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Some individuals with autism may engage in violent behaviour. Research into autism specific factors (ASFs) that may contribute to violence is limited. The purpose of this paper is to explore the feasibility of use of an ASF framework which was developed to inform risk formulation and treatment needs.

Retrospective identification and evaluation of ASFs in offenders with autism (N = 13) at childhood, time of index offence and in current risk behaviours. The ASFs described in the framework were repetitive behaviours and circumscribed interests; poor social understanding and empathy; sensitivity to sensory stimulation; and disruption to rigid behavioural routines or difficulties coping with change.

There was evidence for all four ASFs being consistently present in childhood, contributing to violent behaviour at the index offence and current risk behaviours in at least one case. Poor social understanding and empathy was often present at both childhood and index offence in all cases. Of the seven cases with offence paralleling behaviour, five had at least one ASF present at each timepoint.

This proof-of-concept study provides initial support that ASFs play a role in offending behaviour of individuals with autism. Clinicians working in specialist and generic forensic services, with an in-depth knowledge of autism, could use the ASF framework to enhance risk assessments and facilitate more targeted treatment planning for offenders with autism in specialist and general forensic services.

To the best of the authors’ knowledge, this study is the first to test the application of the ASF framework in an autistic offending population.

The development and clinical application of digital devices to support individuals with dementia can be challenging due to difficulties meeting the needs of a patient population with largely heterogeneous and progressive symptoms. Memjo Ltd has developed a digital interactive prototype tablet to promote cognitive stimulation and reminiscence. This proof-of-concept case-study aims to understand whether the engagement of individuals with dementia and Huntington's disease (HD) at an early stage is a useful approach to inform the initial development of meaningful digital activities and ultimately its potential introduction into clinical practice.

Five patients with dementia and HD at different stages of progression were recruited from an inpatient secure psychiatric hospital. Engagement, usability and preliminary benefits were assessed using a mixed-methods approach through observations, open-ended questions and subjective ratings.

The content of the tool triggered reminiscence, discussion and positive behavioural and emotional responses. The participants were confident using the tablet but needed support interacting with the touchscreen and, at times, to encourage communication. “Music” and “Videos”, were particularly successful in engaging most participants despite their cognitive and physical difficulties.

This case-study shows that co-production in clinical practice can be successfully implemented to develop activities that meet the interests and needs of patients with dementia and Huntington's disease. The varied and flexible assessment provided rich feedback that will be used to improve the device. This highlights avenues of focus for the development of future pools of activities.

Social avoidance disorders can be disruptive to the individual as they begin to over-manage their lives, at times avoiding social and work commitments. A potential therapeutic approach is exposure therapy and a virtual reality (VR) treatment approach, gameChange VR, has been developed. This provides an opportunity to test their fears in virtual environments. This study aims to investigate the feasibility of using this VR approach to treat people with social avoidance problems within a secure mental health setting.

Nine participants completed the gameChange VR sessions. Participants received 30-minute VR sessions for up to six weeks using selected scenarios at five levels of difficulty. Patients’ comments and behaviours were noted and clinical staff also provided feedback on their observations of patients’ use and experience with VR.

Overall, patients felt that the gameChange VR helped them to build their confidence and reduce their overall anxiety as they became more comfortable with the equipment. Both patients and staff generally found the intervention easy to use and the staff reported an overall high level of engagement among the participants. The key issues raised largely related to technical and safety issues.

While a previous study was carried out using gameChange VR with an outpatient cohort, this was the first using an inpatient group in a secure mental health setting. It has demonstrated that the intervention is viable in this setting, although further studies are required to identify the specific patient population that would benefit optimally from the therapy.