Adults with autism spectrum disorder and learning disability presenting with challenging behaviour: how tolerant should we be?
| Pages | 42-52 |
| Published date | 01 January 2013 |
| DOI | https://doi.org/10.1108/JIDOB-05-2013-0010 |
| Date | 01 January 2013 |
| Author | Cristian Raggi,Kiriakos Xenitidis,Maria Moisan,Quinton Deeley,Dene Robertson |
| Subject Matter | Education,Health & social care,Sociology |
Adults with autism spectrum disorder
and learning disability presenting with
challenging behaviour: how tolerant
should we be?
Cristian Raggi, Kiriakos Xenitidis, Maria Moisan, Quinton Deeley and Dene Robertson
Cristian Raggi is a Clinical
Psychologist and Group
Analyst, Neurodevelopmental
Disorders Service (NDS), South
London and Maudsley
Foundation Trust,
Beckenham, UK.
Kiriakos Xenitidis is a
Consultant Psychiatrist and
Group Analyst,
Neurodevelopmental Disorders
Service (NDS), South London
and Maudsley Foundation
Trust, Beckenham, UK.
Maria Moisan is a Trainee in
Psychiatry,
Neurodevelopmental Disorders
Service (NDS), South London
and Maudsley Foundation
Trust, Beckenham, UK.
Quinton Deeley is a Consultant
Psychiatrist,
Neurodevelopmental Disorders
Service (NDS), South London
and Maudsley Foundation
Trust, Beckenham, UK.
Dene Robertson is a
Consultant Psychiatrist,
Neurodevelopmental Disorders
Service (NDS), South London
and Maudsley Foundation
Trust, Beckenham, UK.
Abstract
Purpose – Reporting to the police incidents of challenging behaviour displayed by inpatients with autism
spectrum disorders (ASD) and learning disability (LD) represents an important but often controversial issue.
The purpose of this paper is to contribute to this topic through a brief literature review and the presentation
of a clinical case.
Design/methodology/approach – Case study and literature review.
Findings – The action of reporting to the police can be a useful tool within the therapeutic input provided to
patients with ASD and LD who present with challenging behaviour. This can enable staff to feel legally
supported, and can promote patients’ learning of social rules, in respect of their rights and duties. The
clinical case highlighted that reporting to the police can be effective when it is part of a comprehensive,
multi-professional therapeutic process. This should aim at directing patients towards rehabilitation rather
than incarceration. This should also entail the identification of clear pathways and ongoing involvement of
patients and families.
Originality/value – Despite the relevance for clinical practice of the above debate, little has been published
on this topic. This paper contributes to this discussion through the presentation of a clinical case and
by describing how this issue was addressed within a secure inpatient setting.
Keywords Intellectual disabilities, Offending behaviour, Autism spectrum disorder, Prosecution,
Challenging behaviour
Paper type Case study
Introduction
The interest in autism spectrum disorders (ASD) has considerably increased over the last two
decades. However, proportionately less attention has been paid to the topic of autism and
offending behaviour (Dein and Woodbury-Smith, 2010), especially in the context of learning
disability. Even less attention has been given to the topic of reporting to the police, with limited
literature over the last 25 years on the issues surrounding the process of prosecuting psychiatric
patients (Dinwiddie and Briska, 2004; van Leeuwen and Harte, 2011).
This is an area of high-clinical importance. In fact, a number of studies within UK forensic
settings have indicated a prevalence of offenders with ASD higher than that expected in the
general adult population (Scragg and Shah, 1994; Allen et al., 2008). This is thought to amount
to up to 1.5-2.3 per cent, as reported by Dein and Woodbury-Smith (2010) referring to a study
carried out at Broadmoor high-security psychiatric hospital. Limited research has, however,
been carried out to inform on the implementation of rehabilitation services tailored to offenders
PAGE 42
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JOURNAL OF INTELLECTUAL DISABILITIES AND OFFENDING BEHAVIOUR
j
VOL. 4 NO. 1/2 2013, pp. 42-52, CEmerald Group Publishing Limited, ISSN 2050-8824 DOI 10.1108/JIDOB-05-2013-0010
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