Parmenter , Ph. His publications include 80 articles in professional journals and 45 book chapters in the areas of disability policy, quality of life, dual diagnosis, and vocational training.
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If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account. If the address matches an existing account you will receive an email with instructions to retrieve your username. Skip to Main Content. First published: 1 January About this book The landmark International Handbook of Applied Research in Intellectual Disabilities presents, explains, and illustrates key methods of research and evaluation of proven relevance and value to the field of intellectual disabilities.
It features sections on the concepts and theoretical models underlying research and evaluation, the methods and techniques themselves, and the key application areas where the methods are demonstrated in action. Coverage includes applications in educational, social, family, health, and employment aspects of care and provision for those with intellectual disabilities. Journal of Adolescent Medical Health, No. Author Bios Eric Emerson , Ph. Export Citation s.
Export Citation. Plain Text. Citation file or direct import. For help, please view the citation help. Citation Help. Cancel Export. She noted that these previous studies had used a variety of methods to identify and measure intellectual disability and concluded that the methodological variation between studies might produce the highly diverse prevalence rates. A third source of variation is inclusion criteria, particularly if those considered to be functioning in the borderline intelligence range are included. The influence of social policy changes was demonstrated by Lund who reported a doubling of the incidence of sex offending when comparing sentencing in to and suggested that this rise might have been a result of policies of deinstitutionalisation whereby people with IDD are no longer detained in hospital for indeterminate lengths of time.
He concluded that those with propensities towards offending would be more likely to be living in the community and, as a result, were likely to be subject to normal legal processes should they engage in offending behaviour. Again this indicates a significant change in societal policies. Studies of recidivism rates for offenders with IDD suffer from the same methodological and social policy influences and, due to a lack of controlled studies involving IDD and mainstream offenders, it is difficult to make direct comparisons of recidivism rates.
However, it would appear that recidivism rates for offenders with IDD are consistent with those for populations of mainstream offenders. In one recent study, Gray et al. The IDD group had a lower rate of reconviction for violent offences after two years 4. This trend also held true for general offences 9.
Significant progress has been made in the assessment of risk for future offending in criminal and forensic psychiatric populations. These assessments depend wholly on historical, unchangeable variables for inclusion. Contiguous with the development of actuarial risk assessments, risk assessments based on structured clinical judgement related to the same variables as those used in actuarial assessment were also being developed.
A number of studies have been conducted using risk assessments on offenders with IDD.
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Quinsey, Book and Skilling investigated the predictive validity of the VRAG in 58 men with IDD with serious histories of antisocial and aggressive behaviour followed up for an average of 16 months. They found a significant AUC with a medium effect size of. Gray et al.
Issues in researching the aging of people with intellectual disability
They assessed men and 27 women with IDD discharged from hospital following admission for a criminal offence. Following up these individuals for five years, Gray et al. They concluded that these risk assessment instruments were comparable in predicting future violence for offenders with IDD and the control population. Fitzgerald et al.
Both results were superior to those found with the mentally disordered offenders without IDD. Lindsay et al.
After follow-up of one year, the predictive levels for these tests were AUCs of. For sexual offenders with IDD, similar results have been found for risk assessments. Lofthouse et al. While static risk assessments are promising, caution should be considered for decisions made on offenders with IDD in relation to their risk.
They graded forensic IDD services from generic community services, through community forensic services to low, medium and maximum secure services. This suggests that there were likely to be individuals in secure settings who were assessed as being a low risk and a number in community settings assessed as being a high risk and, given the extensive decision making in relation to these individuals, it seems a somewhat disappointing result. Therefore, a number of factors are likely to account for treatment decisions other than assessed levels of risk.
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Dynamic risk assessments contrast with static risk assessment in that the variables can be changed through treatment and management of the individual. Therefore, these variables can be incorporated into effective risk management plans for offenders with IDD. Studies investigating the predictive value of dynamic variables have suggested that they are as good as static variables in predicting future offences.
Lindsay, Elliot and Astell a found that dynamic indicators of risk, such as poor treatment compliance and antisocial attitudes, correlated with reoffending with a value as high or higher than static variables such as childhood behavioural and attachment problems. Quinsey et al. McMillan, Hastings and Coldwell reported that a clinical rating of risk made by the multi-disciplinary team was as good a predictor of future violence as previous violent incidents.
They found that the total score predicted violence over the ensuing two days with an AUC of. This was a particularly powerful result since the occurrence or absence of the incident was so proximal. In the study by Lofthouse et al. These studies certainly suggest that the dynamic risk assessment might be a potent addition to risk management in this client group.
These developments could have significant implications for the assessment and management of risk for violent and sexual incidents in people with IDD. The findings that proximal indicators are as predictive as static indicators could have an important impact on procedures and practice in helping offenders with IDD to access better services. It is a familiar experience for those working in the field to be restricted in our recommendations because static risk assessment which by definition will never change places the person in the category of high risk despite the fact that they might not have perpetrated any incident for several years.
With the advent of these new assessments, this position could gradually become eroded. The crucial aspect is for further studies to be conducted in this area. For clients with IDD there are two issues for assessment. To ensure comprehension all assessments must be suitably adapted to simplify the language and concepts employed. Lack of understanding is likely to lead to unreliable responding.
Second, because of literacy deficits, all material will have to be read and explained to respondents. Therefore, both the item and the response categories need to be explained. The consequence is that assessments take much longer because the assessor has to read the item and explain the responses in the form of a structured interview.
The adaptations required for assessment of offenders with IDD are extensive and it is extremely important that the psychometric properties of the assessment remain intact with the integrity of the process maintained. The NAS was found to be significantly predictive of whether the patient has physically assaulted others following admission to hospital and total number of physical assaults carried out.
They also found a five-factor structure consisting of threat to self-esteem, external locus of control, disappointment, frustration and resentment. The strategies assessed include use of relaxation skills, counting to 10, walking away calmly, requesting help, use of distraction activities, cognitive reframing and being assertive. The PACS was found to have acceptable test, re-test and inter-rater reliability coefficients and was sensitive to change following anger intervention.
For sexual offenders some work has been completed on knowledge and beliefs in relation to social interaction. With this client group, it is important not only to review cognitive distortions but also to consider the level of sexual knowledge an individual might have. Indeed, one of the first hypotheses put forward to account for inappropriate sexual behaviour in this group was that lack of sexual knowledge could lead the individual to attempt inappropriate sexual contact precisely because they are unaware of the means to establish appropriate interpersonal and sexual relationships.
Therefore, sexual knowledge should always be considered in sex offenders with IDD.