A positive behaviour support practice framework for disability and community services in Australia that prioritises human rights and evidence-based practices.

PURPOSE: This paper introduces a practice framework for individualised positive behaviour support (PBS). The framework incorporates existing function-based PBS principles and integrates contemporary research and Australian legislation to frame practice elements through a human rights lens. It is designed to support people with disability of varied aetiologies across the lifespan in various settings (e.g. home, schools, and aged care). METHODS: Existing research and literature have been reviewed, including key theories and current formulations to inform a new practice framework that reflects recommendations for applications in community settings. RESULTS: The PBS Pathway (PBS-P) framework promotes culturally sensitive and socially valid strategies for empowering the person and their supporters via a clear practice framework. It emphasises evidence-based practices while acknowledging the need for flexibility to meet individual needs. CONCLUSIONS: The PBS-P framework offers a pragmatic approach and focused lens for critical thinking and reflective applications within PBS. It promotes a universal approach across the lifespan and service settings, contributing to a shared understanding of PBS as a rights-based practice. The framework's alignment with current legislation supports adoption within existing systems; however, successful implementation requires skilled practitioners, adequate funding, and policies to support knowledge translation.

The positive behaviour support pathway framework guides individualised practices for people across the lifespan and service settings, with emphasis on data-based decision making to inform socially and culturally valid intervention planning.The framework aligns with current legislation and addresses current concerns relating to poor behaviour support practices and urgent recommendations for practices that protect and promote human rights.

How does the subjective well-being of Australian adults with a congenital corpus callosum disorder compare with that of the general Australian population?

PURPOSE: Very little is known about the subjective well-being (SWB) of adults with a congenital corpus callosum disorder (CCD), the extent to which they feel satisfied with their lives, and what might be helpful in improving their SWB and quality of life. This study measured SWB among Australian adults with a CCD and compared the results with normative data for the wider Australian adult population. METHODS: Online surveys were completed independently by 53 Australian adults with a CCD. Data included demographic profiles and answers to questions about satisfaction with life, employing the Personal Wellbeing Index (PWI) and one open ended question. Domains measured included life as a whole, standard of living, health, achieving in life, personal relationships, safety, community connectedness and future security. The PWI results were statistically analysed and means compared with Australian normative data. The qualitative data were analysed using deductive thematic analysis. RESULTS: Australian adults with a CCD responded with ratings significantly below what might be expected of the adult Australian population in all domains except for standard of living and safety. Quantitative analysis results were supported by qualitative thematic analysis, expressing particular challenges and barriers to feeling satisfaction with life as a whole, personal relationships, achieving in life, health and future security. CONCLUSION: Evidence from the PWI and accompanying qualitative responses indicate that SWB of Australian adults with CCD is significantly reduced compared with the general population. Further research is needed to examine the lived experience and explore solutions for support of this community.

Very little is known about the quality of life and personal well-being of Australian adults who have a corpus callosum disorder (CCD), a rare brain condition with complex impacts ranging from mild to severe. People with a CCD are born missing part or all of their corpus callosum, the connecting body between the two halves of the brain. This study asked adults with a CCD to rate their own personal wellbeing in an online questionnaire and the results were compared with those of the general Australian population. Participants were also asked to describe how a CCD affected their lives in their own words. We found that adults with a CCD have significantly lower personal wellbeing than the general Australian population. The most concerning issues were with relationships, life achievements, mental health and not having a secure future. The results tell us that we need to explore personal wellbeing in more depth using research methods in which adults with a CCD can tell us more about the impacts of a CCD on their lives. We need to ask how they think the quality of their lives could be improved and what supports would help to achieve that.

Identifying priorities for Australian disability research using Q methodology.

BACKGROUND: Globally, there are over an estimated one billion people with disability. Research priorities with a focus on diagnosis and treatment of conditions or policy and service initiatives, traditionally decided by researchers, may not align with priorities of those with lived experience of disability. OBJECTIVE: To explore and inform disability research for Australia, including perspectives of people with disability. METHODS: As part of a research program, we used Q methodology to explore "what should guide the Australian research agenda?" People with disability, their families, community organizations and researchers were purposively recruited and sorted 25 statements, developed iteratively using data collated from systematic research mapping and a prior consultation process. The sorting grid ranged from -4 to +4, according to "Which topics should guide disability research the least to the most?" Factor analysis revealed four distinct but interrelated participant viewpoints. RESULTS: 52 participants (65 % female, aged 18-65+ years, 37 % people living with disability), sorted the statements. Viewpoint 1 - design and delivery of services across the lifespan. Viewpoint 2 - understanding the diverse experience of those with disability. Viewpoint 3 - designing systems to address impacts of disability for the individual, their families and society. Viewpoint 4 - addressing mental health for those with disability no matter where they live. CONCLUSION: These viewpoints focused on design and delivery of services to address the impacts of disabling environments and attitudes on individuals living with impairments, their families and society. The four viewpoints provide a framework for future disability research in consultation with those with lived experience.

'Let me tell you, I see echolalia as being a part of my son's identity': Exploring echolalia as an expression of neurodiversity from a parental perspective.

LAY ABSTRACT: Echolalia is a commonly found speech and language condition in autistic children. Children with echolalia repeat words and phrases they previously hear in place of proving a non-repetitive response. In research and when visiting speech and language services, one of the common goals is to modify these repetitions so that these children may, more socially, engage with their surrounding environment. In our research, we identified that not all parents want their children's echolalia to be modified. Some parents want their child to be able to enjoy echolalia and others don't want anyone to intervene because they see it as something that makes their child unique and being unique is something to be celebrated. We believe that there might be a way for speech and language services who want to modify echolalia and the parents in our study who do not want their child's echolalia to be modified, to be able to exist side-by-side.

Mapping the parent experience of echolalia in autism spectrum disorder onto a conceptual taxonomy.

PURPOSE: Echolalia, the repetition of previously heard speech, is prevalent in a variety of neurologic and psychiatric disorders. Within the context of echolalia in autism spectrum disorder (ASD), research and intervention historically assume a clinical standpoint with two opposing paradigms: behaviourism and developmentalism. The literature is largely silent on how those other than researchers and clinicians understand echolalia. This study examined how parents experience echolalia through their children with ASD. The aim of the study was to ascertain if the parental perception of echolalia in ASD aligns with, or offers alternative perspectives to, current clinically-orientated views. METHOD: We employed online semi-structured interviews to document the experiences of 126 parents, reflecting on their children with ASD aged 3 to 34 years of age, to determine if the parent experience could be mapped onto existing clinical frameworks, or if they might offer new perspectives. We used hermeneutic phenomenological data analysis in an abductive framework. RESULT: Echolalia has predominantly been represented in literature through the perspectives of behaviourism or developmentalism. We found however, that echolalia is a phenomenon that is experienced by parents in a variety of different ways to that of the current clinically-orientated understandings. Such new ways of understanding echolalia that emerged from our analysis include one understanding which is dependent upon how echolalia is heard, and one in which parents are "waiting for echolalia to evolve." CONCLUSION: The traditional dichotomous clinical positions do not resonate with all parents, and reliance on these traditional perspectives alone may impact effective engagement with parents and the success of interventions and support strategies. Our findings have implications for future research, the education of clinicians and educators, and the design of support and intervention for those who have echolalia.

Late effects of polio: Interviewing general practitioners and health professionals about the need for and the means of promoting continuing professional development.

BACKGROUND AND OBJECTIVES: Polio Australia estimates tens of thousands of polio survivors are experiencing late effects of polio (LEoP), including increased cases among young women of childbearing age in some migrant communities. Because polio has been declared eradicated in Australia, the provision and uptake of education by general practitioners (GPs) and healthcare professionals (HCPs) is minimal. We explored the awareness of LEoP among HCPs and ways to enhance knowledge dissemination to improve clinical practice. METHOD: A qualitative study was undertaken, informed by a descriptive (transcendental) phenomenological approach. Semistructured interviews were audio recorded, transcribed and analysed inductively, with a conciliation among the research team used to finalise the themes. RESULTS: HCPs expressed the importance of learning about LEoP and how this may help build supportive patient-practitioner relationships and contribute to patient outcomes. Factors influencing the uptake of professional development included motivation, possibly stemming from a lack of awareness of LEoP, together with the time and logistical limitations of practice generally. DISCUSSION: Online learning activities followed by an assessment may be attractive for some HCPs, but peer-based and multidisciplinary continuing professional development activities remain preferred.

Assistance Dogs for People with Younger (Early)-Onset Dementia: The Family Carer's Experience.

There is growing evidence for trained assistance dogs promoting the health, wellbeing, and quality of life of people in a variety of circumstances, including for those with dementia. Little is known about people with younger (early)-onset dementia (YOD) and family carers. As part of a larger study involving 14 people with YOD matched with trained assistance dogs over a two-year period, we report analyses of interviews with 10 family carers conducted on multiple occasions investigating their experience with an assistance dog. Interviews were recorded, transcribed and subjected to inductive thematic analysis. They told a range of experiences; the good and the challenging. Findings fell into three areas: the human-animal bond; relationship dynamics; and responsibility for caring. Concerns were raised with respect to the resources required of carers together with the financial resources needed to support an assistance dog. The study concludes that trained assistance dogs can play an important role promoting the health and wellbeing of both people with YOD and of their family carers. However, support needs to be in place as the circumstances of the family member with YOD changes and the role of the assistance dog as part of the family also changes. Practical (financial) support of a scheme such as the Australian National Disability Insurance Scheme (NDIS) could be important to sustaining such support.

Echolalia as defined by parent communication partners.

Backgrounds and aims: Echolalia, the repetition of previous speech, is highly prevalent in Autism. Research into echolalia has historically assumed a clinical standpoint, with two opposing paradigms, behaviourism and developmentalism, offering differing support and intervention programs. These paradigms offer a multitude of clinical operationalised definitions; despite attempts, there continue to be challenges regarding how echolalia is to be defined. Stepping out of the dichotomous clinically orientated literature, we examined how parents summarise and formalise their understanding of echolalia as a communication partner. The objectives of this study were three-fold: (1) to investigate how echolalia is described and defined by parents; (2) to examine if existing clinical definitions align with those of parents; and (3) to begin to consider the implications of such findings for a collaborative approach between clinical perspectives and the parent experience. We bring to the fore the voices of parents, who have historically remained absent from echolalia literature. That is to say, we step outside of the clinical realm and listen to parents: something which has been previously unconsidered but represents a new vital addition to the echolalia literature. Methods: We employed a Grounded Theory approach to document the definitions of 133 parents. Results: We found that parents reported a multiplicity of important elements that are key to their understanding of echolalia. Conclusions and implications: Additionally, we found that clinical definitions do not resonate within the parent experience; parents experience echolalia in a different way to that of clinicians and parents can offer insight into our understanding of the phenomena. Our findings show that while some parents might align themselves with either a behavioural or developmental positionality, sometimes there is an overlap depending upon the context in which their child repeats and some parents advance interpretations that are not readily aligned with either of the traditional clinical schools of thought. We present implications for both clinicians and parents in ways that point towards a collaborative approach to support the person with echolalia.

Realising economic and social rights for children with communication and swallowing disability: Sustainable Development Goals 1, 8 and 10.

PURPOSE: This commentary describes the economic disempowerment of children with communication and/or swallowing disability and outlines why attending to their economic and social needs is essential for the realisation of the United Nations' Agenda 2030. RESULT: Children with communication and/or swallowing disability encounter intersectional disempowerment on account of both their disability, and their status as children. In particular, they experience unique barriers to the realisation of their economic and social rights. This presents a number of challenges to the realisation of Agenda 2030, and its Sustainable Development Goals (SDGs). Drawing on the broader disability rights and child rights literature, we outline these issues, and describe four empowering solutions, within the scope of this special issue commentary. CONCLUSION: We describe that speech-language pathologists must interpret the discussion of these issues as a call to action for our profession. This commentary focusses on the Agenda 2030 Sustainable Development Goals of, No Poverty (SDG 1), Decent Work and Economic Growth (SDG 8), and Reduced Inequalities (SDG 10), and also addresses the goals of Zero Hunger (SDG 2), Good Health and Well-Being (SDG 3), Quality Education (SDG 4), Gender Equality (SDG 5) and Partnerships for the Goals (SDG 17).

Repeating purposefully: Empowering educators with functional communication models of echolalia in Autism.

Background and Aims: Echolalia, the repetition of speech, is highly prevalent in school aged children with Autism. Prior research has found that individuals with echolalia use their repetitions to engage in communicatively functional speech, in the absence of self-generated speech. Educators are the natural audience for a wide vary of echoed utterances across environments and in differing contexts. The objectives of this paper were three-fold: (1) to systematically investigate how researchers identify and ascribe communicative function to echoed utterances; (2) to gather and evaluate the evidence that might assist teachers to identify and better understand echoed utterances as being communicatively purposeful; and (3) to provide teachers with evidence-informed response strategies they can use to assist their students on their journey towards more self-generated speech. Main Contribution: Prior research in the field of echolalia has generally been segmented into opposing viewpoints. A paucity of work in the echolalia field has meant that there is limited work that has sought to view how a communicative function to echolalia has been ascribed from across multiple disciplines and fields. As such, there is limited literature to guide the practice of classroom educators. This review combines communicative models from across various disciplines with the view to supporting classroom educators by providing guidance on how they might assist their students with echolalia. This review represents the first contribution to the research literature in this area. Conclusions and Implications: Research into echolalia did not originally emanate from the field of education; however, anecdotes from classroom educators were cited as the primary impetus for the creation of some of the communicatively functional models. We found that although there are many techniques that researchers have used to attribute a communicative function to echolalia, some of these can be easily employed by educators in their practice. By adopting these techniques, educators are placed in a position that may assist with the identification of communicative echolalia; subsequently they are better placed to acknowledge and respond to their students.

Short report: Gendered workplace social interaction processes in autism.

BACKGROUND: Navigating workplace social interactions can be stressful for autistic people and be experienced differently by gender. A better understanding of the autistic experience of these difficulties is needed to inform effective policy, practice, and individualized support. METHOD: Fifty-five autistic individuals (n women=32; n men=22) participated in either an online survey or focus group. Data were analyzed using inductive thematic analysis. RESULTS: The data suggests that the social and interaction expectations placed upon autistic individuals differ by gender and can contribute to occupational stress. CONCLUSIONS: The data provides a basis for further investigation considering Conservation of Resources Theory and its practical application to inform reasonable adjustments in the workplace for autistic people. WHAT THIS PAPER ADDS: The gendered workplace experiences of autistic people is an emerging area of research. However, how workplace social interactions are experienced by each gender remains under-researched. An understanding of this could help decrease occupational stress, inform reasonable adjustments, and increase labor market participation in this population. This paper adds to the existing literature in showing that workplace social interactions for autistic people are experienced differently by gender. As such, the implications in the experience of occupational stress may also differ. Therefore, the importance of having reasonable adjustments in the workplace that account for gender is highlighted.

The Future of Disability Research in Australia: Protocol for a Multiphase Research Agenda-Setting Study.

BACKGROUND: For people with disabilities to live a good life, it is essential that funded research in health and social care addresses their interests, meets their needs, and fills gaps in our understanding of the impact that services, systems, and policies may have on them. Decisions about research funding should be based on an understanding of the research priorities of people with disabilities, their supporters and allies, disability researchers, service providers, and policy makers working in the field. OBJECTIVE: The aim of this protocol is to describe the research design and methods of a large-scale, disability research agenda-setting exercise conducted in 2021 in Australia. METHODS: The research agenda-setting exercise involves 3 integrated phases of work. In the first phase, a previous audit of disability research in Australia is updated to understand previous research and continuing gaps in the research. Building on this, the second phase involves consultation with stakeholders-people with disabilities and their supporters and family members, the disability workforce, and people working within services and connected sectors (eg, aging, employment, education, and housing), academia, and public policy. Data for the second phase will be gathered as follows: a national web-based survey; a consultation process undertaken through the government and nongovernment sector; and targeted consultation with Aboriginal and Torres Strait Islander people, children with disabilities and their families, people with cognitive disability, and people with complex communication needs. The third phase involves a web-based survey to develop a research agenda based on the outcomes of all phases. RESULTS: We have started working on 2 parts of the research prioritization exercise. Through the research-mapping exercise we identified 1241 journal articles and book chapters (referred to as research papers) and 225 publicly available reports (referred to as research reports) produced over the 2018-2020 period. Data collection for the national survey has also been completed. We received 973 fully completed responses to the survey. Analysis of these data is currently underway. CONCLUSIONS: This multi-method research agenda-setting study will be the first to provide an indication of the areas of health and social research that people across the Australian disability community consider should be prioritized in disability research funding decisions. Project results from all phases will be made publicly available through reports, open-access journal publications, and Easy Read documents. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31126.

Trained assistance dogs for people with dementia: a systematic review.

This systematic review investigated evidence for the effectiveness of trained assistance dogs as an intervention and support for people with dementia. Peer-reviewed articles were retrieved from multiple databases (SCOPUS, Web of Science, and Google Scholar). Reference lists of the articles retrieved were also screened to identify key authors for inclusion. Articles were subject to a quality review, and the results synthesised to address the research questions. Both qualitative and quantitative data were reported. There was evidence of the potential positive effects of dog-assisted interventions in relation to mood, prosocial behaviours, activities of daily living and/or quality of life, cognitive impairment and symptoms specific to dementia, and existential functions. However, the form and quality of the studies varied considerably. It was concluded that further research is needed, particularly for those with younger onset dementia (YOD), for whom there were no specific studies available. Attention needs to be given to establishing adequate-sized samples and designs incorporating control groups. Research would benefit from employing mixed-methods, allowing for the triangulation of qualitative and quantitative data. For deteriorating conditions such as the dementias, studies need to be conducted over time. Furthermore, given the important place family members play in the lives of those with dementia, the effects of dog-assisted interventions on the wider family should also be considered.

"I Would Love to Just Be Myself": What Autistic Women Want at Work.

Background: Autistic individuals experience barriers obtaining and sustaining employment. In the general population, gender also impacts labor market experiences. Understanding the occupational aspirations and expectations of individuals disaggregated by autism diagnosis and gender may assist the development of tailored workplace policies and support strategies. Methods: We used inductive thematic analysis to understand the employment expectations of 89 participants (34 autistic women, 32 typically developing women, and 23 autistic men) who answered open-ended items in an online survey. Participants were ages 18 to 68 years. We identified themes and compared these by autism diagnosis and gender. Results: The first major theme emerging from the data was the desire for an opportunity to have a fulfilling career (i.e., fit), with associated minor themes of job-person and person-environment fit. With no associated minor themes, the second and third major themes were desire for stable employment and low hope for finding meaningful work. Differences were apparent by autism diagnosis and not gender. Conclusions: It is pertinent that autistic women have job-person and person-environment fit to thrive at work. Workplace policies and procedures influencing attitudinal, structural, and procedural change appear warranted to facilitate inclusion of autistic women in the labor market. Lay summary: Why was this study done?: Autistic people have a lot of difficulties gaining and maintaining suitable work. Yet, no one has asked autistic women what they hope their future in the workforce could look like. Asking this question can highlight problems and possible solutions to help autistic women gain and maintain meaningful employment.What was the purpose of this study?: To help understand the aspirations of autistic women regarding their employment.What did the researchers do?: We asked autistic and nonautistic women, as well as autistic men, in Australia to answer open-ended questions in an online survey about work. One question was "what do you hope for your future in the workforce?" We organized people's responses into categories, or themes, which described different aspects of participants' answers. We then compared written responses of the autistic and nonautistic women, as well as the answers of autistic women and men.What were the results of the study?: Participants' responses can be described with three major themes: (1) an opportunity to have a fulfilling career that matches interests and skills in a suitable environment; (2) wanting stable employment; and (3) having low hope for finding meaningful work. Finding a job that suits interests, skills, and work preferences within a supportive environment was mentioned as vital for sustained participation in the labor market by autistic women. Although these things were also mentioned by nonautistic women, they were much more important for autistic women. Furthermore, autistic women's and men's aspirations are similar, and of equal importance to each of them.What do these findings add to what was already known?: Much is already known about the experiences of autistic men in the workplace. This study addresses and builds on the little research about the occupational aspirations and expectations of autistic women. The results of this study suggest that autistic women want an opportunity to find meaningful and stable work where they "fit in" with the freedom to be themselves. Because some similarities were found between what autistic and nonautistic women (as well as autistic men) need in the workplace, if changes affecting businesses are made to help autistic women, more people would benefit.What are potential weaknesses in the study?: This research is limited by the way information was obtained from participants, and sample characteristics; for example, the autistic women were diagnosed with autism at a younger age than the autistic men. It is a small, qualitative study from a single open-ended survey item. Obtaining participants using social media may mean people in metropolitan areas more likely participated. Furthermore, the sample was from Australia only, looked at people who identified as women or men, and did not address racial or ethnic diversity.How will these findings help autistic adults now or in the future?: Understanding the aspirations of autistic women can suggest interventions that help them succeed in the workforce. The strong desire for job-person-environment fit by autistic women could, for example, suggest encouraging more flexible workplace practices supportive of career development. Or, it could suggest creating a free, or subsidized, support service to help autistic people of all ages find work that matches (or can be molded) to suit their skills, abilities, work preferences, and environmental (e.g., sensory) needs.

Challenges for females with high functioning autism in the workplace: a systematic review.

PURPOSE: Individuals with High Functioning Autism (HFA) experience high levels of underemployment and unemployment, resulting in negative economic, social, and health outcomes. Given what is known about labor market participation difficulties experienced by women generally, and the paucity of research concerning women with HFA, this systematic review synthesized what is known about the labor market experiences of women with HFA. METHOD: A systematic review of the literature concerning adult females with HFA in relation to the workplace yielded 1947 results; 11 met inclusion criteria being based on original data, but not necessarily focusing solely on women. RESULTS: The total number participants with HFA across all studies was 731 (M = 66.45, SD = 95.44, Mdn = 18.00) aged between 18 and 70 years (M = 34.38, SD = 7.71); females represented 38% (n = 279) of those sampled. The principal challenges reported for individuals with HFA at work were communication, social interaction, and stress, together with negative mental and physical health. CONCLUSION: These results should be interpreted with caution. Of the studies found, 73% were qualitative and based on small samples. Only one paper differentiated female data in analyses. These factors combined suggest large-scale mixed method research focused on females with HFA is required to gain an accurate insight into the challenges faced in the workplace, to in turn inform intervention and support. However, implications for rehabilitation based on what is known are discussed. Implication for Rehabilitation Unemployment and underemployment of persons with High Functioning Autism (HFA) poses social, health and economic issues for both individuals and the wider community. Those with HFA have the intellectual capacity to make a substantial contribution to the workplace. Based on what is known, some of the challenges for females with HFA might be similar to those experienced by men with HFA, however it is possible that there are gender-based differences (in both type and severity of challenges) that require attention.

Examples of individual supported living for adults with intellectual disability.

BACKGROUND: This article provides a qualitative account of four models of support for adults with intellectual disability in individual supported living (ISL) arrangements. MATERIALS AND METHODS: Completion of the first 50 evaluations of 150 arrangements for the third phase of the ISL project provided the examples. RESULTS: Four approaches are described: living alone, co-residency, relationship and host family. Within each type, wide variations occur particularly based on security of tenure, formal and informal support and management variations. CONCLUSION: Fifty evaluations so far illustrated a wide range of approaches to ISL, providing evidence of the critical importance of the formal and informal support environment and reinforcing the contention that ISL is appropriate for people with high support needs.

Initiatives to reduce the use of seclusion and restraints on people with developmental disabilities: a systematic review and quantitative synthesis.

Contrary to the expectations articulated in public policy, restrictive interventions are commonly used in support services for people with developmental disabilities. This systematic review and quantitative synthesis was undertaken to investigate whether the use of seclusion and restraints on people with developmental disabilities can be reduced. Searches of the Academic Search Complete, CINAHL, MEDLINE, and PsycINFO electronic databases returned 7226 records, of which 11 met the inclusion criteria for this review. A further 3 papers were obtained through scanning the reference lists of those articles included from the initial literature search. All 14 studies were single-subject designs focusing on initiatives to reduce physical or mechanical restraint. Between the baseline and intervention phases, there were mean reductions in the frequency and duration of restraint use of 79% (SD=21%, n=13 subjects from 7 studies) and 45% (SD=58%, n=10 subjects from 6 studies), respectively. For studies in which restraint use to manage agitation and aggression was targeted, there was a 79% (SD=21%, n=13 subjects from 7 studies) decrease in the frequency and a 28% (SD=67%, n=6 subjects from 3 studies) reduction in the duration of restraint. With respect to studies in which restraint use to prevent self-harm was targeted, there was a 71% (SD=34%, n=4 subjects from 3 studies) reduction in restraint use. Effect sizes were calculable, using non-overlap approaches, for 9 of the 14 studies. The magnitudes of the effect sizes suggest that, on average, the interventions were effective in reducing the use of restraints. The effects generated in studies where restraint use for self-harm was targeted were typically more pronounced than those in which restraint use for agitation and aggression was addressed. There were broad variations, however, in the percentage reductions in restraint use and in the magnitudes of the effect sizes. Although the findings of this review are encouraging, more research is needed, in which greater attention must be paid to rigorous research design, application, and analysis.

Interacting with adults with congenital deafblindness: The experiences of disability support workers.

BACKGROUND: This study aimed to gain greater insight into the perspectives of staff on their interactions with adults with congenital deafblindness in light of the research literature reporting these interactions to be lacking in quality and quantity. METHOD: Data from interviews with 8 disability support workers were analysed using the approach described by Charmaz (2006). RESULTS: Three key themes emerged from the interview data, which support and elaborate on findings of previous studies. These were (1) the construction of client happiness, (2) the rationalisation of client disengagement, and (3) imperatives of the staff role. These findings elucidate the reasons for staff behaviour in their interactions with adults with congenital deafblindness. CONCLUSION: The findings suggest the need for staff policy and procedural documents to be explicit about the importance of social interaction between staff and clients.

A preliminary investigation of the utility of the "Behavior Support Plan Quality Evaluation Guide II" for use in Australia.

BACKGROUND: The quality of behaviour support plans (BSPs) can be an important influence on the quality of the support provided to people with disability who show challenging behaviours. The Behavior Support Plan Quality Evaluation Guide II (BSP-QE II) is one tool that may be useful in assessing the quality of behaviour support plans. It has previously been used to assess BSPs to support children in schools in the USA. In this preliminary study, we examined the utility of the BSP-QE II for assessing behaviour support plans designed for adults with an intellectual disability in community support services in Australia. METHOD: Experienced practitioners were surveyed concerning the relevance of BSP-QE II components to the evaluation of BSPs in Australia, and an audit was conducted of randomly selected BSPs submitted as a statutory requirement to the Office of the Senior Practitioner. RESULTS: The BSP-QE II showed evidence of acceptable construct validity and interrater reliability. There was evidence of a need for substantial improvement in the quality of BSPs, consistent with previous findings conducted using other audit tools. CONCLUSIONS: The findings support the utility of the BSP-QE II, to inform and evaluate service planning in supporting adults with intellectual disability who show challenging behaviour.