L in winter and < 10 mg/L in sumnner) for ammonium. The Queenston Shale and Fonthill Sand sets removed the most total nitrogen. Plants had no effect on total nitrogen removal, but did influence how nitrogen was cycled within the system. Plants increased the removal of suspended solids by 14%, BOD5 by 10% and total phosphorus by 22%. Plants also increased the amount of dissolved oxygen that entered the system. During the plant growing season removal of total phosphorus was better in all sets with plants regardless of media type. The sets containing Queenston Shale and Fonthill Sand media achieved the best results and plants in the Queenston Shale set increased treatment efficiency for every parameter except nitrogen. Vertical flow wetland sewage treatment systems can be designed and built to consistently meet MOE discharge requirements year-round for BOD5, suspended solids, total phosphorus and ammonium. This system Is generally superior to the free water systems and sub-surface horizontal flow systems in cold climate situations.