Improving access to the justice system for people with communication difficulties : a training program for people working in the justice system

This training package is provided as a guide and resource to promote awareness and understanding of people who have complex communication needs and give people who work in law and justice system strategies to facilitate successful communication interactions. Complex communication needs are defined as communication problems associated with a wide range of physical, sensory and environmental causes which restrict/limit an individual's ability to participate independently in society. They and their communication partners may benefit from using Alternative and Augmentative Communication (AAC) methods. Alternative and Augmentative Communication (AAC) is an approach or communication system that makes it possible for a person without speech to communicate. AAC includes gestures and sign language, picture and alphabet boards and high technology electronic communication devices that produce computerised speech. Many people with complex communication needs use a combination of AAC communication to express themselves. It is hoped that this package will facilitate access to the justice system for a group of people who may experience social disadvantage as a result of their complex communication needs. The information included in the package is not exhaustive. It is designed to : provide the trainer and staff with a general understanding of complex communication needs; challenge misconceptions about people who have little or no functional speech; provide practical strategies and guidelines to assist staff to more successfully communicate with people with complex communication needs.

Using the DBC-P Hyperactivity Index to screen for ADHD in young people with autism and ADHD: a pilot study

This study aimed to (1) determine preliminary validity of the Developmental Behaviour Checklist-Hyperactivity Index (DBC-HI) as a screening measure of combined-type ADHD in autism and ADHD, and (2) compare emotional-behavioural disturbance using the DBC in autism, ADHD and autism + ADHD. Forty-nine age- and PIQ-matched young people [6-18 years; 12 autism, 13 ADHD, 12 autism + ADHD, 12 typically developing] were recruited. Parents completed the Conners-Revised Rating Scale and DBC. The DBC-HI displayed strong internal consistency and good external validity, reliably measuring combined-type ADHD. The DBC-HI distinguished autism from autism + ADHD with fair sensitivity and specificity. Individuals with autism + ADHD exhibited a more severe profile of emotional-behavioural disturbance than autism or ADHD alone. The DBC may be a useful 'all-in-one' screening tool to (1) identify comorbidity and (2) determine the severity of emotional-behavioural disturbance in autism and/or ADHD. © 2014 Elsevier Ltd.

Efficacy of Cognitive Processes in Young People with High-Functioning Autism Spectrum Disorder Using a Novel Visual Information-Processing Task

Autism spectrum disorders (ASD) are characterised by a unique pattern of preserved abilities and deficits within and across cognitive domains. The Complex Information Processing Theory proposes this pattern reflects an altered capacity to respond to cognitive demands. This study compared how complexity induced by time constraints on processing affect cognitive function in individuals with ASD and typically-developing individuals. On a visual information-processing task, the Subtle Cognitive Impairment Test, both groups exhibited sensitivity to time-constraints. Further, 65 % of individuals with ASD demonstrated deficits in processing efficiency, possibly attributable to the effects of age and clinical comorbidities, like attention deficit hyperactivity disorder. These findings suggest that for some ASD individuals there are significant impairments in processing efficiency, which may have implications for education and interventions. © 2014 Springer Science+Business Media New York.

Online health information seeking: How people with multiple sclerosis find, assess and integrate treatment information to manage their health

Background and objective: The Internet is increasingly prominent as a source of health information for people with multiple sclerosis (MS). But there has been little exploration of the needs, experiences and preferences of people with MS for integrating treatment information into decision making, in the context of searching on the Internet. This was the aim of our study. Design: Sixty participants (51 people with MS; nine family members) took part in a focus group or online forum. They were asked to describe how they find and assess reliable treatment information (particularly online) and how this changes over time. Thematic analysis was underpinned by a coding frame. Results: Participants described that there was both too much information online and too little that applied to them. They spoke of wariness and scepticism but also empowerment. The availability of up-to-date and unbiased treatment information, including practical and lifestyle-related information, was important to many. Many participants were keen to engage in a 'research partnership' with health professionals and developed a range of strategies to enhance the trustworthiness of online information. We use the term 'self-regulation' to capture the variations in information seeking behaviour that participants described over time, as they responded to their changing information needs, their emotional state and growing expertise about MS. © 2014 John Wiley & Sons Ltd.

Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD

We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a waitlist. Following the intervention program, participants who were initially symptomatic reported significantly lower depression and stress scores on the Depression Anxiety Stress Scales in comparison to individuals on the waitlist. There was no significant change in anxiety related symptoms. The benefits were maintained at 3 and 9 month follow-up. Our findings demonstrate the potential of CBT in a small group setting for assisting young people with ASD who have symptoms of depression and stress.

Development and evaluation of a screening tool to identify people with diabetes at increased risk of medication problems relating to hypoglycaemia and medication non-adherence

Abstract Aims: To develop and evaluate a screening tool to identify people with diabetes at increased risk of medication problems relating to hypoglycaemia and medication non-adherence. Methods: A retrospective audit of attendances at a diabetes outpatient clinic at a public, teaching hospital over a 16-month period was conducted. Logistic regression was undertaken to examine risk factors associated with medication problems relating to hypoglycaemia and medication non-adherence and the most predictive set of factors comprise the Diabetes Medication Risk Screening Tool. Evaluating the tool involved assessing sensitivity and specificity, positive and negative predictive values, cut-off scores, inter-rater reliability, and content validity. Results: The Diabetes Medication Risk Screening Tool comprises seven predictive factors: age, living alone, English language, mental and behavioural problems, comorbidity index score, number of medications prescribed, and number of high-risk medications prescribed. The tool has 76.5% sensitivity, 59.5% specificity, and has a 65.1% positive predictive value, and a 71.8% negative predictive value. A score of 27 or more out of 62 was associated with high-risk of a medication problem. The inter-rater reliability of the tool was high (κ = 0.79, 95% CI 0.75 - 0.84) and the content validity index was 99.4%. Conclusion: The Diabetes Medication Risk Screening Tool has good psychometric properties and can proactively identify people with diabetes at greatest risk of medication problems relating to hypoglycaemia and medication non-adherence.

A systematic review of adherence to restricted diets in people with functional bowel disorders

Functional bowel disorders such as irritable bowel syndrome are commonly experienced within the population, and have an adverse impact on emotions, physical well-being, social activity, and occupational output. Adherence to a restricted diet can reduce symptoms, which in turn leads to increased quality of life and well-being. The aim of this review was to assess the extent to which predictors of dietary adherence have been considered in studies relating to functional bowel disorders and following a restricted diet. This was done firstly by examining such studies which contained a measure or indicator of adherence, and then by examining predictors of adherence within and between studies. A search of PsycINFO, Medline, CINAHL, Web of Science, and Cochrane databases was performed during July 2014, with the search criteria including relevant terms such as gastrointestinal disorder, irritable bowel syndrome, diet, and adherence. Of an initial 7927 papers, 39 were suitable for inclusion. Fourteen of the 39 studies included had a structured measure or indicator of dietary adherence, and the remaining 25 mentioned adherence without any structured levels of adherence. There was little investigation into the predictors of adherence, with symptom relief or induction being the primary goal of most of the studies. This review indicates that predictors of dietary adherence are rarely considered in research regarding functional bowel disorders. Further investigation is needed into the variables which contribute to rates of adherence to restricted diets, and more rigorous research is needed to characterise those individuals most likely to be non-adherent. Such research is necessary to ensure that people with these conditions can be provided with appropriate support and interventions.