Transcript view Mick`s presentation - Good

Working With
Intellectually Disabled
Sexual Offenders
Mick Pykett
Dr Fiona Williams
Intellectual disability
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IQ 70 and below ( as measured by a
standardised IQ assessment)
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Deficits in adaptive functioning
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Evident before 18 years of age
(DSM-IV-TR, 2000)
Impaired adaptive functioning
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Communication and social skills
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( Interacting and communicating with others)
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Independent living skills
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( Shopping, self care, budgeting, dressing and grooming)
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Personal care skills
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( Eating, hygiene, health and safety, dressing and grooming)
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Employment/work skills
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(Self direction, use of own time, leisure time, following directions, completing tasks and getting to places on time)
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Practical academics
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( Reading, computation and telling time)
Language
Mental retardation –USA
 Mental handicap - Ireland
 Learning Disability - UK
 Intellectual Disability –UK 2000 onwards
 Specifc Learning Disability – Average IQ,
Dyslexia, dyscalculia
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Common problems for ID
offenders in prison
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Prisoners are not routinely assessed for ID or
other learning difficulties so the problem is
unknown
Staff are not trained to spot or work with these
difficulties
ID prisoners tend to get into trouble for not
following orders – they may forget them, not
understand them in the first place due to pace of
conversation, take them literally or have
problems initiating a behaviour
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Difficulties with reading and writing and with
adaptive functioning means they have trouble
with choosing activities, canteen orders and food
May have difficulties putting in applications to
healthcare or psychology or reading prison rules
and notices. May be seen as lazy or trouble
makers
Tend to ‘mask’ their behaviours e.g they give an
an answer which may be incorrect – seen as
rude or cheeky
May not respond to offending behaviour
treatment – seen as resistant, not motivated and
risky
Psychological impact
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Fear of failure
Sensitivity to disability
Not confident to ask for help
Frustration/give up easily
Desire to please
Masking
IQ assessment
Weschler Adult Intelligence Scale IV
(WAIS IV)
 Working memory
 Verbal Comprehension
 Perceptual reasoning
 Processing speed
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Verbal expression
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Receptive language problems – Difficulty
understanding long or complex words, decoding
sentences and understanding the meaning of
language
Expressive language problems- Don’t know the
right words to convey meaning, limited range of
vocabulary, use words, sayings and clichés
incorrectly.
Processing speed
May take longer for the brain to find
meaning to what is being said
 Responses are slowed because the brain
is trying to decode
 May lose track of things because they are
trying to decode the last sentence
 Very difficult to multi-task
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Memory
Harder to find and recall memories
 Difficult to hold information in working
memory in order to use it
 Takes longer to record new memories e.g.
learn
 May forget a question asked of them and
try to mask this by answering unusually.
E.g. closed answer to an open question, or
provide an response that doesn’t match
the question
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Perceptual reasoning
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Using your imagination to think things through
in pictures, such as map reading, puzzles,
abstract concepts
Hard to adapt to new novel situations as it is
harder to anticipate what might happen
Difficult to categorise concepts – might struggle
with the difference between thoughts and
feelings
Difficulty with time sequencing and
understanding time related concepts and words
Adapted Treatment Approaches
 Self management
 IQ 60 – 80
 Motorway vs scenic path
 ID individuals can learn
 Its our job to identify the best method to
facilitate learning
 You have to change
 Personalised learning
Introducing VAK
Visual
 Auditory
 Kinaesthetic
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Principles for Working with ID
Move away from exclusive use of the
auditory/verbal style
 Reduce need for abstract thinking and
hypothetical situations
 Reduce load on memory
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Visual
Use pictures, drawings, symbols, posters,
photos
 Ask them to bring in materials e.g.
pictures, books, writing
 Keep the visual stimuli simple and clear –
i.e. Use simple words
 Use timelines to mark out where things
happened
 Visual imagery
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Visual
Try to accompany all your questions
with a visual aid
 Draw situations you want to discuss
 Ask them to draw – to answer any
questions, show you what they mean
 Consider use of visually based
exercises
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Auditory
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One question at a time
Short sentences
Use simple language - avoid words with 3 syllables
or more
No clichés or dry humour
Use metaphors to help them describe – ‘if your
feeling was a colour, cartoon character etc…’
Relate size of feelings to size of objects e.g. as big as
an elephant
Adapt to their language needs – someone with good
receptive language may need to be asked questions
verbally but answer through showing (visually or
kinaesthetically) and vice versa
Auditory
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Encourage group discussions
Use of music if appropriate
Use sound of voice to alter tone and pace of the session
– slow pace of speech
Open questions
Repetition of information to aid recall
Frequent praise
Pair auditory stimuli with visual and kinaesthetic
Kinaesthetic
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Exercises which help them get into a ‘state’ to
work with you – icebreakers, brain breaks
during the interview
Explore things in role-plays – ‘show me’ what
you would do/did do
You show them – demonstrate points or
questions by role play or holding positions
Have them direct you – ‘tell me what I should
do’
Put them in roles to achieve learning e.g.
perspective taking
Kinaesthetic
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Using hand gestures to accompany visual and
auditory material
Use movement when appropriate
Brain breaks
Give each person in the group a specific role to
keep their attention
Games that aid memory and recall
General tips
Be aware of suggestibility – try to avoid
leading questions
 Avoid hypothetical situations
 Check out learning by asking them to
tell you want they understand
 Use common anchors to help them
describe times e.g. meal times, birth
days etc
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Process
Is as important as
Content