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Design
Multicentre cluster researcher-masked randomised controlled trial of manualised PBS staff training programme for managing challenging behaviour in adults with intellectual disability. The control group will receive treatment as usual. Treatment as usual will also be available to the participants in the intervention arm.
Inclusion criteria:
a) Service users: eligible to receive care from intellectual disability services; mild to severe intellectual disability; age 18 years and above; challenging behaviour occurring at least weekly including verbal or physical aggression, hyperactivity, non-responsiveness (total ABC score of at least 15)
b) Service: Willing to participate: availability of at least two staff members willing to train; written agreement by the service manager to participate.
Exclusion criteria:
a) Service users: primary clinical diagnosis of personality disorder or substance misuse; relapse in pre-existing mental disorder; decision by clinical team that a referral to the study would be inappropriate, e.g. there is an open complaint investigation.
b) Service: there are no team members willing to train; the service has already received and implements accredited PBS training for their service users.
Measures
Wechsler Abbreviated Scale of Intelligence
Short version of Adaptive Behaviour Scale (8)
Aberrant Behaviour Checklist (9,10)
Psychiatric Assessment Schedules for Adults with Developmental Disabilities (mini PAS-ADD (11)
EuroQol (ED-5D) (12)
Community Participation and Leisure Activities Scale (GCPLAS) (13)
Uplift/burden scale (14)
Family carer psychiatric comorbidity measured by the GHQ12
Caregiving Difficulty Scale- Intellectual Disability (CDS-ID) (15)
Client Services Receipt Inventory (16)
Participating sites
23 community intellectual disability services will be recruited. In order to recruit the required number of services within the timeframe of the project, we will conduct the trial across several regions in England which cover urban and semi-rural or rural areas