Gender disorders in learning disability – a systematic reviewWood, Ellena ; Halder, Neel
2014 Tizard Learning Disability Review
doi: 10.1108/TLDR-01-2013-0004
Purpose – The purpose of this paper is to systematically review the literature on gender identity disorder (GID) and associated gender disorders in people with learning disabilities and autism, specifically focusing on aetiology, treatment and management. Design/methodology/approach – This study reviewed all the published papers about individuals with both a learning disability and/or autistic spectrum disorder and a gender disorder. Papers from 1980 onwards were included as this was the year of the introduction of GID to the ICD-10. Gender disorders were taken to include the following: GID, transsexualism, cross-dressing, transvestitism or a gender-related sexual disorder. Findings – In total, 16 papers described 43 individuals meeting the inclusion criteria. There was a dearth of guidance on appropriate treatment or management. Research limitations/implications – Only English language papers were searched. This review points towards more research needed in this area. Originality/value – In collating relevant papers the review begins the search for evidence regarding aetiology, treatment and management of gender disorders in an area where evidence-based guidelines are needed.
Commentary on “Gender disorders in learning disabilities – a systematic review”Thompson, David
2014 Tizard Learning Disability Review
doi: 10.1108/TLDR-07-2014-0019
Purpose – The purpose of this paper is to explore the gender identity of people with learning disabilities as a precursor to considerations of gender dysphoria. Design/methodology/approach – Discussion supported by illustrations from the literature. Findings – There is limited research on gender identity for people with learning disabilities. Practical implications – There is an urgent need to look at how men with Klinefelter's syndrome and learning disabilities are supported in relation to common female sexual characteristics. Originality/value – This is personal perspective on gender and people with learning disabilities which may support work with people who question their gender.
Spirituality and learning disability: a review of UK Government guidanceNonye Sango, Precious ; Forrester-Jones, Rachel
2014 Tizard Learning Disability Review
doi: 10.1108/TLDR-01-2014-0005
Purpose – Despite spirituality being a key aspect of quality of life, it appears to remain a low-priority area for social and health care government policy. The purpose of this paper is to identify and describe what, if at all, UK policy says about spirituality in relation to the care of people with learning disabilities (LD). Design/methodology/approach – A systematic policy review using three government databases: legislation.gov.uk; Department of Health and Directgov (now known as gov.uk) was carried out. Findings – The review identified policy gaps and a general lack of government directives in relation to the spiritual care of people with LD. Whilst research in this area is gathering momentum, practical implementation which makes a real difference to the spiritual experiences of people with LD appears to be sparse. Originality/value – To the authors’ knowledge, this is the first systematic policy review on this subject area, highlighting the need for spirituality to become a more supported aspect of social care within LD services.
Private lives, public policy – a commentary on “Spirituality and learning disability: a review of UK Government guidance”Camden-Smith, Claudia
2014 Tizard Learning Disability Review
doi: 10.1108/TLDR-07-2014-0020
Purpose – The purpose of this paper is to provide a commentary on “Spirituality and learning disability: a review of UK Government guidance” by Sango and Forrester-Jones. Design/methodology/approach – The commentary examines the interplay between spirituality and health care in caring for people with a learning disability from a personal perspective and considers the reasons why healthcare professionals and caregivers may not facilitate expression of spirituality in this group. Findings – Carers with a religious affiliation of their own are more likely to engage people with learning disability in exploration of religion and spirituality than those with no religious affiliation. Although government policy in this area is limited, spirituality is an integral part of holistic care and should be addressed by all healthcare professionals and paid carers. Originality/value – This paper explores reasons why carers may find it hard to talk about spirituality and provides guidance and resources for talking about spirituality to people with learning disability.
Early intervention for children with learning disabilities: making use of what we knowGore, Nick ; Hastings, Richard ; Brady, Serena
2014 Tizard Learning Disability Review
doi: 10.1108/TLDR-08-2013-0037
Purpose – The purpose of this paper is to present a rationale for increasing initiatives for early intervention of emotional and behaviour difficulties. Design/methodology/approach – The authors draw on existing literature regarding rates of emotional and behavioural difficulties together with risk factors and processes related to the development of such difficulties. Findings – Rates of emotional and behavioural difficulties amongst children with learning and developmental difficulties are high. A combination of factors relating to the child, the family system, and wider social contexts is likely to account for this. Research limitations/implications – Increased attempts to provide early intervention to children with learning and developmental disabilities together with their families are warranted. Recommendations are made regarding how the development of such supports might best be taken forward. Originality/value – Whilst drawing on pre-existing literature, the value of this paper is the way in which this has been drawn together to provide an overview of risk and development of behavioural and other difficulties amongst children with learning/developmental disabilities.
Commentary: our children deserve betterEmerson, Eric
2014 Tizard Learning Disability Review
doi: 10.1108/TLDR-07-2014-0023
Purpose – The purpose of this paper is to comment on “Early intervention for children with learning disabilities: making use of what we know.” Design/methodology/approach – Narrative review and discussion. Findings – The arguments presented by Nick Gore, Richard Hastings and Serena Brady are fully consistent with the broader scientific literature on prevention and the required future direction of English health policy. Originality value – This commentary places the arguments made by Gore et al. in a broader scientific and policy context.
Access to cancer screening by people with learning disabilities in England 2012/13: information from the Joint Health and Social Care Assessment FrameworkGlover, Gyles ; Christie, Anna ; Hatton, Chris
2014 Tizard Learning Disability Review
doi: 10.1108/TLDR-07-2014-0024
Purpose – The purpose of this paper is to present information from the Joint Health and Social Care Self-Assessment Framework (JHSCSAF) on reported rates of cervical cancer, breast cancer and bowel cancer screening for eligible people with learning disabilities in England in 2012/2013 compared to screening rates for the general population. Design/methodology/approach – Between 94 and 101 Learning Disability Partnership Boards, as part of the JHSCSAF, provided information to allow the calculation of rates of cervical cancer, breast cancer and bowel cancer screening in their locality, for eligible people with learning disabilities and for the population as a whole. Findings – At a national level, reported cancer screening coverage for eligible people with learning disabilities was substantially lower than for the population as a whole (cervical cancer screening 27.6 per cent of people with learning disabilities vs 70 per cent of total population; breast cancer screening 36.8 per cent of people with learning disabilities vs 57.8 per cent of total population; bowel cancer screening 28.1 per cent of people with learning disabilities vs 40.5 per cent of the general population). There were considerable geographical variations in reported coverage for all three screening programmes. Originality/value – Consistent with previous research, localities in England report cancer screening rates for eligible people with learning disabilities considerably below those of the general population. There is an urgent need to address data availability and quality issues, as well as reasonable adjustments to cancer screening programmes to ensure uniformly high rates of cancer screening for people with learning disabilities across England.