Desired Outcomes for Children and Adolescents with Autistic Spectrum Disorders

Within children's services, frameworks for assessing outcomes have been developed in the absence of consultation with children with autistic spectrum disorders and their parents. The research reported here worked with parents, other key adults and children with autistic spectrum disorders to identify desired outcomes. It found similarities with non‐autistic children in terms of the broad types of outcomes desired. However, the presence of autism meant either new or different sorts of outcomes were reported. Implications in terms of the ways outcomes for autistic children are defined and measured, and the role of services in achieving outcomes is discussed. © 2006 The Author(s).     

Regression of area mortality rates on explanatory variables: what weighting is appropriate?

"One can often gain insight into the aetiology of a disease by relating mortality rates in different areas to explanatory variables. Multiple regression techniques are usually employed, but unweighted least squares may be inappropriate if the areas vary in population size. Also, a fully weighted regression, with weights inversely proportional to binomial sampling variances, is usually too extreme. This paper proposes an intermediate solution via maximum likelihood which takes account of three sources of variation in death rates: sampling error, explanatory variables and unexplained differences between areas. The method is also adapted for logit (death rates), standardized mortality ratios (SMRs) and log (SMRs). Two [United Kingdom] examples are presented."     

The Impact of a Structured-Argument Approach on Group Problem Formulation*

Despite advances in decision analysis and decision support systems, few formulaic procedures exist for undertaking problem formulation, particularly in group settings. This leaves managers with little procedural support for the important task of carefully structuring problems. In a laboratory experiment of 29 intact student teams, we contrasted two problem formulation methodologies: a structured argument approach (based on application of formal reasoning) and a group process approach (based on private idea generation prior to public sharing and evaluation of ideas). The structured argument approach took more time to use and failed to bring about more information search and equivocality reduction in group discussions. On the positive side, however, the structured argument approach led to a greater combination of both coverage of critical issues and consensus on those issues. Use of the structured argument approach also resulted in higher satisfaction with the problem definition and commitment to implementing results of the group meeting. Overall, the results reveal cost/benefit tradeoffs associated with developing argumentation-based procedures for problem formulation.     

Government guidance for the Care Act: undermining ambitions for change?

The UK Government claims to be creating a historic change to social care in England through the Care Act by putting people in control of their support. However, this is fundamentally contradicted by the draft guidance published to support the Act. This amounts to a formula for maintaining the prevailing resource-limited approach to assessing and meeting needs. This reality is obscured by a welter of choice and person-centred rhetoric. However, it need not be like this. Councils with a genuine commitment to being person-centred could refer directly to the Care Act to create an alternative future, while service users and their allies could bring about systemic changes if they use the Act to establish new rights.     

The eligibility question – the real source of depersonalisation?

There have been a number of high-profile strategies over recent decades to raise social care above what is widely regarded as an unacceptable service in the United Kingdom. Quite apart from all too frequent high-profile scandals, it is seen as a service that is depersonalising and stigmatising. None of the strategies to bring about change, most of them introduced to great fanfares, have delivered the changes they promised. This article sets out a view that the reason why they have all failed is that none of them have identified or therefore tackled the underlying problem, which is the relationship between needs and resources. Underfunding has long been a serious concern for campaigning organisations. The article does not detract from that contention. However, it sets out how strategies to manage the gap between needs and resources, more than the funding gap per se, are themselves the root cause of depersonalised and chronically impoverished services. The unlikely source of these strategies can be traced to the unintended consequences of an Act of Parliament that had the best of intentions.     

Poverty and Disabled People: challenging dominant debates and policies

This article explores the relationship between poverty, disability and impairment in a global context. It challenges dominant critiques of poverty and disability, and explores the critiques, policy proposals and developments of the disabled people's movement to combat poverty. It offers an international perspective including the experience of both the North and South.