Structured autism programme had impact on quality of life by reducing challenging behaviour


Quality of life as a treatment outcome in services for people with learning disabilities and autism has received little attention in the literature. The researchers in this study combined quality of life measures with objective observations of challenging behaviours to evaluate outcomes for adults with learning disabilities and autism living in two different residential services. The researchers set out to test the hypothesis that any decrease in challenging behaviour would be related to an improved quality of life.

They followed 31 adults with autism spectrum disorder and learning disabilities for 45 months. The adults were living in two residential programmes, the Autism Programme with a Structured Method (PAMS) and a traditional programme for people with learning disabilities

They completed the Quality of Life Inventory in a Residential Environment (IQVMR) and the severity of autistic features for each person every twelve months during the period. They measured challenging behaviour using the Aberrant Behaviour Checklist (ABC).  This was completed every 3 months.

They found significant differences in the outcomes for the two groups. For those in the autism programme with structured method (PAMS) they found that stereotypic behaviour and inappropriate speech had significantly decreased and the IQVMR total score had increased.  Those in the comparison group in the traditional residential service for people with learning disabilities however had scores on the ABC which did not change and their IQVMR total scores decreased.

The authors concluded from their analysis of scores that the PAMS programme had an effect on challenging behaviours and that quality of life improvements did not directly depend on the type of programme, but in fact on reducing challenging behaviour, measured by the ABC.

They concluded that the PAMS programme had had a positive though indirect influence on quality of life for those people receiving support through it by reducing challenging behaviour.

Comparing residential programmes for adults with autism spectrum disorders and intellectual disability: outcomes of challenging behaviour and quality of life, Gerber, F., et al., in Journal of Intellectual Disability Research, 55: 918–932

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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