Hocken, K

Smith, L

Winder, B

Nottingham Trent Institutional Repository (IRep)

The development and validation of two screening measures to help in the identification of intellectually disabled (ID) offenders.Dr Belinda Winder, Kerensa Hocken & Lorraine SmithWhatton Conference 2014Overview• Introduction– Research aims– ID Definition• IQ– Why is IQ important– Evaluation the NOMS IQ Screening Tool– Results– Advantages for the prison service• Adaptive Functioning (AF)– Why is AF important– The Adaptive Functioning Assessment Tool (AFAT)– How will this benefit prisoners and the prison service• Conclusions2What is the research about?• Research aim:Improve ID assessment within the prison service• Achieved Via:– An evaluation of a new IQ screening tool – Development of a new measure of Adaptive functioningWhat is ID?• ID = Intellectual Disability• ID diagnosis requires low levels of IQ and adaptive functioning (AF).• What is AF?The DSM-5 defines adaptive functioning as: ‘the ability to meet developmental and socio-cultural standards for personal independence and social responsibility’Adaptive functioning deficits can limit functioning in one or more activities of daily life such as communication, social participation and independent living, across multiple environments such as home, school, work, and community.4IQ• There are 2 types of treatment programmes:• Important IQ is assessed as wrong treatment means:– More likely to drop out, linked to higher levels or re-offending– Unethical to place ID offenders into the core programme – Treatment places are expensive- not used effectively then it is costly 6Core Becoming New MeRelies on written and verbal skillsIncludes simplified techniques, concepts andlanguage.IQ above 80 IQ below 80Why is IQ important?Why a new IQ test?The WASI is currently used as a screening measure— Requires a trained psychologist to administer it— Time and resource intensivee— Need to be fully trained in it’s use• New tool developed by NOMS = NOMS IQ Screening tool✓ Shorter and quicker than the WASI✓ Information is already available via the OASys database✓ It needs to be evaluated before it can be usedCoreFurther IQ testingAbove 80Below 80NOMS IQ Screening Tool• The NOMS IQ screening tool - 7 items from the OASys 1. Problems with reading, writing and/or numeracy. 2. Has learning difficulties 3. Educational or vocational qualifications at or above GCSE level 4. Work-related skills5. Currently of no fixed abode or in transient accommodation6. Has difficulties reading7. Has difficulties with numeracy• High scores on the new tool indicate low levels of IQ.• A cut-off of three or above is indicative of an IQ below 80. • NOMS claim that the OASys ST is able to accurately identify 85% of offenders scoring below 80 on the WAIS-IV8Evaluating the NOMS IQ Screening tool9Results:10• The NOMS IQ Screening tool was tested to see:• If it could place people onto the correct treatment programme.• Whether it can predict if a persons IQ is above or below 80.• Prisoners had already attended treatment, had an IQ score on file and their NOMS IQ Screening tool score was summed.The analysis showed that:• The NOMS IQ ST can accurately place people onto the correct treatment programme.• Using a NOMS IQ score cut off as 3 the accuracy is 95%• This rises to 99% if a score of 2 is used• The NOMS IQ screening tool is an accurate predictor of whether a person’s IQ is above 80.• Using a NOMS IQ score of 2 the accuracy is 97%• Using a score of 3 the accuracy is 93%So What?!?!?Advantages for the prison service:• Those who score 3 or less = IQ above 80             Core treatment programme• Those who score 10 or more = IQ below 80              BNM• NOMS claimed it was 85% accurate, this study suggests even higher accuracy.• 49/80 of the participants had an NOMS IQ score of 3 or lower.• If the prison service adopt the tool it would mean that these individualswould not require any further IQ testing – placed straight onto the C-SOTP.• 5/80 had an NOMS IQ score of 10 or 11 and could be placed straight ontothe BNM programme without any further IQ testing.• 54/80- no further IQ testing = 67.5% of the sample population.• IQ testing time reduced by a factor of 3 - only a third of the prisonerpopulation would need to be tested using the longer WAIS assessment.12Adaptive Functioning (AF)Why is AF important?• Talbot (2007;2008) looked at ID individuals experience of the CJS:– Unable to access prison information. – Experience difficulties adapting to prison rules and discipline.– Some prisoners with ID did not know why they were in prison.– Increase likelihood of being victimised.– More likely to receive inadequate levels of support. – Routinely excluded from certain activities and opportunities. – Spend more time alone.– Higher levels of anxiety and depression.– Increased risk of suicide and/or self harm.– Receive inappropriate treatment (drop-out increases recidivism, places are expensive, impacts on sentence length).– Most staff expressed concern about the vulnerability of these individuals.14Why a new AF measure?• Historical over-reliance on IQ when assessing ID.• There is no AF assessment that accurately measures AF amongst prisoners.• Current AF measures are inappropriate for use in prison populations:– Items based on community behaviours e.g. obeys traffic light signals– They are expensive, lengthy, administered by trained psychologist and no permission to adapt them.• AFCL developed by NOMS– Not been tested and has no scoring procedure.• Consequently prisoners are not currently being accurately assessed.– Affects Treatment decisions– Experience within prison- if needs are not identified then supports cannot be put in place.The Adaptive Functioning Assessment Tool (AFAT)16Item Development• Staff and prisoners described a typical day inside prison:– Opportunities to display adaptive behaviour?– Make their own decisions?– Difficulties they face within the prison? • Items were developed directly from what each participant had said.• A conceptual framework of AF was developed via a review of current AF measures, definitions of AF, literature and discussions with experts.– The items were organised under the criteria set out in the conceptual framework17Stays on the topic of conversations; does not go off on a tangentThey respond ‘yes’ regardless of what is being askedAvoids spending time with othersDoesn’t understand why he gets into troubleAdaptive functioning domainContentCommunicationHow the individual pays attentionWhat the individual understandsHow the individual uses sentencesHow they express themselvesSocial ParticipationHow the individual interacts with othersHow they display sensitivity to othersHow they individual adapts their behaviour depending on the surroundings/peopleHow they control their feelings around othersPersonal IndependenceHow the individual presents themselves: how they dress and practice personal hygieneHow the individual uses time, money and the telephoneTheir overall level of managing within the prison e.g. how they adhere to the prison ruesand regime, seeking assistance, use of time.How well they can complete prison procedures and get what he wants e.g. filling outapplications, ordering from stores, filling out meal sheetFunctioning in Education, Work and Treatment ProgrammesDo they need help with reading and writing- what is their abilityHow well the individual can follow instructionsWhat is the quality and speed of the individuals workHow the individual interacts with othersWhat is their attention span, do they need thing repeating?18Item analysis• Originally 115 items were produced.– Needed to be reduced for practical reasons – too long.• Scored as either 0, 1 or 2, depending on how often or well the individual can perform the behaviour;– 0 = NEVER, 1 = SOMETIMES/PARTIALLY, 2 = USUALLY• Some examples of the retained items:• The conceptual framework states that the 4 domains should be fully covered – all were represented by the 46 items19Is able to express themselves clearly to othersAttends arranged appointmentsIs easily led by other peopleHow will this benefit prisoners and the prison service?• The AFAT is the first measure of AF that is suitable to use in a prison setting.• AFAT can be used in the diagnosis of ID, removing the emphasis away from sole reliance on IQ.• The AFAT can better inform treatment decisions- Core Vs BNM.• It can be used to identify supports required for prisoners,• Since The Prison Service Order 2855 (2005) states:‘It is Prison Service Policy….that disabled prisoners are not discriminated against in any aspect of prison life and that equality of opportunity in accessing all parts of prison life, and in particular to address their offending behaviour and be resettled is offered to all prisoners.’(pg. 5). • The next step is to evaluate the scale – Early analyses indicate that it is valid and reliable - that is, it is measuring what it purports to measure (AF) and the test is consistent20Conclusions:• ID and AF are both important in the assessment of ID.• There is a lack of validated tools used to assess AF in the prison service.• The NOMS IQ Screening Tool is a highly accurate predictor of whether an individual’s IQ is over or above the 80 threshold and placing people onto the correct TP.– It doesn’t tell you the exact IQ score but it does tell you with a high probability (93% confidence) whether an individuals IQ is above 80.– It is a carries many advantages over the WASI- it’s quicker and the information is readily available via the OASys database.– It will speed up the process of IQ assessment• The AFAT can be used to assess AF levels which will help diagnose ID.– Useful for treatment decisions and support assessments– Early analyses suggest that it is a valid and reliable measure• Both tools need further testing before they can be generalised to other populations21Thanks for listening ☺• Any questions???22

The development and validation of two screening measures to help in the identification of intellectually disabled (ID) offenders

http://irep.ntu.ac.uk/id/eprint/32658/1/PubSub10036_Winder.pdf

The development and validation of two screening measures to help in the identification of intellectually disabled (ID) offenders

Abstract

Similar works

Full text

Available Versions

Nottingham Trent Institutional Repository (IRep)