Evaluation of the 'Risk Assessment Protocol for Intellectual Disabilites' in community services for adults with a learning disability

Review of the research literature on the prevalence of physical aggression in community teams for adults with a learning disability (CLDTs) suggests that services are managing people who are physically aggressive, which impacts on services. This suggests that there is a need for services to use risk assessment instruments of physical aggression to support teams to accurately identify those who will be physically aggressive to others. Established risk assessment instruments are resource intensive and so a screen, such as The Risk Assessment Protocol for Intellectual Disabilities (RAPID), developed in forensic psychiatric patients with a learning disability (LD), could support services to target their limited resources. \nThe predictive validity of the RAPID to predict physical aggression, property aggression and verbal aggression, in a community sample of adults with a LD was evaluated. The RAPID was compared to an established risk assessment instrument, the VRAG, in order to assess its concurrent validity. The predictive validity of the items of the RAPID were analysed to provide a measure of construct validity. The RAPID was also compared to a Risk Rating made by staff, to assess incremental validity. In addition, the ability of the RAPID to be easily and reliably scored was evaluated. \nThe RAPID predicted incidents of physical aggression with a large effect size. The RAPID was highly correlated with the VRAG, which suggests that it has good concurrent validity. Some of the items of the RAPID predicted physical aggression, which suggests some construct validity. It was not possible to establish that the RAPID has incremental validity above the VRAG or the Risk Rating. The RAPID was found to have good inter-rater reliability. The findings of the study suggest that the RAPID could be used to support CLDTs to make informed decisions about the completion of risk assessment instruments, risk management plans and interventions that aim to reduce the risk of physical aggression.