Assessing Risk in a Community Intellectual Disability Sample. The Clinical Utility of the Dynamic Risk Assessment and Management System (DRAMS): A Study of Clinician Evaluations

Literature Review: Growing numbers of people with intellectual disabilities are now living in the community and as a result are more exposed to the risk of offending. Assessment of risk is therefore becoming progressively within the remit of professionals working within community settings. The aim of the current review was to critically evaluate the literature on assessing the risk of offending in people with intellectual disabilities living within the community. The review highlighted that there are a number of barriers to assessing risk in such settings and that services which do exist for this population are often variable in their availability. In addition to this, unlike non-intellectually disabled populations, there is currently no standardised tool specifically for assessing risk in people with intellectual disabilities. Further research is needed to develop specialised risk assessment tools and to better understand and meet the needs of this client group. Research Report: The clinical utility of a newly-developed risk assessment tool, the Dynamic Risk Assessment and Management System (DRAMS), designed specifically for offenders with intellectual disabilities was investigated on a sample of 8 participants. The experience of clinicians' in carrying out the DRAMS was compared with their experience of carrying out the Functional Analysis of Care Environments Risk Profile (FACE) for the same participants. A randomised cross-over design found a significant difference between the two conditions, indicating that the DRAMS was favoured by the clinicians in terms of clinical utility and usability with intellectually impaired offenders. A thematic analysis of clinician experiences in administering the two measures supported this finding. In addition, verbal IQ of the offenders was found to be more highly correlated with the difference in scores on the Clinician Feedback Questionnaires than performance IQ, indicating that the clinicians found the DRAMS to be a more clinically useful tool with those offenders with a higher verbal IQ. Critical Appraisal: Reflections on research process, origins of the research question, and conducting the project are discussed.