{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:10:47Z","timestamp":1787015447903,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J intellect Disabil Res"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This paper examines clinical outcomes of an approach to referrals for concerns about severe behavioural distress in people with intellectual disabilities (ID) that is based on the concepts of emotional development (EDev) and attachment. Due to research and clinical experiences suggesting that positive behaviour support (PBS) may have limited long\u2010term impact, an alternative approach is proposed, which focuses on relational factors and emotional skills already held by carers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>We report the process and outcomes of a brief standardised assessment using the Scale of Emotional Development\u2013Short (SED\u2010S) which then informed an attachment\u2010based workshop. Outcomes were measured by way of the Health of the Nation Outcome Scales\u2013Learning Disabilities (HoNOS\u2010LD) administered at (a) assessment, (b) following 1\u20132 intervention workshops and (c) at 6\u2010month follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significantly fewer sessions and hours of clinical time were required for the EDev intervention than the prior PBS interventions. Results demonstrated significant improvements from assessment to post\u2010intervention, which were maintained 6\u2009months later. Almost half (48%) of the participants were referred while in unsettled accommodation arrangements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides initial evidence supporting an approach that shows promise as an alternative to existing models of care based upon applied behaviour analysis. Future well\u2010controlled studies across multiple sites are needed, but if these findings are replicated, the priority for intervention may shift from reduction in behavioural risks to robust care relationships which meet the person's emotional needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jir.70008","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T01:03:46Z","timestamp":1751936626000},"page":"1097-1104","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of an Intervention Programme for People With Intellectual Disabilities and Behavioural Concerns Based on Emotional Development"],"prefix":"10.1111","volume":"69","author":[{"given":"Allan","family":"Skelly","sequence":"first","affiliation":[{"name":"Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust  Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jade","family":"Wigham","sequence":"additional","affiliation":[{"name":"Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust  Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7435-0084","authenticated-orcid":false,"given":"Mark","family":"Hudson","sequence":"additional","affiliation":[{"name":"Mental Health and Clinical Neurosciences, School of Medicine University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"issue":"1","key":"e_1_2_8_2_1","first-page":"4","article-title":"Clinical Outcomes of Staff Training in Positive Behavioural Support to Reduce Challenging Behaviour in Adults With Intellectual Disability: Further Thoughts on Intervention, Implementation and Interpretation","volume":"8","author":"Allen D.","year":"2018","journal-title":"International Journal of Positive Behaviour Support"},{"key":"e_1_2_8_3_1","volume-title":"Facing the Challenge: An Ordinary Life for People With Learning Difficulties and Challenging Behaviour","author":"Blunden R.","year":"1987"},{"key":"e_1_2_8_4_1","volume-title":"Incorporating Attachment Theory Into Practice: Clinical Practice Guideline for Clinical Psychologists Working With People Who Have Intellectual Disabilities","author":"British Psychological Society","year":"2017"},{"key":"e_1_2_8_5_1","volume-title":"Challenging Behaviour: A Unified Approach\u2014Update","author":"British Psychological Society","year":"2016"},{"key":"e_1_2_8_6_1","first-page":"726","article-title":"Less Secure Attachment Behaviour to Specific Caregivers Is Associated With Maladaptive Behaviour in Day Care","volume":"52","author":"De Schipper J. 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School of Social Sciences Humanities and Law Teesside University."},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13175113"},{"key":"e_1_2_8_27_1","unstructured":"National Institute for Health and Care Excellence.2015. \u201cChildren's Attachment: Attachment in Children and Young People Who Are Adopted From Care in Care or at High Risk of Going Into Care.\u201dTools and resources | Children's attachment: attachment in children and young people who are adopted from care in care or at high risk of going into care | Guidance | NICE."},{"key":"e_1_2_8_28_1","unstructured":"National Institute for Health and Care Excellence.2016. \u201cChildren's Attachment: Quality Standard.\u201dOverview|Children's attachment|Quality standards|NICE."},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/00207640231175773"},{"key":"e_1_2_8_30_1","volume-title":"The Circle of Security Intervention: Enhancing Attachment in Early Parent\u2013Child Relationships","author":"Powell B.","year":"2014"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jaba.163"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.180.1.61"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2016.08.019"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0215474"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12697"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192013109"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1027\/00589-000"},{"key":"e_1_2_8_38_1","volume-title":"Love, Attachment and Intellectual Disability: Meeting Emotional Needs and Developmental Trauma","author":"Shimmens V.","year":"2023"},{"key":"e_1_2_8_39_1","unstructured":"Simler A.2019. \u201cAn Investigation Into Positive Behavioural Support and Quality of Life. 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