Browsing by Person "Maciver, Donald"

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A multi-disciplinary framework and rapid assessment tool for developmental co-ordination disorder services.
(2009-08) Forsyth, Kirsty; Maciver, Donald; Howden, Stella; Owen, Christine; Shepherd, C.; Rush, Robert
A Rasch analysis of the model of human occupation screening tool single observation form (MOHOST-SOF) in mental health
(SAGE, 2016-01) Maciver, Donald; Morley, M.; Forsyth, Kirsty; Bertram, N.; Edwards, T.; Heasman, D.; Rennison, J.; Rush, Robert; Willis, Suzie
Introduction This study examined the psychometric properties of the model of human occupation screening tool single observation form. Method Clinical records were extracted pre- and post-treatment for 152 mental health service users. Data were model of human occupation screening tool single observation form scores and demographics. We investigated the form using Rasch analysis; we also present an analysis of change over time. Results We identified four misfitting items and evidence of instability with respect to change over time. After anchoring to adjust for unstable estimates, it was possible to measure client change, and there were significant differences in scores pre-post treatment indicating client improvement in ability. Conclusion The study provides initial psychometric assessment of this version of the model of human occupation screening tool.
ACHIEVE - active in children's health: integrating evidence, valuing experience
(The Royal Society of Medicine Journals, 2012-06) Mulvanny, A.; Whitehead, Jacqueline; Forsyth, Kirsty; Maciver, Donald; Walsh, M.; Healthcare Improvement Scotland; Knowledge Transfer Partnership
The article discusses a study to develop a comprehensive procedure for continued assessment of children aged between of 0-18 years with attention deficit hyperactivity disorder (ADHD). The authors have designed a pathway incorporating 6 key performance indicators (KPIs) including a standardized classroom observation schedule, structured and equitable training opportunities and access to paediatric and Child and Adolescent Mental Health Services (CAMHS) occupational therapy where appropriate.
An analysis of prescribing data in attention-deficit hyperactivity disorder for adolescents and adults in Scotland
(Cambridge University Press, 2024-08-08) Radley, Andrew; Melia, Barry; Maciver, Donald; Rutherford, Marion; Boilson, Marie
Background Medication, combined with environmental and psychosocial support, can mitigate adverse outcomes in attention-deficit hyperactivity disorder (ADHD). There is a need for research into regional and national prescription volumes and patterns, especially among adults. Aims This study analysed prescribing patterns for medications commonly used to treat ADHD in adolescents and adults. Method Data was extracted from the NHS Scotland Prescribing Information System on prescriptions for 7806 adolescents (aged 10–19 years) and 4998 adults (aged 20–59 years) in 2019. This included medications listed under Section 4.4 of the British National Formulary. We explored 2019 prescription patterns across different regions and estimated ADHD prevalence levels. Additionally, we assessed changes in dispensed prescriptions, defined daily dose and costs, compared with figures from 2010. Results Between 2010 and 2019, prescriptions for ADHD medications increased (dispensed prescriptions +233.2%, defined daily dose +234.9%, cost +216.6%). Despite these increases, analysis indicated that in 2019, considering a 5% estimated ADHD prevalence among adolescents, 73% were not prescribed medication, increasing to 81% at a 7% estimated prevalence. Similarly, among adults with a 2% estimated prevalence, 91% were not prescribed medication, rising to 96% at a 4% estimated prevalence. Regional disparities were evident, with 41–96% of adolescents and 85–100% of adults, based on ADHD prevalence estimates, not receiving a prescription, depending on area. Conclusions Although prescription rates for ADHD medication have increased over time, the data do not indicate excessive use of medication. Instead, they suggest that for some groups there is a lower use of medication compared with expected prevalence figures, especially among adults.
Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland
(Sage, 2025) Maciver, Donald; Roy, Anusua Singh; Johnston, Lorna; Boilson, Marie; Curnow, Eleanor; Johnstone-Cooke, Victiora; Rutherford, Marion
This study examined differences in referral and diagnosis based on sex recorded at birth (hereafter, ‘sex’), using case notes from 408 individuals diagnosed by 30 multidisciplinary teams across Scotland. Analyses focused on male-to-female ratios and median ages at referral and diagnosis across attention-deficit/hyperactivity disorder, autism and intellectual disability. The lifespan male-to-female ratio across all diagnoses was 1.31, varying by category and age. In autism, the male-to-female ratio was 2.21 for children under 10 years, but there were more females in adolescence (male-to female ratio=0.79) and adulthood (male-to-female ratio=0.94). Across the lifespan, combining all diagnoses, females were referred later (median ages: 14.4 vs 19.7 years; p<0.001) and diagnosed later (median ages: 15.2 vs 20.2 years; p<0.001), indicating a 5-year delay. Among autistic children and adolescents, females were referred later (median age: 7.5 vs 10.5years; p=0.002) and diagnosed later (median age: 9.3 vs 11.9years; p=0.003). However, no significant differences were found in age of referral or diagnosis for autistic adults. Overall, the results indicate partial equalisation of sex ratios across the lifespan, pronounced asymmetry in younger age groups, andconsistent delays in referral and diagnosis ages for females.
Associations between adolescent psychosocial factors and disengagement from education and employment in young adulthood among individuals with common mental health problems
(Springer, 2022-03-11) Tayfur, Sumeyra N.; Prior, Susan; Singh Roy, Anusua; Maciver, Donald; Forsyth, Kirsty; Irvine-Fitzpatrick, Linda
Transition to adulthood can be a challenging developmental task for adolescents with common mental health problems and is linked to adverse outcomes such as ‘not in education, employment or training’ (NEET). This study investigated longitudinal associations between adolescent psychosocial factors (e.g., self-esteem, aspirations, bullying, physical activity) and later NEET status among individuals with common mental health problems (i.e., depression and anxiety). A secondary data analysis of the Next Steps cohort study was completed using waves 2 and 8. Psychosocial factors, mental health, and background characteristics were captured when participants were aged 15–16 years (wave 2) while still in compulsory education. The 12-item General Health Questionnaire was used to identify adolescents with common mental health problems. The study population consisted of 2224 participants (females 66.8%) of which 1473 (66.2%) were aged 15 years and 751 (33.8%) were aged 16 years in wave 2. The outcome was NEET status at ages 25–26 years (wave 8). The results showed that after adjusting for background characteristics, adolescent self-esteem, locus of control, bullying, physical activity, job aspirations, and attitudes to school predicted NEET status. Educational aspirations, substance use, and behavioural problems were not significantly associated with NEET status. These findings provide new insights into the role of adolescent psychosocial factors in the context of education and employment outcomes for youth at risk and highlight the necessity of targeted mental health support to improve life chances.
Beyond Accommodations: Supporting Autistic Health Professionals. Practice based guide for employers and employees
(National Autism Implementation Team, 2024) Curnow, Eleanor; Rutherford, Marion; Maciver, Donald; Johnston, Lorna; Utley, Isabelle; Murray, M; Johnstone-Cooke, Victoria; Muggleton, J; Jenkins, N; Gray, A; Meff, T
This guide is intended to support neurodivergent people working in the healthcare sector by providing information and practical suggestions based upon the views and preferences of neurodivergent adults. Autistic people can have poor employment outcomes, are under-represented in the workforce, and often experience discrimination and poor mental health (Buckley et al., 2021; Bury et al., 2021; Wood et al., 2022). Employment is often precarious (short term, part-time, low paid) and individuals are underemployed or overqualified for their current roles. Although, as not all autistic people are diagnosed or choose to share their autistic identity, the literature may not reflect the true picture. It is therefore important that we increase our understanding of the challenges facing autistic people not only in gaining employment but within the workforce. This study draws on the experience of autistic professionals working in health and education because professionals working within health and education are well placed to become influential positive role models (Lawrence, 2019). The guidance is based on information obtained during a review of published literature and interviews with thirty-four autistic people who work in professional roles within health and education in Scotland. They were asked about their experiences of training, recruitment, and employment, particularly factors that offered them support, and factors which challenged them. They also provided recommendations for improving training, recruitment, and employment for neurodivergent people in the future. The guide was also reviewed by people working in management and human resources roles across health and education. This guide is intended to provide information which will support neurodivergent people in employment. Often adjustments to language, mindsets and actions do not cost money and can provide benefit to the whole diverse workforce. Throughout this guide we have included direct quotations obtained during interviews with autistic professionals. This guide and the research on which it is based was conducted by a team which includes autistic and non-autistic researchers. Although our focus has been on autistic people, it is well known that most autistic people experience co-occurring mental health and neurodevelopmental differences. Similar experiences are shared by people with ADHD or who identify as neurodivergent.
Beyond Accommodations: Supporting Autistic Professionals in Education. Practice based guide for employers and employees
(National Autism Implementation Team, 2024) Curnow, Eleanor; Rutherford, Marion; Maciver, Donald; Johnston, Lorna; Utley, Isabelle; Murray, M; Johnstone-Cooke, Victoria; Muggleton, J; Jenkins, N; Gray, A; Meff, T
This guide is intended to support neurodivergent people working by providing information and practical suggestions based upon the views and preferences of neurodivergent adults. Autistic people can have poor employment outcomes, are under-represented in the workforce, and often experience discrimination and poor mental health (Buckley et al., 2021; Bury et al., 2021; Wood et al., 2022). Employment is often precarious (short term, part-time, low paid) and individuals are underemployed or overqualified for their current roles. Although, as not all autistic people are diagnosed or choose to share their autistic identity, the literature may not reflect the true picture. It is therefore important that we increase our understanding of the challenges facing autistic people not only in gaining employment but within the workforce. This study draws on the experience of autistic professionals working in health and education because professionals working within health and education are well placed to become influential positive role models (Lawrence, 2019). The guidance is based on information obtained during a review of published literature and interviews with thirty-four autistic people who work in professional roles within health and education in Scotland. They were asked about their experiences of training, recruitment, and employment, particularly factors that offered them support, and factors which challenged them. They also provided recommendations for improving training, recruitment, and employment for neurodivergent people in the future. The guide was also reviewed by people working in management and human resources roles across health and education. This guide is intended to provide information which will support neurodivergent people in employment. Often adjustments to language, mindsets and actions do not cost money and can provide benefit to the whole diverse workforce. Throughout this guide we have included direct quotations obtained during interviews with autistic professionals. This guide and the research on which it is based was conducted by a team which includes autistic and non-autistic researchers. Although our focus has been on autistic people, it is well known that most autistic people experience co-occurring mental health and neurodevelopmental differences. Similar experiences are shared by people with ADHD or who identify as neurodivergent.
A brief neuro-affirming resource to support school absences for autistic learners: development and program description
(Frontiers Media, 2024-03-22) Johnston, Lorna; Maciver, Donald; Rutherford, Marion; Gray, Anna; Curnow, Eleanor; Utley, Izy
Background: Education should be inclusive, nurturing each individual’s potential, talents, and creativity. However, criticisms have emerged regarding support for autistic learners, particularly in addressing disproportionately high absence levels within this group. The demand for accessible, person-centered, neuro-affirming approaches is evident. This paper provides a program description of a structured absence support framework, developed and implemented during and following the Covid-19 pandemic. We detail creation, content, and implementation. Methods: We collaborated with stakeholders, reviewed literature and drew on existing theoretical frameworks to understand absence in autistic learners, and produced draft guidance detailing practical approaches and strategies for supporting their return to school. The final resource was disseminated nationally and made freely available online with a supporting program of work around inclusive practices. Results: The resource is rooted in neuro-affirming perspectives, rejecting reward-based systems and deficit models of autism. It includes key messages, case studies and a planning framework. It aims to cultivate inclusive practices with an autism-informed lens. The principles promoted include recognizing the child’s 24-hour presentation, parental partnership, prioritizing environmental modifications, and providing predictable, desirable and meaningful experiences at school. Feedback to date has been positive in terms of feasibility, face validity, and utility. Conclusion: This novel, freely available resource provides a concise, practical framework for addressing absence in autistic learners by cultivating a more inclusive, equitable, and supportive educational system in which autistic individuals can thrive.
Chapter 16: Eliciting Clients’ Perspectives: Gathering Information From Clients, Caregivers, and Other Professionals
(Wolters Kluwer, 2024) Popova, Evguenia S.; Kramer, Jessica M.; Scott, Patricia J.; Maciver, Donald; Linddahl, Iréne; Norrby, Eva
Chapter 22: Applying the Model of Human Occupation to Individuals With Mental Health Conditions
(Wolters Kluwer, 2024) Melton, Jane C.; Harding, Becky; Cooper, John R.; Allen, Susan; Reed, Melissa; Forsyth, Kirsty; Prior, Susan; Maciver, Donald; Harrison, Michele; Raber, Christine; Quick, Laura
Community‐based participation of children with and without disabilities
(Wiley, 2019-11-25) Arakelyan, Stella; Maciver, Donald; Rush, Robert; O'Hare, Anne; Forsyth, Kirsty
AIM To describe and compare the socio-demographic characteristics and community-based participation of children with and without disabilities.
Contextual factors influencing neuro-affirming practice – identifying what helps or hinders implementation in health and social care
(SAGE Publications, 2025-09-09) Gray, Anna; Johnston, Lorna; Rutherford, Marion; Curnow, Eleanor; Maciver, Donald
There has been limited research to date into contextual factors hindering or supporting the successful implementation of neuro-affirming practice in support for Autistic and otherwise neurodivergent adults. We used a Realist Evaluation approach to explore key contexts affecting neuro-affirming practice. A preliminary programme theory of key aspects of support was developed. Views on current practice were sought through structured interviews with 32 senior professionals in leadership roles within Health and Social Care services in Scotland. This study identified important contexts shaping the implementation of neuro-affirming practice for adults. Results indicate widespread professional support for modifying practice to better accommodate neuro-affirming ideas, and scope to achieve this. However, some contexts, including limited resources, restrictive eligibility criteria and rigid service structures, hinder progress. Growing demand for services was often viewed as a restrictive context, but it also offered a chance to rethink conventional, one-size-fits-all models and adopt neuro-affirming approaches. The study is important in addressing a current gap in research into professional perspectives of the contexts required to develop transdiagnostic, neuro-affirming approaches and pathways for Autistic and neurodivergent adults. The insights from this study may offer transferable practice approaches, applicable across different countries with similar healthcare contexts.
Determinants of school attendance in elementary school students in Japan: A structural equation model
(BMC, 2021-07-27) Nakamura-Thomas, Hiromi; Sano, Nobuyuki; Maciver, Donald
Background Managing school nonattendance is a priority worldwide. Frequent school nonattendance in early school years has immediate and long-term negative effects. Although strategies to address nonattendance are being developed and implemented, the number of students with school nonattendance issues is increasing. In this study, we explored students’ feelings and perceptions about attending school and the potential determinants of a positive attitude towards attending school.
Development and implementation of the CIRCLE Framework
(Taylor & Francis, 2019-07-12) Maciver, Donald; Hunter, Cathleen; Adamson, Amanda; Grayson, Zoe; Forsyth, Kirsty; McLeod, Iona
We report the implementation of a new framework supporting teacher practice for inclusion of children with disabilities in mainstream classrooms. Eight schools in one Scottish authority took part. Questionnaire, focus group and interview data were gathered. Results indicated that the framework was well-received and provided a useful resource for class teachers. The framework was perceived as a feasible method for supporting teachers and related personnel to think systematically about key issues relating to children with disabilities in the classroom. It was suggested that provision of a common language was supportive of collaborative working. Areas for revision included a system of navigation and simplification in the framework manual.
Development of a pathway for multidisciplinary neurodevelopmental assessment and diagnosis in children and young people
(MDPI, 2021-11-11) Rutherford, Marion; Maciver, Donald; Johnston, Lorna; Prior, Susan; Forsyth, Kirsty
There is a variable standard of access to quality neurodevelopmental assessment and diagnosis. People may have negative experiences, encountering lengthy waiting times, and inconsistent practices. Practitioners need guidance on standards and practices for assessment and diagnosis matched to new ways of working. In this paper, we present a new pathway and recommendations for multidisciplinary neurodevelopmental assessment and diagnosis for children and young people (<19 years), developed by the Scottish Government funded National Autism Implementation Team (NAIT). Our research used the Medical Research Council guidance for the development of complex interventions and included several iterative stages. Stage 1: n = 44 stakeholders attended an event on developing new practices for diagnosis and assessment. Stage 2: a literature synthesis was completed by the research team of clinical guidelines and diagnosis and assessment tools. Stage 3: an event with n = 127 stakeholders included discussion and debate of the data from stages 1 and 2. Recommendations and a draft pathway were written. Stage 4: successive drafts of recommendations and the pathway documentation were circulated among an advisory group, including multidisciplinary clinical experts and people with lived experience, until the final pathway was agreed upon. The finalised pathway includes guidance on terminology, assessment, diagnosis, triage, time standards and engagement of people with lived experience. The new pathway has been adopted by the Scottish Government. The pathway and associated documentation are freely available online for use by others.
Development, psychometrics and feasibility of the School Participation Questionnaire: A teacher measure of participation related constructs
(Elsevier, 2020-09-19) Maciver, Donald; Tyagi, Vaibhav; Kramer, Jessica; Richmond, Janet; Todorova, Liliya; Romero-Ayuso, Dulce; Nakamura-Thomas, Hiromi; van Hartingsveldt, Margo; Johnston, Lorna; O'Hare, Anne; Forsyth, Kirsty
Background We report development of the SPQ (School Participation Questionnaire) a teacher-completed measure of participation related constructs for schools. The SPQ was developed to support participation-related assessment, interventions, and research in the inclusive school context.
Developmental Co-ordination disorder: supporting professionals to provide evidence based care.
(2009-03) Forsyth, Kirsty; Maciver, Donald; Howden, Stella; Owen, Christine; Shepherd, C.; Rush, Robert
Developmental Coordination Disorder: A synthesis of evidence to underpin an allied health professions' framework
(Taylor & Francis, 2008-06) Forsyth, Kirsty; Maciver, Donald; Howden, Stella; Owen, Christine; Shepherd, C.
Children with Developmental Coordination Disorder (DCD) lack the motor coordination necessary to perform tasks considered appropriate for their age, given normal intellectual ability and the absence of other neurological disorders. DCD is a common childhood disorder that can develop into a long-term condition that has a significant impact on society. A key method of managing DCD is through the assessment and interventions of allied health professionals (AHPs). To date, no integrated AHP framework for the assessment and treatment of DCD exists. The present article illustrates the methods used to synthesise multiple data sources (policy, scientific evidence, service user views and AHP perspectives) by a multidisciplinary group of AHP researchers and practitioners. Through this process a series of principles of good practice were identified, and then developed into a framework for AHPs working with children with DCD. In this article the methodology used to enable synthesis from different evidence sources will be presented, as will the resultant framework. The findings will then be discussed within the current literature emphasising the importance of health/education partnership in the support and management of these children.
Diagnostic Assessment of Autism in Adults -Current Considerations in Neurodevelopmentally Informed Professional Learning with reference to ADOS-2
(Frontiers Media, 2023-10-05) Curnow, Eleanor; Utley, Izy; Rutherford, Marion; Johnston, Lorna; Maciver, Donald
Services for the assessment and diagnosis of autism in adults in the United Kingdom have been widely criticised and there is an identified need for further research in this field. There is a call for diagnostic services to become more accessible, person-centred, neurodiversity affirming, and respectful. In Scotland, there is a need for workforce development which will increase capacity for diagnostic assessment and support for adults. ADOS-2 is a gold-standard diagnostic assessment tool for autism recommended in clinical guidelines. However, diagnostic procedures such as the ADOS-2 are rooted in the medical model and do not always sit comfortably alongside the neurodiversity paradigm preferred by the autistic community. Training and educational materials need to account for the differences between these approaches and support clinicians to provide services which meet the needs of the adults they serve. The National Autism Implementation Team work alongside ADOS-2 training providers to support clinicians in Scotland, to provide effective diagnostic assessment within a respectful environment. The team engaged with clinicians who had attended ADOS training to identify areas of uncertainty or concern. Training materials were developed to support ADOS assessors to incorporate key principles including 'nothing about us without us;' 'difference not deficit;' 'environment first;' 'diagnosis matters,' 'language and mindsets matter;' and 'a neurodevelopmental lens,' to support the provision of neurodiversity affirming practice. The National Autism Implementation Team also provided examples of actions which can be undertaken by clinicians to enhance the assessment experience. Training materials are based on research evidence and clinical experience.