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Mirzaian CB, Deavenport-Saman A, Hudson SM, Betz CL. Barriers to Mental Health Care Transition for Youth and Young Adults with Intellectual and Developmental Disabilities and Co-occurring Mental Health Conditions: Stakeholders' Perspectives. Community Ment Health J 2024; 60:1104-1116. [PMID: 38619698 PMCID: PMC11199219 DOI: 10.1007/s10597-024-01262-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/25/2024] [Indexed: 04/16/2024]
Abstract
Youth and young adults (YYA) with intellectual and developmental disabilities (IDD) have high rates of co-occurring mental health (MH) conditions. The time during transition from pediatric to adult health and mental health care can be a very challenging, with risk of loss of services leading to poor outcomes. This study aimed to explore barriers to transition from pediatric to adult health and mental health care and services for individuals with IDD and co-occurring MH conditions, by eliciting the view of stakeholders, including disability advocates. Qualitative analysis was conducted using grounded theory, and themes were coded based upon the social-ecological model (SEM). We generated themes into multiple levels: the individual level, the family level, the provider level, the systems of care level, and the societal level. Stakeholders expressed a critical need to improve coordination between systems, and to increase provider availability to care for YYA with IDD and co-occurring MH conditions.
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Affiliation(s)
- Christine B Mirzaian
- Division of General Pediatrics, Children's Hospital Los Angeles, 4650 Sunset Blvd. MS #76, Los Angeles, CA, 90027, USA.
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - Alexis Deavenport-Saman
- Division of General Pediatrics, Children's Hospital Los Angeles, 4650 Sunset Blvd. MS #76, Los Angeles, CA, 90027, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Sharon M Hudson
- AltaMed Institute for Health Equity, AltaMed Health Services, Los Angeles, CA, USA
| | - Cecily L Betz
- Division of General Pediatrics, Children's Hospital Los Angeles, 4650 Sunset Blvd. MS #76, Los Angeles, CA, 90027, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Hesselmans S, Meiland FJM, Adam E, van de Cruijs E, Vonk A, van Oost F, Dillen D, de Vries S, Riegen E, Smits R, de Knegt N, Smaling HJA, Meinders ER. Effect of stress-based interventions on the quality of life of people with an intellectual disability and their caregivers. Disabil Rehabil Assist Technol 2024; 19:2198-2206. [PMID: 38037304 DOI: 10.1080/17483107.2023.2287161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 11/03/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE People with intellectual disabilities often show challenging behaviour, which can manifest itself in self-harm or aggression towards others. Real-time monitoring of stress in clients with challenging behaviour can help caregivers to promptly deploy interventions to prevent escalations, ultimately to improve the quality of life of client and caregiver. This study aimed to assess the impact of real-time stress monitoring with HUME, and the subsequent interventions deployed by the care team, on stress levels and quality of life. MATERIALS AND METHODS Real-time stress monitoring was used in 41 clients with intellectual disabilities in a long-term care setting over a period of six months. Stress levels were determined at the start and during the deployment of the stress monitoring system. The quality of life of the client and caregiver was measured with the Outcome Rating Scale at the start and at three months of use. RESULTS The results showed that the HUME-based interventions resulted in a stress reduction. The perceived quality of life was higher after three months for both the clients and caregivers. Furthermore, interventions to provide proximity were found to be most effective in reducing stress and increasing the client's quality of life. CONCLUSIONS The study demonstrates that real-time stress monitoring with the HUME and the following interventions were effective. There was less stress in clients with an intellectual disability and an increase in the perceived quality of life. Future larger and randomized controlled studies are needed to confirm these findings.
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Affiliation(s)
| | - Franka J M Meiland
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Medicine for Older People, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Esmee Adam
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network of the Care Sector Zuid Holland, Leiden, The Netherlands
| | | | | | | | | | | | | | | | - Nanda de Knegt
- Prinsenstichting, Care Center for People with Intellectual Disabilities, Purmerend, The Netherlands
| | - Hanneke J A Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network of the Care Sector Zuid Holland, Leiden, The Netherlands
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Adam E, Meiland F, Frielink N, Meinders E, Smits R, Embregts P, Smaling H. User Requirements and Perceptions of a Sensor System for Early Stress Detection in People With Dementia and People With Intellectual Disability: Qualitative Study. JMIR Form Res 2024; 8:e52248. [PMID: 38905626 PMCID: PMC11245304 DOI: 10.2196/52248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 04/09/2024] [Accepted: 04/24/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Timely detection of stress in people with dementia and people with an intellectual disability (ID) may reduce the occurrence of challenging behavior. However, detecting stress is often challenging as many long-term care (LTC) residents with dementia and residents with ID have communication impairments, limiting their ability to express themselves. Wearables can help detect stress but are not always accepted by users and are uncomfortable to wear for longer periods. Integrating sensors into clothing may be a more acceptable approach for users in LTC. To develop a sensor system for early stress detection that is accepted by LTC residents with dementia and residents with ID, understanding their perceptions and requirements is essential. OBJECTIVE This study aimed to (1) identify user requirements for a garment-integrated sensor system (wearable) for early stress detection in people with dementia and people with ID, (2) explore the perceptions of the users toward the sensor system, and (3) investigate the implementation requirements in LTC settings. METHODS A qualitative design with 18 focus groups and 29 interviews was used. Focus groups and interviews were conducted per setting (dementia, ID) and target group (people with dementia, people with ID, family caregivers, health care professionals). The focus groups were conducted at 3 time points within a 6-month period, where each new focus group built on the findings of previous rounds. The data from each round were used to (further) develop the sensor system. A thematic analysis with an inductive approach was used to analyze the data. RESULTS The study included 44 participants who expressed a positive attitude toward the idea of a garment-integrated sensor system but also identified some potential concerns. In addition to early stress detection, participants recognized other potential purposes or benefits of the sensor system, such as identifying triggers for challenging behavior, evaluating intervention effects, and diagnostic purposes. Participants emphasized the importance of meeting specific system requirements, such as washability and safety, and user requirements, such as customizability and usability, to increase user acceptance. Moreover, some participants were concerned the sensor system could contribute to the replacement of human contact by technology. Important factors for implementation included the cost of the sensor system, added value to resident and health care professionals, and education for all users. CONCLUSIONS The idea of a garment-integrated sensor system for early stress detection in LTC for people with dementia and people with ID is perceived as positive and promising by stakeholders. To increase acceptability and implementation success, it is important to develop an easy-to-use, customizable wearable that has a clear and demonstrable added value for health care professionals and LTC residents. The next step involves pilot-testing the developed wearable with LTC residents with dementia and residents with ID in clinical practice.
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Affiliation(s)
- Esmee Adam
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- University Network for Care sector Zuid-Holland, Leiden University Medical Center, Leiden, Netherlands
| | - Franka Meiland
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Department of Medicine for Older people, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Noud Frielink
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | | | - Reon Smits
- Mentech Innovation B.V., Eindhoven, Netherlands
| | - Petri Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Hanneke Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- University Network for Care sector Zuid-Holland, Leiden University Medical Center, Leiden, Netherlands
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Kei N, Hassiotis A, Royston R. The effectiveness of parent-Child observation in parent-Mediated programmes for children with developmental disabilities and externalizing disorders: A systematic review and meta-analysis. Clin Child Psychol Psychiatry 2024; 29:713-736. [PMID: 37748447 DOI: 10.1177/13591045231203097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
This systematic review evaluated the treatment effects of communication-focused parent-mediated interventions (CF-PMT), a form of intervention that involves therapists observing parent-child interactions and giving feedback to parents on how they can practice positive parenting strategies to prevent or reduce externalizing behaviours in children with developmental disabilities. A literature search was conducted on three electronic databases. To be included in the review, studies had to: evaluate CF-PMT where therapists give feedback after observing parent-child interactions; examine changes in externalizing behaviours amongst children with any forms of developmental disability; and adopt a randomised controlled trial study design. Fifteen studies met eligible criteria for the literature review, of those, 13 studies had available data on changes in the primary (child externalizing behaviours) and secondary outcomes (parental stress, child linguistic abilities and child social responsiveness). We found significant treatment effects for CF-PMT in reducing child externalizing behaviours (d = -.60) but not for any of the secondary outcomes. A sensitivity analysis showed a small but significant treatment effect for parental stress (d = -.18). Considerable bias was observed due to the lack of available information reported by studies on aspects measured by the Mixed Methods Appraisal Tool. Overall, we found evidence to support the benefits of complex interventions which incorporate direct parent-child observations and feedback to improve behavioural outcomes amongst children with developmental disabilities.
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Affiliation(s)
- Noel Kei
- University College London, London, UK
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Rice LJ, Cannon L, Dadlani N, Cheung MMY, Einfeld SL, Efron D, Dossetor DR, Elliott EJ. Efficacy of cannabinoids in neurodevelopmental and neuropsychiatric disorders among children and adolescents: a systematic review. Eur Child Adolesc Psychiatry 2024; 33:505-526. [PMID: 36864363 PMCID: PMC10869397 DOI: 10.1007/s00787-023-02169-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/14/2023] [Indexed: 03/04/2023]
Abstract
A better understanding of the endocannabinoid system and a relaxation in regulatory control of cannabis globally has increased interest in the medicinal use of cannabinoid-based products (CBP). We provide a systematic review of the rationale and current clinical trial evidence for CBP in the treatment of neuropsychiatric and neurodevelopmental disorders in children and adolescents. A systematic search of MEDLINE, Embase, PsycINFO, and the Cochrane Central Register of Trials was performed to identify articles published after 1980 about CBP for medical purposes in individuals aged 18 years or younger with selected neuropsychiatric or neurodevelopmental conditions. Risk of bias and quality of evidence was assessed for each article. Of 4466 articles screened, 18 were eligible for inclusion, addressing eight conditions (anxiety disorders (n = 1); autism spectrum disorder (n = 5); foetal alcohol spectrum disorder (n = 1); fragile X syndrome (n = 2); intellectual disability (n = 1); mood disorders (n = 2); post-traumatic stress disorder (n = 3); and Tourette syndrome (n = 3)). Only one randomised controlled trial (RCT) was identified. The remaining seventeen articles included one open-label trial, three uncontrolled before-and-after trials, two case series and 11 case reports, thus the risk of bias was high. Despite growing community and scientific interest, our systematic review identified limited and generally poor-quality evidence for the efficacy of CBP in neuropsychiatric and neurodevelopmental disorders in children and adolescents. Large rigorous RCTs are required to inform clinical care. In the meantime, clinicians must balance patient expectations with the limited evidence available.
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Affiliation(s)
- Lauren J Rice
- The University of Sydney, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, Sydney, NSW, Australia.
- Sydney Children's Hospitals Network, Kids Research, Sydney, Australia.
- The University of Sydney, Faculty of Medicine and Health, Brain and Mind Centre, Sydney, NSW, Australia.
| | - Lisa Cannon
- The University of Sydney, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, Sydney, NSW, Australia
- Telethon Kids Institute, Perth Children's Hospital, Perth, WA, Australia
| | - Navin Dadlani
- The University of Sydney, Faculty of Medicine and Health, Brain and Mind Centre, Sydney, NSW, Australia
| | - Melissa Mei Yin Cheung
- The University of Sydney, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, Sydney, NSW, Australia
- Sydney Children's Hospitals Network, Kids Research, Sydney, Australia
| | - Stewart L Einfeld
- The University of Sydney, Faculty of Medicine and Health, Brain and Mind Centre, Sydney, NSW, Australia
| | - Daryl Efron
- Department of General Paediatrics, Health Services, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - David R Dossetor
- Sydney Children's Hospitals Network, Kids Research, Sydney, Australia
| | - Elizabeth J Elliott
- The University of Sydney, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, Sydney, NSW, Australia
- Sydney Children's Hospitals Network, Kids Research, Sydney, Australia
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Bjurulf B, Reilly C, Hallböök T. Caregiver reported behavior, sleep and quality of life in children with Dravet syndrome: A population-based study. Epilepsy Behav 2024; 150:109560. [PMID: 38071826 DOI: 10.1016/j.yebeh.2023.109560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/02/2023] [Accepted: 11/21/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE The aim of this population-based study was to assess behavior, sleep, and quality of life, and explore factors associated with these in children with Dravet syndrome. METHODS The Developmental Behavior Checklist, the Insomnia Severity Index, and a global question regarding quality of life from the Epilepsy and Learning Disabilities Quality of Life scale were completed by primary caregivers of 42/48 Swedish children with Dravet syndrome, born 2000-2018. Factors associated with problems with insomnia, behavior and quality of life were analyzed using multivariable linear regression. RESULTS Scores indicating significant behavioral problems were seen in 29/40 (72 %) children, scores indicating moderate or severe clinical insomnia in 18/42 (43 %) and scores indicating poor or very poor quality of life in 7/41 (17 %). On multivariable analysis, autistic symptoms were significantly associated with behavioral problems (p = 0.013), side-effects of anti-seizure medications (ASMs) were associated with insomnia (p = 0.038), whilst insomnia was significantly associated with poor quality of life (p = 0.016). SIGNIFICANCE Dravet syndrome in children is associated with significant problems with behavior, sleep and quality of life. There is a need to optimize treatment via ASMs and develop and evaluate interventions to treat behavioral and sleep difficulties to optimize outcomes.
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Affiliation(s)
- Björn Bjurulf
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden.
| | - Colin Reilly
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden
| | - Tove Hallböök
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden
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Dubé C, Morin AJS, Olivier E, Gilbert W, Tracey D, Craven RG, Maïano C. School Experiences and Anxiety Trajectories Among Youth with Intellectual Disabilities. J Autism Dev Disord 2023:10.1007/s10803-023-06127-y. [PMID: 37898583 DOI: 10.1007/s10803-023-06127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/30/2023]
Abstract
This study investigated how the school experiences and personal characteristics of youth with Intellectual Disabilities (ID) contribute to their longitudinal trajectories of anxiety. To this end, we relied on a sample of 390 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged from 11 to 22 (M = 15.70), and recruited in Canada (n = 140) and Australia (n = 250). Across three yearly time points, all participants completed self-report measures of anxiety, school climate, and victimization. Our results revealed a slight normative decrease in anxiety over time and showed that experiences of school victimization were associated with higher levels of anxiety (initially and momentarily) and increases in victimization were accompanied by increases in anxiety over time. Perceptions of attending a school that fosters security and promotes learning also tended to be accompanied by lower levels of anxiety (initially and momentarily). Momentary increases in perceptions of attending a school that fosters positive peer interactions were associated with momentary decreases in anxiety, whereas momentary increases in perceptions of attending a school characterized by positive teacher-student relationships and an equitable treatment of all students both led to small momentary increases in anxiety once all other components of student school experiences were considered. The theoretical and practical implications of these results are discussed.
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Affiliation(s)
- Céleste Dubé
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke W, Montreal, QC, H4B 1R6, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke W, Montreal, QC, H4B 1R6, Canada.
| | - Elizabeth Olivier
- Département de psychopédagogie et d'andragogie, Université de Montréal, Montréal, Canada
| | - William Gilbert
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, Canada
| | - Danielle Tracey
- School of Education, Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Rhonda G Craven
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO|Campus de Saint-Jérôme), Saint-Jérome, Canada
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Branford D, Sun JJ, Burrows L, Shankar R. Patterns of antiseizure medications prescribing in people with intellectual disability and epilepsy: A narrative review and analysis. Br J Clin Pharmacol 2023; 89:2028-2038. [PMID: 37060156 DOI: 10.1111/bcp.15748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/26/2023] [Accepted: 04/03/2023] [Indexed: 04/16/2023] Open
Abstract
People with intellectual disabilities (PwID) have a bidirectional relationship with epilepsy. Nearly 25% of PwID have seizures and 30% people with epilepsy are thought to have a significant intellectual impairment. Furthermore, 70% of PwID are thought to have treatment-resistant epilepsy. In the United Kingdom, antiseizure medications (ASMs) are the second most widely prescribed psychotropic agent for PwID. However, it is unclear what the current evidence and patterns is on current prescribing of ASMs, including when and how a case is made to withdraw them. A narrative review along with an analysis of large-scale NHS Digital published data (2015-2020) on several aspects of ASM prescribing by general practices for PwID was undertaken. The review results and data analysis are consolidated and presented as 11 themes to provide a comprehensive overview of the study topic. Recent studies estimate that one-third and one-fifth of PwID are prescribed ASMs. A history of epilepsy is seen as the primary prescribing reason; however, often it is a legacy, and the indication is no longer clear. The proportion receiving ASMs continues to rise with age. This pattern of use does not correlate well with seizure onset. There are limited data on de-prescribing ASMs in PwID. The study population heterogenicity, associated polypharmacy, multimorbidity and higher sudden unexpected death in epilepsy risks are outlined. Suggestions are made from available evidence for improving prescribing practices for PwID and seizures, and key areas for further research in this complex clinical area are outlined.
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Affiliation(s)
- David Branford
- Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, Truro, UK
| | - James J Sun
- Royal Free London NHS Foundation Trust, London, UK
| | | | - Rohit Shankar
- Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, Truro, UK
- Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, UK
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Di Sarro R, Varrucciu N, Di Santantonio A, Natali F, Kaleci S, Bianco A, Cappai M, Lucchi F, Bertelli MO. Appropriateness of psychopharmacological therapies to psychiatric diagnoses in persons with autism spectrum disorder with or without intellectual disabilities: a cross-sectional analytic study. Expert Opin Drug Saf 2023; 22:1271-1281. [PMID: 36681385 DOI: 10.1080/14740338.2023.2172396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND Observational studies highlighted high rates of psychotropic medication in persons with autistic spectrum disorder (ASD) with or without intellectual disability, which seems to be associated with the management of problem behaviors more than co-occurrent psychiatric disorders. The purpose of the study is to investigate psychopharmacology use and diagnoses of co-occurrent psychiatric disorder (PD) in persons with ASD attending a public mental health service in Emilia Romagna, Italy. METHODS The present study is a multicenter, cross-sectional study. RESULTS 275 persons out of 486 (56.5%) resulted to receive at least one psychotropic drug, compared to 74 persons (15.2%) that were diagnosed with a PD. 63.6% were on poly-pharmacotherapy (2-10 compounds), with 37.8% receiving 3 or more medications. Antipsychotics were the most frequently prescribed class of psychotropic drugs (89%), followed by antiepileptics/mood stabilizers/lithium (42.1%) and anxiolytics (BDZ) (38.5%). Most common psychiatric disorders were psychotic disorders (29.7%), followed by anxiety disorders (17.5%), bipolar disorders (12.2%), and depressive disorders (9.4%). CONCLUSIONS Our findings support earlier research showing that many individuals with ASD receive pharmacotherapy without being diagnosed with a co-occurring psychiatric disorder, indicating that the main reasons for prescription and the type of compound frequently have little to no link with specific psychopathology.
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Affiliation(s)
- Rita Di Sarro
- Health and Disability Integrated Program, Public Local Health Bologna, Italy
| | - Niccolò Varrucciu
- Health and Disability Integrated Program, Public Local Health Bologna, Italy
| | - Anna Di Santantonio
- Health and Disability Integrated Program, Public Local Health Bologna, Italy
| | - Francesca Natali
- Health and Disability Integrated Program, Public Local Health Bologna, Italy
| | - Shaniko Kaleci
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Annamaria Bianco
- CREA (Research and Clinical Centre), San Sebastiano Foundation, Misericordia di Firenze, Florence, Italy
| | - Michela Cappai
- Emilia-Romagna Region, Mental Health and Pathological Addictions, Italy
| | - F Lucchi
- Department of Mental Health and Pathological Addictions, Public Local Health Bologna, Italy
| | - Marco O Bertelli
- CREA (Research and Clinical Centre), San Sebastiano Foundation, Misericordia di Firenze, Florence, Italy
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Marrus N, Koth KA, Hellings JA, McDonald R, Gwynette MF, Muhle R, Lohr WD, Vasa RA. Psychiatry training in autism spectrum disorder and intellectual disability: Ongoing gaps and emerging opportunities. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:679-689. [PMID: 35920285 DOI: 10.1177/13623613221112197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Children, adolescents, and adults with autism spectrum disorder and intellectual disability experience high rates of co-occurring psychiatric conditions throughout their lifetime. However, there is a shortage of psychiatrists to treat these populations. We evaluated how much education psychiatrists-in-training receive on how to care for individuals with autism spectrum disorder/intellectual disability. We found that in many psychiatry programs, residents receive limited training experiences in autism spectrum disorder/intellectual disability involving lectures and patient contact and that psychiatry program directors would benefit from more resources to strengthen education in autism spectrum disorder/intellectual disability.
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Affiliation(s)
- Natasha Marrus
- Washington University School of Medicine in St. Louis, USA
| | | | | | | | | | | | | | - Roma A Vasa
- Johns Hopkins University School of Medicine, USA
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11
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Melvin GA, Freeman M, Ashford LJ, Hastings RP, Heyne D, Tonge BJ, Bailey T, Totsika V, Gray KM. Types and correlates of school absenteeism among students with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:375-386. [PMID: 36744441 DOI: 10.1111/jir.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/24/2022] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND It appears that students with intellectual disability (ID) are more frequently absent from school compared with students without ID. The objective of the current study was to estimate the frequency of absence among students with ID and the reasons for absence. Potential reasons included the attendance problems referred to as school refusal, where absence is related to emotional distress; truancy, where absence is concealed from parents; school exclusion, where absence is instigated by the school; and school withdrawal, where absence is initiated by parents. METHODS Study participants were 629 parents (84.6% mothers) of Australian school students (Mage = 11.18 years; 1.8% Aboriginal and/or Torres Strait Islander) with an ID. Participants completed a questionnaire battery that included the School Non-Attendance ChecKlist via which parents indicated the reason their child was absent for each day or half-day absence their child had over the past 20 school days. The absence data presented to parents had been retrieved from school records. RESULTS Across all students, absence occurred on 7.9% of the past 20 school days. In terms of school attendance problems as defined in existing literature, school withdrawal accounted for 11.1% of absences and school refusal for 5.3% of absences. Students were also absent for other reasons, most commonly illness (32.0%) and appointments (24.2%). Of students with more than one absence (n = 217; 34.5%), about half were absent for more than one reason. Students attending mainstream schools had lower attendance than those attending special schools. CONCLUSIONS Students with ID were absent for a range of reasons and often for multiple reasons. There were elevated rates of school withdrawal and school refusal. Understanding the reasons for absenteeism can inform targeted prevention and intervention supports.
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Affiliation(s)
- G A Melvin
- School of Psychology, Deakin University, Burwood, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - M Freeman
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - L J Ashford
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Hawthorn, Australia
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - D Heyne
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - B J Tonge
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - T Bailey
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - V Totsika
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
- Division of Psychiatry, University College London, London, UK
| | - K M Gray
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
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12
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Branford D, Sun JJ, Shankar R. Antiseizure medications prescribing for behavioural and psychiatric concerns in adults with an intellectual disability living in England. Br J Psychiatry 2023; 222:191-195. [PMID: 36786124 DOI: 10.1192/bjp.2022.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Antiseizure medications (ASMs) are the second most widely prescribed psychotropic for people with intellectual disabilities in England. Multiple psychotropic prescribing is prevalent in almost half of people with intellectual disabilities on ASMs. This analysis identifies limited evidence of ASM benefit in challenging behaviour management and suggests improvements needed to inform clinical practice.
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Affiliation(s)
- David Branford
- Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, UK
| | - James J Sun
- Royal Free London NHS Foundation Trust, London, UK
| | - Rohit Shankar
- Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Bodmin, UK
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13
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Orim MA, Orim SO, Adeleke PO, Essien EE, Olayi JE, Essien CK, Dada OA, Ewa JA, Eke VU, Igba IU, Ogar RO, Owan VJ. Cognitive behavioral therapy as treatment intervention for aggressive behaviors in clients with intellectual disabilities and concomitant mental health conditions. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:395. [PMID: 36824399 PMCID: PMC9942128 DOI: 10.4103/jehp.jehp_545_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/26/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Few researchers have examined the effectiveness of cognitive behavioral therapy in treating aggressive behaviors among individuals with dual diagnosis (intellectual disability and mental health conditions) due to the relatively recent interest in the field of psychopathology in intellectual disability. This study investigated the effectiveness of cognitive behavioral therapy in treating aggressive behaviors among clients with dual diagnoses in a community rehabilitation center, Ibadan, Oyo state, and the moderating effects of parenting style and socioeconomic status in the associations. MATERIALS AND METHOD A 2 × 2 × 2 pre-test post-test factorial design was used. Parenting style and socioeconomic status at two levels each moderated the associations. A sample of 22 participants purposively selected was exposed to treatment using cognitive behavioral therapy, while the other five were exposed to placebo treatment all for 8 weeks. Data collected were analyzed using Line Chart and Analysis of Covariance (ANCOVA). RESULTS Improvements were found in the post-treatment scores obtained on the Aggressive Scale for Youths. A reduction in the Aggressive Incidents chart was recorded for each participant in the treatment group when compared with the control group, using a line chart and Analysis of Covariance (ANCOVA). Evidence also demonstrated that parenting style (authoritarian and authoritative), F (1,14) = 0.75, P <.05, η2 =0.05), and socioeconomic status (high and low), F (1,14) = 0.01, P =0.020, η2 =.00), moderated the associations. CONCLUSION Cognitive behavioral therapy is seen as a treatment intervention for individuals with intellectual disability co-existing with mental health manifesting aggressive behaviors in the community or other settings. This should be used to improve the client's quality of life under these conditions.
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Affiliation(s)
- Matthew A. Orim
- Department of Special Education, University of Calabar, Nigeria
| | - Samuel O. Orim
- Department of Special Education, University of Calabar, Nigeria
| | | | - Essien E. Essien
- Department of Social Science Education, University of Calabar, Nigeria
| | - James E. Olayi
- Department of Special Education, University of Calabar, Nigeria
| | - Cecilia K. Essien
- Department of Continuing Education and Development Studies, University of Calabar, Nigeria
| | - Oluseyi A. Dada
- Department of Special Education, University of Calabar, Nigeria
| | - James A. Ewa
- Department of Special Education, University of Calabar, Nigeria
| | - Vitalis U. Eke
- Department of Special Education, University of Calabar, Nigeria
| | | | - Raymond O. Ogar
- Department of Special Education, University of Calabar, Nigeria
| | - Valentine J. Owan
- Department of Educational Foundations, University of Calabar, Nigeria
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14
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Chandler S, Carter Leno V, White P, Yorke I, Hollocks MJ, Baird G, Pickles A, Simonoff E, Charman T. Pathways to adaptive functioning in autism from early childhood to adolescence. Autism Res 2022; 15:1883-1893. [PMID: 35899846 PMCID: PMC9796413 DOI: 10.1002/aur.2785] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/15/2022] [Indexed: 01/07/2023]
Abstract
Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. This study examines longitudinal and contemporaneous associations of adaptive functioning in autistic youth across a wide ability range. Parent-reported autism symptoms, co-occurring emotional, behavioral and attention deficit hyperactivity disorder (ADHD) symptoms, and IQ were assessed in early childhood (M age 7 years; T1) and 6 years later in adolescence (M age 13 years; T2) in 179 autistic youth. Adaptive functioning was assessed at T2. Structural equation modeling estimated pathways to adaptive functioning from autism, and psychiatric symptoms at T1 and T2, testing whether associations were driven by continuity of behaviors from T1 to T2 or their contemporaneous effect at T2, or both, controlling for T1 IQ. Lower adaptive functioning at T2 was associated with higher T1 and T2 ADHD symptoms (β = -0.14, and β = -0.21) but not behavioral nor emotional symptoms at either timepoint. Lower adaptive functioning at T2 was also associated with lower T1 IQ (β = 0.43) and higher social communication symptoms (β = -0.37) at T2 but not T1, but the relationship with ADHD symptoms remained. Paths were not moderated by sex or IQ. Increased symptoms of ADHD, both in early childhood and contemporaneously, were associated with reduced adaptive functioning in adolescence. Co-occurring ADHD may be a modifiable risk factor for adaptive function impairments and should be routinely assessed and when present evidence-based treatments initiated which may benefit adaptive functioning outcomes. LAY SUMMARY: Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. In a community sample higher attention deficit/hyperactivity disorder (ADHD) symptoms, but not emotional or behavioral symptoms, in both early childhood and contemporaneously were associated with lower adaptive functioning in autistic adolescents. Co-occurring ADHD may be a modifiable risk factor for adaptive function difficulties in autism.
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Affiliation(s)
- Susie Chandler
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | - Philippa White
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Isabel Yorke
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Matthew J. Hollocks
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK
| | | | - Andrew Pickles
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,Maudsley Biomedical Research Centre for Mental HealthLondonUK
| | - Emily Simonoff
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK,Maudsley Biomedical Research Centre for Mental HealthLondonUK
| | - Tony Charman
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK
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15
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Panditaratne S, Hronis A, Roberts R, Kneebone I. Participant experiences of Fearless Me! ©: Cognitive behaviour therapy for anxiety in children with intellectual disabilities. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03215-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractResearch shows that almost half of children with intellectual disabilities (ID) experience mental ill-health at any given time point. However, traditional cognitive behaviour therapy (CBT) may not be appropriate for children with ID due to the cognitive deficits associated with their diagnosis. The Fearless Me! © CBT program for anxiety is adapted to accommodate the cognitive abilities of children with ID. The aim of the current study was to provide the first qualitative evaluation of the Fearless Me! © program by exploring participant experiences. Eight mother–child dyads were interviewed using a semi-structured protocol. The responses were transcribed and analysed using thematic analysis. Identified codes and themes were cross-checked with an independent researcher and discrepancies were resolved. Parents found the program to be positive and useful for acquiring knowledge. They commented on features of the program, significance of inter- and intra-personal factors and whether the program suited the capability of their child. They also discussed features of treatment outcomes. The qualitative results highlighted that experiences of the program varied. Themes identified included those relating to barriers and facilitators to participation and treatment-related change. The themes provide guidance for program revisions and can inform future delivery of the Fearless Me! © program.
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Saima S, Ihara H, Ogata H, Gito M, Murakami N, Oto Y, Ishii A, Takahashi A, Nagai T. Relationship Between Sensory Processing and Autism Spectrum Disorder-Like Behaviors in Prader-Willi Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:249-263. [PMID: 35443050 DOI: 10.1352/1944-7558-127.3.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 07/20/2021] [Indexed: 06/14/2023]
Abstract
The relationship between sensory processing and ASD-like and associated behaviors in patients with Prader-Willi Syndrome (PWS) remains relatively unexplored. Examining this relationship, 51 adults with PWS were administered the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS), Short Sensory Profile (SSP-J), Food-Related Problem Questionnaire (FRPQ), and Aberrant Behavior Checklist (ABC-J). Based on SSP-J z-scores, participants were classified into three severity groups. Analysis of variance was performed to compare the behavioral scores of these three groups. Statistically significant group differences were observed in PARS (p = .006, ηp2 = .194) and ABC-J (p = .006, ηp2 = .193) scores. Our findings suggest that the level of sensory processing may predict ASD-like and aberrant behaviors in adults with PWS, implying the importance of a proper assessment for early intervention.
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Affiliation(s)
- Sohei Saima
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Hiroshi Ihara
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Hiroyuki Ogata
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Masao Gito
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Nobuyuki Murakami
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Yuji Oto
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Atsushi Ishii
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Asami Takahashi
- Sohei Saima, Hiroshi Ihara, Hiroyuki Ogata, Masao Gito, Nobuyuki Murakami, Yuji Oto, Atsushi Ishii, and Asami Takahashi, Dokkyo Medical University Saitama Medical Center, Japan
| | - Toshiro Nagai
- Toshiro Nagai, Nakagawanosato Ryoiku Center, Japan. Sohei Saima and Hiroshi Ihara contributed equally to this article
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Training Culturally Diverse Caregivers to Decrease Their Child's Challenging Behaviors: A Systematic Review and Meta-analysis. J Autism Dev Disord 2022:10.1007/s10803-022-05564-5. [PMID: 35478073 DOI: 10.1007/s10803-022-05564-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 12/14/2022]
Abstract
Parents are the primary source of support for their children and can become principal interventionists for preventing and treating their child's challenging behavior. Yet, providing adequate and adapted training for culturally diverse families can be difficult due to the increase of international migration and the diversity of languages spoken worldwide. This systematic review and meta-analysis evaluated 13 studies that implemented training for caregivers with limited proficiency in the majority language. Overall, the results suggested a moderate-small treatment effects on positive and negative parenting practices. The results also indicated moderate-small treatment effects on challenging behaviors exhibited by both individuals with developmental disabilities and typically developmental. Findings are discussed in terms of strategies used and recommendations for future research and practice.
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18
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Cunningham AC, Hall J, Einfeld S, Owen MJ, van den Bree MBM. Assessment of emotions and behaviour by the Developmental Behaviour Checklist in young people with neurodevelopmental CNVs. Psychol Med 2022; 52:574-586. [PMID: 32643597 PMCID: PMC7794095 DOI: 10.1017/s0033291720002330] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/19/2020] [Accepted: 06/08/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND A number of genomic conditions caused by copy number variants (CNVs) are associated with a high risk of neurodevelopmental and psychiatric disorders (ND-CNVs). Although these patients also tend to have cognitive impairments, few studies have investigated the range of emotion and behaviour problems in young people with ND-CNVs using measures that are suitable for those with learning difficulties. METHODS A total of 322 young people with 13 ND-CNVs across eight loci (mean age: 9.79 years, range: 6.02-17.91, 66.5% male) took part in the study. Primary carers completed the Developmental Behaviour Checklist (DBC). RESULTS Of the total, 69% of individuals with an ND-CNV screened positive for clinically significant difficulties. Young people from families with higher incomes (OR = 0.71, CI = 0.55-0.91, p = .008) were less likely to screen positive. The rate of difficulties differed depending on ND-CNV genotype (χ2 = 39.99, p < 0.001), with the lowest rate in young people with 22q11.2 deletion (45.7%) and the highest in those with 1q21.1 deletion (93.8%). Specific patterns of strengths and weaknesses were found for different ND-CNV genotypes. However, ND-CNV genotype explained no more than 9-16% of the variance, depending on DBC subdomain. CONCLUSIONS Emotion and behaviour problems are common in young people with ND-CNVs. The ND-CNV specific patterns we find can provide a basis for more tailored support. More research is needed to better understand the variation in emotion and behaviour problems not accounted for by genotype.
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Affiliation(s)
- Adam C. Cunningham
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Jeremy Hall
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Stewart Einfeld
- Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Michael J. Owen
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | | | - Marianne B. M. van den Bree
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
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19
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Boulton KA, Coghill D, Silove N, Pellicano E, Whitehouse AJO, Bellgrove MA, Rinehart NJ, Lah S, Redoblado‐Hodge M, Badawi N, Heussler H, Rogerson N, Burns J, Farrar MA, Nanan R, Novak I, Goldwater MB, Munro N, Togher L, Nassar N, Quinn P, Middeldorp CM, Guastella AJ. A national harmonised data collection network for neurodevelopmental disorders: A transdiagnostic assessment protocol for neurodevelopment, mental health, functioning and well-being. JCPP ADVANCES 2021; 1:e12048. [PMID: 37431407 PMCID: PMC10242941 DOI: 10.1002/jcv2.12048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/11/2021] [Indexed: 01/03/2023] Open
Abstract
Background Children with neurodevelopmental disorders share common phenotypes, support needs and comorbidities. Such overlap suggests the value of transdiagnostic assessment pathways that contribute to knowledge about research and clinical needs of these children and their families. Despite this, large transdiagnostic data collection networks for neurodevelopmental disorders are not well developed. This paper describes the development of a nationally supported transdiagnostic clinical and research assessment protocol across Australia. The vision is to establish a harmonised network for data collection and collaboration that promotes transdiagnostic clinical practice and research. Methods Clinicians, researchers and community groups across Australia were consulted using surveys and national summits to identify assessment instruments and unmet needs. A national research committee was formed and, using a consensus approach, selected assessment instruments according to pre-determined criteria to form a harmonised transdiagnostic assessment protocol. Results Identified assessment instruments were clustered into domains of transdiagnostic assessment needs, which included child functioning/quality of life, child mental health, caregiver mental health, and family background information. From this, the research committee identified a core set of nine measures and an extended set of 14 measures that capture these domains with potential for further modifications as recommended by clinicians, researchers and community members. Conclusion The protocol proposed here was established through a strong partnership between clinicians, researchers and the community. It will enable (i) consensus driven transdiagnostic clinical assessments for children with neurodevelopmental disorders, and (ii) research studies that will inform large transdiagnostic datasets across neurodevelopmental disorders and that can be used to inform research and policy beyond narrow diagnostic groups. The long-term vision is to use this framework to facilitate collaboration across clinics to enable large-scale data collection and research. Ultimately, the transdiagnostic assessment data can be used to inform practice and improve the lives of children with neurodevelopmental disorders and their families.
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Borland RL, Cameron LA, Tonge BJ, Gray KM. Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well-being in children and adolescents with intellectual disability: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:399-420. [PMID: 34796601 DOI: 10.1111/jar.12961] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/06/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND This systematic review aimed to explore the effects of sport and physical activity on behaviour and emotional problems, mental health and psychosocial well-being of children and adolescents with intellectual disability. METHOD Five databases were searched systematically (ERIC, MEDLINE, PsycINFO, SportDISCUS and SCOPUS), up to 28 February 2021. Thirty-two studies met criteria for inclusion. RESULTS Studies in this review included case studies (n = 15), treatment trials (n = 14), cross sectional studies (n = 2) and a cohort study (n = 1). Evidence was positive, though high risk of bias in treatment trials (7 of 14 rated high) meant generalisability of results was limited. CONCLUSIONS The available evidence suggests a positive relationship between physical activity and improved behaviour and emotional problems, mental health and psychosocial well-being; however, more robust randomised controlled trials are required to confirm this.
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Affiliation(s)
- Ross L Borland
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Lauren A Cameron
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Bruce J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
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Laignier MR, Lopes-Júnior LC, Santana RE, Leite FMC, Brancato CL. Down Syndrome in Brazil: Occurrence and Associated Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211954. [PMID: 34831710 PMCID: PMC8620277 DOI: 10.3390/ijerph182211954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/03/2021] [Accepted: 10/12/2021] [Indexed: 11/20/2022]
Abstract
Background: Down syndrome is the most frequent genetic cause of intellectual disability, with an estimated birth prevalence of 14 per 10,000 live births. In Brazil, statistical data on the occurrence of babies born with Down syndrome remain unclear. We aimed to estimate the occurrence of Down syndrome between 2012 and 2018, and to observe its association with maternal, gestational, paternal characteristics, and newborn vitality. Methods: A retrospective study was carried out using secondary data included in the Certificate of Live Birth in a state located in the southeastern region of Brazil. Data analysis was performed in the software Stata 14.1. Pearson’s chi-square test for bivariate analysis, and logistic regression for multivariate analysis were performed, with a 95% confidence interval (CI) and a significance of 5%. Results: We observed that 157 cases of Down syndrome were reported among 386,571 live births, representing an incidence of 4 in 10,000 live births. Down syndrome was associated with maternal age ≥ 35 years, paternal age ≥ 30 years, the performance of six or more prenatal consultations, prematurity, and low birth weight (p < 0.05). Conclusions: Women aged 35 and over were more likely to have children born with Down syndrome. In addition, there is an association of Down syndrome with premature birth, low birth weight, and the number of prenatal consultations (≥6).
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Affiliation(s)
- Mariana Rabello Laignier
- Nursing Department at the Health Sciences Center, Universidade Federal do Espírito Santo, Vitória 29075-910, Brazil; (L.C.L.-J.); (F.M.C.L.)
- Correspondence:
| | - Luís Carlos Lopes-Júnior
- Nursing Department at the Health Sciences Center, Universidade Federal do Espírito Santo, Vitória 29075-910, Brazil; (L.C.L.-J.); (F.M.C.L.)
| | - Raquel Esperidon Santana
- Associação de Pais, Amigos e Pessoas com Síndrome de Down do Espírito Santo, Vitória 29075-910, Brazil; (R.E.S.); (C.L.B.)
| | - Franciéle Marabotti Costa Leite
- Nursing Department at the Health Sciences Center, Universidade Federal do Espírito Santo, Vitória 29075-910, Brazil; (L.C.L.-J.); (F.M.C.L.)
| | - Carolina Laura Brancato
- Associação de Pais, Amigos e Pessoas com Síndrome de Down do Espírito Santo, Vitória 29075-910, Brazil; (R.E.S.); (C.L.B.)
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22
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Kostulski M, Breuer D, Döpfner M. Does parent management training reduce behavioural and emotional problems in children with intellectual disability? A randomised controlled trial. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 114:103958. [PMID: 33915381 DOI: 10.1016/j.ridd.2021.103958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/26/2021] [Accepted: 04/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Children with intellectual disability (ID) are more likely to develop behavioural and emotional problems. However, specific interventions for the treatment of these problems in children with ID have rarely been evaluated. Parent management training (PMT) has been shown to be effective in reducing behavioural and emotional problems for other mental disorders. Therefore, we developed and evaluated a special PMT intervention for parents of children with ID. METHODS The PMT was developed based on existing programs for children with other mental disorders. The effects of the PMT were analysed in a randomised controlled trial (intervention group: n = 21; waitlist control group: n = 21). The primary outcome was behavioural and emotional problems of children as rated by parents. Additionally, effects on parent-rated family burden and positive and negative parenting were assessed. OUTCOME For the primary outcome, a statistically significant reduction of behavioural and emotional problems of the children emerged, with moderate effects for disruptive/ antisocial behaviour and anxiety. Family burden was reduced as a trend, with a small effect size. There was a significant increase in positive parenting and no effect on negative parenting.
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Affiliation(s)
- Michael Kostulski
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Dieter Breuer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.
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Hussain R, Wark S, Janicki MP, Parmenter T, Knox M, Tabatabaei-Jafari H. Mental health of older people with mild and moderate intellectual disability in Australia. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:535-547. [PMID: 33786909 DOI: 10.1111/jir.12825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/30/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The progressive increase in life expectancy of people with intellectual disability (ID) has resulted in enhanced survival into old age and has also seen a growth in research on both lifelong and emerging ageing-related health issues. Health issues amongst provider-supported adults have been previously studied, but these studies have not always included older community-dwelling adults with ID. METHODS A study examining the extent of mental health of 391 community-dwelling adults with ID age 60 and older in both metropolitan and rural areas of two East Coast Australian states was undertaken using a cross-sectional survey. Examined were a range of demographic (age, sex, living arrangements, employment and socio-economic status) and life (co-morbidities, adverse life events and social support) factors. Data were parsed by two age groupings (60-65: n = 234 and >65: n = 157). RESULTS Findings revealed that older community-dwelling adults with ID have many of the same mental health disorders as do other ageing people, with the exception of significant psychiatric disorders often associated with older age. Over a third (35%: n = 137) reported some one or more mental health disorders. Age, sex, location (rural or urban), financial hardship, social support or type of living arrangement were not statistically significant as risk factors for poor mental health. However, employment status was a clear predictor. Stepwise regression models showed a strong association between mental ill-health and adverse life events and between mental ill-health and multiple physical co-morbidities. CONCLUSIONS The cross-sectional nature of the study limits causal inference. The cumulative effect of chronic health conditions and adverse life events cannot be prevented retrospectively. However, greater awareness amongst both health professionals and care staff that older adults with ID have a high likelihood of significant and/or repeated traumas and need better health care to limit physical co-morbidity may assist in providing support that is better tailored to individual needs in older age to reduce the burden of mental ill-health.
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Affiliation(s)
- R Hussain
- ANU Medical School, Australian National University, Australia
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - S Wark
- School of Rural Medicine, University of New England, Armidale, NSW, Australia
| | - M P Janicki
- Disability and Human Development, University of Illinois, Chicago, IL, USA
| | - T Parmenter
- Center for Disability Studies, Sydney Medical School, University of Sydney, NSW, Australia
| | - M Knox
- Center for Disability Studies, Sydney Medical School, University of Sydney, NSW, Australia
| | - H Tabatabaei-Jafari
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, ACT, Australia
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Menezes M, Robinson MF, Harkins C, Sadikova E, Mazurek MO. Unmet health care needs and health care quality in youth with autism spectrum disorder with and without intellectual disability. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2199-2208. [PMID: 34030515 DOI: 10.1177/13623613211014721] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT The increase in the prevalence of autism spectrum disorder has placed greater demands on the health care system. Children and adolescents with autism spectrum disorder often experience challenges accessing high-quality physical and mental health care due to characteristic social-communication deficits and behavioral difficulties, as well as high rates of complex medical and psychiatric comorbidities. Intellectual disability commonly co-occurs with autism spectrum disorder and individuals affected by this co-occurrence may have additional impairments that compound challenges accessing health care. This study investigated the relations among co-occurring intellectual disability, unmet physical and mental health care needs, and health care quality in a large, nationally distributed sample of youth with autism spectrum disorder using structural equation modeling techniques. Co-occurring intellectual disability was significantly associated with unmet mental health care needs in children with autism. In addition, unmet mental health care needs mediated the relationship between co-occurring intellectual disability and health care quality; youth with autism spectrum disorder and co-occurring intellectual disability who had a past-year unmet mental health need had significantly poorer caregiver-reported health care quality. These findings suggest that youth with autism spectrum disorder and co-occurring intellectual disability may be more likely to experience unmet mental health care needs and receive poorer quality of care than the broader autism spectrum disorder population.
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25
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Culnane E, Loftus H, Efron D, Williams K, Di Iorio N, Shepherd R, Marraffa C, Lubitz L, Antolovich G, Prakash C. Development of the Fearless, Tearless Transition model of care for adolescents with an intellectual disability and/or autism spectrum disorder with mental health comorbidities. Dev Med Child Neurol 2021; 63:560-565. [PMID: 33332592 PMCID: PMC8247054 DOI: 10.1111/dmcn.14766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 12/04/2022]
Abstract
AIM First, to understand the barriers to achieving effective transition and the supports required from the perspective of parents and carers, adolescents with intellectual disability and/or autism spectrum disorder and co-existing mental health disorders (often termed 'dual disability'), and those who provide services to this group. Second, to develop an informed model of shared care to improve the transition of adolescents with dual disabilities. METHOD Carers and a young adult with a dual disability were surveyed about their experience of transition care. Other key stakeholders including paediatricians, general practitioners, and policy makers were also interviewed. These data informed the model of care. RESULTS Paediatricians and general practitioners reported difficulties establishing working relationships to foster smooth transitions, and carers reported lacking a regular general practitioner with adequate expertise to care for people with dual disabilities. A process of shared care between paediatricians and general practitioners was developed and initiated by a dedicated transition manager, who assisted with care coordination and service linkages. Standardized clinical assessment tools were also introduced to determine patient and carer support needs. INTERPRETATION This study highlights the potential to improve transition outcomes for adolescents with dual disabilities and their carers through early transition planning, consistent methods of assessing patient and carer needs, and shared care. WHAT THIS PAPER ADDS Adolescents with co-occurring disabilities require a collaborative health and disability service interface. Fearless, Tearless Transition is a new approach to transitioning adolescents with dual disabilities from paediatric to adult care. Carers of adolescents with dual disabilities require support navigating and negotiating services. Engaging general practitioners and paediatricians in shared care early during the transition process is essential.
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Affiliation(s)
- Evelyn Culnane
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia
| | - Hayley Loftus
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Health ServicesMurdoch Children’s Research InstituteMelbourneVICAustralia
| | - Daryl Efron
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Department of General MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Centre for Community Child HealthThe Royal Children’s HospitalMelbourneVICAustralia
| | - Katrina Williams
- Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Health ServicesMurdoch Children’s Research InstituteMelbourneVICAustralia,Department of PaediatricsMonash UniversityMelbourneVICAustralia
| | - Nikki Di Iorio
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Department of Mental HealthThe Royal Children’s HospitalMelbourneVICAustralia
| | - Rebecca Shepherd
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia
| | - Catherine Marraffa
- Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Health ServicesMurdoch Children’s Research InstituteMelbourneVICAustralia,Department of Neurodevelopment and DisabilityThe Royal Children’s HospitalMelbourneVICAustralia
| | - Lionel Lubitz
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Department of General MedicineThe Royal Children’s HospitalMelbourneVICAustralia
| | - Giuliana Antolovich
- Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Health ServicesMurdoch Children’s Research InstituteMelbourneVICAustralia,Department of Neurodevelopment and DisabilityThe Royal Children’s HospitalMelbourneVICAustralia
| | - Chidambaram Prakash
- Centre for Community Child HealthThe Royal Children’s HospitalMelbourneVICAustralia
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Torra Moreno M, Canals Sans J, Colomina Fosch MT. Behavioral and Cognitive Interventions With Digital Devices in Subjects With Intellectual Disability: A Systematic Review. Front Psychiatry 2021; 12:647399. [PMID: 33927655 PMCID: PMC8076520 DOI: 10.3389/fpsyt.2021.647399] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/17/2021] [Indexed: 01/01/2023] Open
Abstract
In recent years, digital devices have been progressively introduced in rehabilitation programs and have affected skills training methods used with children and adolescents with intellectual disabilities (ID). The objective of this review is to assess the effects of the use of digital devices on the cognitive functions and behavioral skills in this population, and to acknowledge their potential as a therapeutic tool. Electronic databases were analyzed until February 2020 using search formulas with free terms related to ID and the use of digital systems with children or adolescents. The risk of bias in randomized controlled trials was assessed by means of the modified Cochrane Collaboration tool and the quality level of the non-randomized studies was assessed using the Newcastle-Ottawa Scale. Forty-four studies were analyzed, most of which were categorized as low quality. Of the executive function studies analyzed, 60% reported significant improvements, most commonly related to working memory. Within the cognitive skills, 47% of the studies analyzed reported significant improvements, 30% of them in language. Significant improvements in the social (50%) and behavioral domains (30%) were also reported. These results suggest that digital interventions are effective in improving working memory and academic skills, and positively affect both the social and behavioral domains. Little information has been published regarding the duration of the effects, which could be limited in time. Further research is necessary to assess long-term effectiveness, the influence of comorbidities, and the effects on subjects with severe ID. The inclusion of smartphones and special education centers is also necessary.
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Affiliation(s)
- Marta Torra Moreno
- Jeroni de Moragas Private Fundation, Tarragona, Spain
- Jeroni de Moragas Association, Tarragona, Spain
| | - Josefa Canals Sans
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain
| | - Maria Teresa Colomina Fosch
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain
- Research Group in Neurobehavior and Health (NEUROLAB), Tarragona, Spain
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27
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IDTWO: A Protocol for a Randomised Controlled Trial of a Web-Based Mental Health Intervention for Australians with Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052473. [PMID: 33802311 PMCID: PMC7967603 DOI: 10.3390/ijerph18052473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/22/2022]
Abstract
People with intellectual disability (ID) experience higher rates of mental illness and reduced access to appropriate care and treatment. Tailored electronic mental health (eMH) programs offer opportunities to address these disparities. The aim of this study is to examine whether a fully automated and self-guided eMH program tailored to the needs of people with ID can reduce symptoms of anxiety and depression and improve daily functioning in people with borderline-to-mild ID. Australians with borderline-to-mild ID, aged 16 years and older with mild-to-moderate depression and/or anxiety symptoms will be eligible to participate with the help of a nominated carer, if necessary. A randomised controlled trial with a sample size of 150 participants divided into treatment and waitlist control arms will be conducted. Participants randomised to the intervention group will have full access to the Healthy Mind program for eight weeks. The waitlist control group will gain full access to the program following the eight-week treatment period. Efficacy will be assessed on the Anxiety, Depression, and Mood Scale; Kessler-10; and the World Health Organisation Disability Assessment Schedule 2.0 across three time-points (baseline, eight weeks, and three months). We expect that people who use the intervention will report reduced depression and anxiety, relative to the control group. To our knowledge, this is the first study to examine the effectiveness of a fully automated eMH program for improving mental health in people with ID. We expect our study to render new knowledge on the delivery and effects of internet-based cognitive behaviour therapy (CBT) tools for people with ID.
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28
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Grande E, Giovannini M, Marriere E, Pultar P, Quinlan M, Chen X, Rahmanzadeh G, Curigliano G, Cui X. Effect of capmatinib on the pharmacokinetics of digoxin and rosuvastatin administered as a 2-drug cocktail in patients with MET-dysregulated advanced solid tumours: A phase I, multicentre, open-label, single-sequence drug-drug interaction study. Br J Clin Pharmacol 2020; 87:2867-2878. [PMID: 33300203 PMCID: PMC8359310 DOI: 10.1111/bcp.14697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022] Open
Abstract
Aims Capmatinib, an orally bioavailable, highly potent and selective MET inhibitor, was recently approved to treat adult patients with metastatic nonsmall cell lung cancer with METex14 skipping mutations. The study investigated the effect of capmatinib on the pharmacokinetics of a single oral dose of digoxin and rosuvastatin in patients with MET‐dysregulated advanced solid tumours. Methods This was a multicentre, open‐label, single‐sequence study. An oral drug cocktail containing 0.25 mg digoxin and 10 mg rosuvastatin was administered to adult patients with MET‐dysregulated advanced solid tumours on Day 1, and then on Day 22 with capmatinib. Between Days 11 and 32, capmatinib 400 mg was administered twice daily to ensure the attainment of steady state for drug–drug interaction assessment. Pharmacokinetics of cocktail drugs and safety of capmatinib were evaluated. Results Thirty‐two patients were enrolled. Compared to digoxin alone, the geometric mean ratios (90% confidence interval) of area under the concentration–time curve from time zero to infinity and maximum concentration for digoxin plus capmatinib were 1.47 (1.28, 1.68) and 1.74 (1.43, 2.13), respectively. Compared to rosuvastatin alone, the geometric mean ratios (90% confidence interval) of area under the curve to infinity and maximum concentration for rosuvastatin plus capmatinib were 2.08 (1.56, 2.76) and 3.04 (2.36, 3.92), respectively. Most frequent adverse events (≥25% for all grades) were nausea, asthenia, constipation, vomiting, peripheral oedema and pyrexia. Most frequent Grade 3/4 adverse events (≥5%) were anaemia, pulmonary embolism, asthenia, dyspnoea, nausea and vomiting. Conclusion This study demonstrated that capmatinib is an inhibitor of P‐gp and BCRP transporters, with clinically relevant drug–drug interaction potential. Capmatinib was well‐tolerated and no unexpected safety concerns were observed.
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Affiliation(s)
- Enrique Grande
- Medical Oncology Department, MD Anderson Cancer Center Madrid, Madrid, Spain
| | | | | | | | | | - Xinhui Chen
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | | - Giuseppe Curigliano
- Istituto Europeo di Oncologia, IRCCS, Milan, Italy.,University of Milano, Milan, Italy
| | - Xiaoming Cui
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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29
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Borland RL, Hu N, Tonge B, Einfeld S, Gray KM. Participation in sport and physical activity in adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:908-922. [PMID: 33006215 DOI: 10.1111/jir.12782] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 08/10/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND People with intellectual disability face a number of barriers to participation in physical activity. This paper aimed to determine rates of sport and physical activity participation in an Australian sample of adults with intellectual disability, compared with rates of participation in the general Australian population. A secondary aim was to investigate factors that may contribute to participation of adults with intellectual disability. METHOD Participants were part of the Australian Child to Adult Development (ACAD) study, consisting of a community sample with intellectual disability (n = 305), groups of adults with autism (n = 94), Down syndrome (n = 64), fragile X syndrome (n = 52), Williams syndrome (n = 45), and Prader-Willi syndrome (n = 30). Participation in sport/physical activity was reported over the past 3 months. Rates of participation were reported for adults with intellectual disability and compared with rates in a general Australian population sample. The relationship between participation in physical activity and age, degree of intellectual disability, physical mobility, living situation, socio-economic disadvantage, and behaviour and emotional problems were also conducted. RESULTS Participants in the ACAD community sample with intellectual disability participated in sport/physical activity at lower rates than the general Australian population (42% compared with 71%). Having no physical mobility impairment was significantly associated with higher rates of participation. Those with Down syndrome participated in sport/physical activity at higher rates than the community sample with intellectual disability, while no difference in sport/physical activity participation was observed in the groups with autism or other syndromes. CONCLUSION Australian adults with intellectual disability participate in sport and physical activity at lower rates than the general population. Having a physical mobility impairment was associated with lower rates of participation. However, people living in supported accommodation were more likely to participate than those in other living situations. Having Down syndrome was associated with a higher participation rate than the community sample.
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Affiliation(s)
- R L Borland
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - N Hu
- Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Australia
| | - B Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - S Einfeld
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - K M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
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30
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Dadlani N, Small J, Starling J, Einfeld S. Clozapine in the management of persistent destructive behaviour in a 17-year-old boy with intellectual disability. BMJ Case Rep 2020; 13:13/11/e235346. [PMID: 33148570 DOI: 10.1136/bcr-2020-235346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The management of challenging and refractory destructive behaviour in young patients with intellectual disability (ID) is a major issue faced by families, carers and healthcare professionals who support them. Often, paediatricians and psychiatrists use various behavioural and psychopharmacological approaches, including polypharmacy. We report on one such patient who benefitted greatly from a trial of clozapine, resulting in less aggression, improved quality of life and potentially huge cost savings. We conclude that clozapine may represent a beneficial though seldom-used option for severe, destructive behaviour in young people with ID.
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Affiliation(s)
- Navin Dadlani
- The University of Sydney Brain and Mind Research Institute, Camperdown, New South Wales, Australia .,Child and Adolescent Psychiatry, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | | | - Jean Starling
- Concord Centre for Mental Health, Concord, New South Wales, Australia.,Discipline of Psychiatry, The University of Sydney Sydney Medical School, Sydney, New South Wales, Australia
| | - Stewart Einfeld
- The University of Sydney Brain and Mind Research Institute, Sydney, New South Wales, Australia
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32
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Muratori F, Santocchi E, Calderoni S. Psychiatric assessment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:217-238. [PMID: 32977880 DOI: 10.1016/b978-0-444-64148-9.00016-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies have consistently reported an increased prevalence of psychiatric comorbidity (PC) in individuals with neurodevelopmental disorders (NDDs) compared with typically developing controls, with high rates of anxiety disorders in autism spectrum disorders and challenging behaviors in children and adolescent with intellectual disability. Psychiatric assessment in this population should include multiple sources of information, derived from multiple contexts and using multiple methods, with accurate detection of contributing and trigger factors. It is important to focus on detecting change from the child's baseline functioning and to use, when possible, ad hoc instruments for assessing PC in the NDD population. Modifications in the setting and assessment procedures should be scheduled based on the child's age, developmental level, and sensory sensitivities. Simultaneously, validated screening instruments, which dimensionally assess the symptomatology of several NDDs and psychiatric disorders, are warranted to not only assist in the identification of PCs in NDDs but also discriminate among different NDDs. Changes from DSM-IV-TR to DSM-5 have had an impact on the diagnosis of several disorders in children and adolescents and, subsequently, on the current diagnostic tools, requiring appropriate and prompt modifications of the available instruments.
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Affiliation(s)
- Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Santocchi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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33
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Oosterveld-Vlug M, Oldenkamp M, Mastebroek M, Boeije H. What difficulties do people with mild intellectual disabilities experience when seeking medical help from their GP? A qualitative study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:178-189. [PMID: 32924273 DOI: 10.1111/jar.12796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 07/28/2020] [Accepted: 08/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with intellectual disabilities often have low health literacy as a result of their limited language comprehension. The aim of this study was to explore the difficulties Dutch people with intellectual disabilities experience during the process of considering and seeking medical help from their GP. The study was intended as input for an online intervention supporting health literacy. METHODS A qualitative study, in which 12 semi-structured interviews were conducted with people with mild intellectual disabilities and 4 with relatives of people with mild intellectual disabilities. The interviews were analysed following the principles of thematic analysis. RESULTS Difficulties were experienced in the following activities: assessing and proactively reacting to health complaints, processing health information, communicating with a GP and retaining information from the consultation. Support workers and relatives play an important role in all these activities. CONCLUSIONS To increase the capacity of people with intellectual disabilities to manage their health and seek care from their GP, it is important to support them in the activities they find difficult. Recommendations resulting from the study have been incorporated in an online intervention.
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Affiliation(s)
| | - Marloes Oldenkamp
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Mathilde Mastebroek
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Hennie Boeije
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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de Vries PJ, Belousova E, Benedik MP, Carter T, Cottin V, Curatolo P, Dahlin M, D'Amato L, Beaure d'Augères G, Ferreira JC, Feucht M, Fladrowski C, Hertzberg C, Jozwiak S, Lawson JA, Macaya A, Marques R, Nabbout R, O'Callaghan F, Qin J, Sander V, Sauter M, Shah S, Takahashi Y, Touraine R, Youroukos S, Zonnenberg B, Kingswood JC, Jansen AC. Tuberous Sclerosis Complex-Associated Neuropsychiatric Disorders (TAND): New Findings on Age, Sex, and Genotype in Relation to Intellectual Phenotype. Front Neurol 2020; 11:603. [PMID: 32733359 PMCID: PMC7358578 DOI: 10.3389/fneur.2020.00603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/25/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Knowledge is increasing about TSC-Associated Neuropsychiatric Disorders (TAND), but little is known about the potentially confounding effects of intellectual ability (IA) on the rates of TAND across age, sex, and genotype. We evaluated TAND in (a) children vs. adults, (b) males vs. females, and (c) TSC1 vs. TSC2 mutations, after stratification for levels of IA, in a large, international cohort. Methods: Individuals of any age with a documented visit for TSC in the 12 months prior to enrolment were included. Frequency and percentages of baseline TAND manifestations were presented by categories of IA (no intellectual disability [ID, intelligence quotient (IQ)>70]; mild ID [IQ 50–70]; moderate-to-profound ID [IQ<50]). Chi-square tests were used to test associations between ID and TAND manifestations. The association between TAND and age (children vs. adults), sex (male vs. female), and genotype (TSC1 vs. TSC2) stratified by IA levels were examined using the Cochran–Mantel–Haenszel tests. Results: Eight hundred and ninety four of the 2,211 participants had formal IQ assessments. There was a significant association (P < 0.05) between levels of IA and the majority of TAND manifestations, except impulsivity (P = 0.12), overactivity (P = 0.26), mood swings (P = 0.08), hallucinations (P = 0.20), psychosis (P = 0.06), depressive disorder (P = 0.23), and anxiety disorder (P = 0.65). Once controlled for IA, children had higher rates of overactivity, but most behavioral difficulties were higher in adults. At the psychiatric level, attention deficit hyperactivity disorder (ADHD) was seen at higher rates in children while anxiety and depressive disorders were observed at higher rates in adults. Compared to females, males showed significantly higher rates of impulsivity and overactivity, as well as autism spectrum disorder (ASD) and ADHD. No significant age or sex differences were observed for academic difficulties or neuropsychological deficits. After controlling for IA no genotype-TAND associations were observed, except for higher rates of self-injury in individuals with TSC2 mutations. Conclusions: Findings suggest IA as risk marker for most TAND manifestations. We provide the first evidence of male preponderance of ASD and ADHD in individuals with TSC. The study also confirms the association between TSC2 and IA but, once controlling for IA, disproves the previously reported TSC2 association with ASD and with most other TAND manifestations.
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Affiliation(s)
- Petrus J de Vries
- Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Elena Belousova
- Research and Clinical Institute of Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - Tom Carter
- TSA Tuberous Sclerosis Association, Nottingham, United Kingdom
| | - Vincent Cottin
- Hôpital Louis Pradel, Claude Bernard University Lyon 1, Lyon, France
| | | | - Maria Dahlin
- Astrid Lindgren Childrens Hospital, Stockholm, Sweden
| | | | | | | | - Martha Feucht
- Universitätsklinik für Kinder-und Jugendheilkunde, Affiliated Partner of the ERN EpiCARE, Vienna, Austria
| | - Carla Fladrowski
- Associazione Sclerosi Tuberosa ONLUS, Milan, Italy.,European Tuberous Sclerosis Complex Association, Dattein, Germany
| | | | - Sergiusz Jozwiak
- Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland.,Department of Neurology and Epileptology, The Children's Memorial Health Institute, Warsaw, Poland
| | - John A Lawson
- The Tuberous Sclerosis Multidisciplinary Management Clinic, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Alfons Macaya
- Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ruben Marques
- Novartis Farma S.p.A., Origgio, Italy.,Institute of Biomedicine (IBIOMED), University of Leon, León, Spain
| | - Rima Nabbout
- Department of Pediatric Neurology, Necker Enfants Malades Hospital, Paris Descartes University, Paris, France
| | - Finbar O'Callaghan
- Clinical Neurosciences Section, Institute of Child Health, University College London, London, United Kingdom
| | - Jiong Qin
- Department of Pediatrics, Peking University People's Hospital (PKUPH), Beijing, China
| | | | | | - Seema Shah
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - Yukitoshi Takahashi
- National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, NHO, Shizuoka, Japan
| | - Renaud Touraine
- Department of Genetics, CHU-Hôpital Nord, Saint-Étienne, France
| | | | | | - John C Kingswood
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Centre, St Georges University of London, London, United Kingdom
| | - Anna C Jansen
- Pediatric Neurology Unit, Department of Pediatrics, UZ Brussel VUB, Brussels, Belgium
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Arora S, Goodall S, Viney R, Einfeld S. Societal cost of childhood intellectual disability in Australia. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:524-537. [PMID: 32329168 DOI: 10.1111/jir.12732] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND There is limited research quantifying the direct and indirect economic costs associated with intellectual disability (ID) in Australia. Costs incurred by families, governments and broader society include time spent providing care, absenteeism and increased healthcare utilisation. The purpose of this research is to quantify the costs associated with ID in childhood using a range of methods to collect cost data. METHODS Costs included healthcare service utilisation, pharmaceutical use, caregiver productivity losses and time spent providing care because of the child's disability. The sample comprised caregivers with a child with ID aged between 2 and 10 years old recruited in Australia. Healthcare service utilisation and pharmaceutical use were obtained from routinely collected administrative claims data. Healthcare utilisation not captured in the routinely collected administrative data and absenteeism data were obtained from a retrospective recall-based questionnaire. Time spent providing care because of the child's disability was obtained using a time-use diary. RESULTS The total cost of ID in Australia was estimated to be AUD 72 027 per year per child, and the total cost of ID in childhood was estimated to be AUD 12.5 billion per year. The cost to governments of ID in childhood was estimated to be AUD 6385 per child per year, resulting in a total cost to government of AUD 1.1 billion per year. CONCLUSIONS This is the first study to estimate the direct and indirect costs associated with ID in childhood. The results of this research demonstrate the considerable economic impact of ID in childhood on families, governments and broader society in terms of both direct and indirect costs. An understanding of the cost implications of any intervention are critical in assisting policymakers in planning and prioritising of health services.
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Affiliation(s)
- S Arora
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Broadway, New South Wales, Australia
| | - S Goodall
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Broadway, New South Wales, Australia
| | - R Viney
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Broadway, New South Wales, Australia
| | - S Einfeld
- Brain and Mind Centre, University of Sydney, Brain and Mind Centre, Camperdown, New South Wales, Australia
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Early Behavioral Intervention for Young Children with Intellectual and Developmental Disabilities. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00201-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Werner S, Stern I, Roth D, Tenenbaum A. Help-Seeking by Parental Caregivers of Individuals with Intellectual Disabilities and Dual Diagnosis. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:321-333. [PMID: 30604003 DOI: 10.1007/s10488-018-00915-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study examined the roles of stigma and of enabling factors in help-seeking by parental caregivers of individuals with intellectual disabilities and dual diagnosis. Questionnaires were completed by 195 family caregivers. Lower family stigma was related to higher personal enabling factors (e.g. knowledge about services and previous experience in seeking help), which in turn was related to higher help-seeking behaviors. Higher professional enabling factors (e.g. attitude of the professional, services in the vicinity) were related to higher intentions to seek help, which were related to higher help-seeking behaviors. Professionals can help families achieve a greater sense of self-efficacy in their own help-seeking process by providing them with knowledge about services and facilitating a more positive experience in the process.
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Affiliation(s)
- Shirli Werner
- Center for Disability Studies, Paul Baerwald School of Social Work & Social Welfare, Hebrew University of Jerusalem, Mount Scopus, 91905, Jerusalem, Israel.
| | - Ira Stern
- Center for Disability Studies, Paul Baerwald School of Social Work & Social Welfare, Hebrew University of Jerusalem, Mount Scopus, 91905, Jerusalem, Israel
| | - Dana Roth
- Research and Evaluation Department, Beit Issie Shapiro, Ra'anana, Israel
| | - Ariel Tenenbaum
- Down syndrome and the IDD Evaluation Centers, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel
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Spinocerebellar ataxia type 48: last but not least. Neurol Sci 2020; 41:2423-2432. [PMID: 32342324 DOI: 10.1007/s10072-020-04408-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Biallelic mutations in STUB1, which encodes the E3 ubiquitin ligase CHIP, were originally described in association with SCAR16, a rare autosomal recessive spinocerebellar ataxia, so far reported in 16 kindreds. In the last 2 years, a new form of spinocerebellar ataxia (SCA48), associated with heterozygous mutations in the same gene, has been described in 12 kindreds with autosomal dominant inheritance. METHODS We reviewed molecular and clinical findings of both SCAR16 and SCA48 described patients. RESULTS AND CONCLUSION SCAR16 is characterized by early onset spastic ataxia and a wide disease spectrum, including cognitive dysfunction, hyperkinetic disorders, epilepsy, peripheral neuropathy, and hypogonadism. SCA48 is an adult-onset syndrome characterized by ataxia and cognitive-psychiatric features, variably associated with chorea, parkinsonism, dystonia, and urinary symptoms. SCA48, the last dominant ataxia to be described, could emerge as the most frequent among the SCAs due to conventional mutations. The overlap of several clinical signs between SCAR16 and SCA48 indicates the presence of a continuous clinical spectrum among recessively and dominantly inherited mutations of STUB1. Different kinds of mutations, scattered over the three gene domains, have been found in both disorders. Their pathogenesis and the relationship between SCA48 and SCAR16 remain to be clarified.
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Hussain R, Wark S, Janicki MP, Parmenter T, Knox M. Multimorbidity in older people with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1234-1244. [PMID: 32307771 DOI: 10.1111/jar.12743] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 02/24/2020] [Accepted: 03/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is paucity of research from Australia about comorbidity in older people with intellectual disability (PwID). This paper examines the burden of chronic diseases and associated sociodemographic correlates in a cohort of PwID aged 60+. METHODS A cross-sectional survey was used with community-dwelling older PwID in urban/rural regions of two Australian states. Recruitment was undertaken via a multi-prong approach and each subject (N = 391; 236 urban/155 rural) personally interviewed. RESULTS Findings show older PwID experience considerable multimorbidity (X = 3.8; 53.5% had 2-6 conditions). Conditions included arthritis (40%), diabetes (26%), cardiovascular diseases (23.6%), asthma (16.1%), carcinomas (10.0%) and mental health disorders (34.5%). CONCLUSIONS There was significant multimorbidity in older PwID, with evolution of life trajectories of select conditions associated with socioeconomic disadvantage and heath facility access barriers. Greater scrutiny of progressive health debilitation leading into older age and increased engagement by healthcare systems is required earlier in the lives of PwID.
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Affiliation(s)
- Rafat Hussain
- Australian National University, Canberra, ACT, Australia
| | - Stuart Wark
- University of New England, Armidale, NSW, Australia
| | | | | | - Marie Knox
- University of Sydney, Sydney, NSW, Australia
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Children and adolescents with epilepsy in rehabilitation centers: A French prospective transversal study. Epilepsy Behav 2020; 104:106898. [PMID: 31986442 DOI: 10.1016/j.yebeh.2019.106898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 12/10/2019] [Accepted: 12/30/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The reason why some children and adolescent with epilepsy (CAWE) still challenge the "inclusive" educative policy needs to be explored. METHODS/PATIENTS We conducted a transversal study in French medical, social, and educative rehab centers (MSERCs) dedicated to CAWE to describe the profile of 263 centers-involved (CI)-CAWE. Centers-involved CAWE were prospectively followed from September 2012 to August 2013. Medical, social, and educative rehab centers were dichotomized according to their care-provider agreement (i.e., CAWE of "moderate" (M) vs. "severe" (S) conditions). Clinical factors known to impact clinical outcome and quality of life (QoL) in epilepsy and four disabling conditions at risk to impact school life (i.e., cognitive and psychiatric/behavioral disorders, risk of physical hazards (i.e., refractory seizures with unpredictable loss of tone and/or awareness), and one or more seizure/week) were evaluated. The electronic chart of the French collaborative database (namely GRENAT) was used for data collection allowing comparison with the profile of 731 "normally integrated and schooled" (NIS)-CAWE extracted from GRENAT and matching for generation (i.e., born between 1988 and 2006). RESULTS Centers-involved CAWE's profile was found, after adjustment, to be associated with clinical factors and disabling conditions reflecting the poorest clinical outcome and health-related quality of life (HR-QoL) (all p < 0.001). A cutoff of two disabilities/child highly discriminated NIS-CAWE vs. CI-CAWE. Centers-involved CAWE of S-MSERCs were the most severe (all p < 0.001), and the type of cognitive disability (i.e., intellectual disability (ID) vs. specific learning disorders (SLD)) highly paralleled the types of MSERCs (S vs. M). Using a parent-informant questionnaire, the number of disabilities/child was found to correlate with both the evaluation of the impact of epilepsy (r = 0.47, p < 0.001) and the HR-QoL (r = 0.37, p < 0.001). A satisfactory social life was reported (83.8%) even after S vs. M dichotomization (77.2% vs. 94.7%; p < 0.001). CONCLUSION Multiple disabilities rather than epilepsy per se challenge the inclusive educative policy. Evaluation of disabilities could be the missing bridge to optimize this policy and understand its limits.
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Farris O, Royston R, Absoud M, Ambler G, Barnes J, Hunter R, Kyriakopoulos M, Oulton K, Paliokosta E, Panca M, Paulauskaite L, Poppe M, Ricciardi F, Sharma A, Slonims V, Summerson U, Sutcliffe A, Thomas M, Hassiotis A. Clinical and cost effectiveness of a parent mediated intervention to reduce challenging behaviour in pre-schoolers with moderate to severe intellectual disability (EPICC-ID) study protocol: a multi-centre, parallel-group randomised controlled trial. BMC Psychiatry 2020; 20:35. [PMID: 32000729 PMCID: PMC6993328 DOI: 10.1186/s12888-020-2451-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/21/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Children with intellectual disabilities are likely to present with challenging behaviour. Parent mediated interventions have shown utility in influencing child behaviour, although there is a paucity of UK research into challenging behaviour interventions in this population. NICE guidelines favour Stepping Stones Triple P (SSTP) as a challenging behaviour intervention and this trial aims to evaluate its clinical and cost effectiveness in preschool children with moderate to severe intellectual disabilities. METHODS This trial launched in 2017 at four sites across England, with the aim of recruiting 258 participants (aged 30-59 months). The Intervention Group receive nine weeks of SSTP parenting therapy (six group sessions and three individualised face to face or telephone sessions) in addition to Treatment as Usual, whilst the Treatment as Usual only group receive other available services in each location. Both study groups undergo the study measurements at baseline and at four and twelve months. Outcome measures include parent reports and structured observations of behaviour. Service use and health related quality of life data will also be collected to carry out a cost effectiveness and utility evaluation. DISCUSSION Findings from this study will inform policy regarding interventions for challenging behaviour in young children with moderate to severe intellectual disabilities. TRIAL REGISTRATION NUMBER Clinicaltrials.gov, NCT03086876. Registered 22nd March 2017, https://clinicaltrials.gov/ct2/show/NCT03086876.
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Affiliation(s)
- Olayinka Farris
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Rachel Royston
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Michael Absoud
- Evelina London Children’s Hospital, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH and King’s College London, Strand, London, WC2R 2LS UK
| | - Gareth Ambler
- Department of Statistical Science, University College London, Gower Street, London, WC1E 6BT UK
| | - Jacqueline Barnes
- Department of Psychological Sciences, Birbeck University of London, Malet Street, London, WC1E 7HX UK
| | - Rachael Hunter
- Research Department of Primary Care and Population Health, Royal Free Medical School, NW3 2PF, London, UK
| | - Marinos Kyriakopoulos
- South London and Maudsley NHS Foundation Trust and Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, PO66 De Crespigny Park, London, SE5 8AF UK
| | - Kate Oulton
- Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH UK
| | - Eleni Paliokosta
- The Effra Clinic, 4th Floor, 86-90 Paul Street, London, EC2A 4NE UK
| | - Monica Panca
- Research Department of Primary Care and Population Health, Royal Free Medical School, NW3 2PF, London, UK
| | - Laura Paulauskaite
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Michaela Poppe
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Federico Ricciardi
- Department of Statistical Science, University College London, Gower Street, London, WC1E 6BT UK
| | - Aditya Sharma
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE1 7RU UK
| | - Vicky Slonims
- Evelina London Children’s Hospital, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH and King’s College London, Strand, London, WC2R 2LS UK
| | | | | | - Megan Thomas
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool Victoria Hospital, Whinney Heys Road, Blackpool, FY3 8NR UK
| | - Angela Hassiotis
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
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Teague SJ, Newman LK, Tonge BJ, Gray KM. Attachment and child behaviour and emotional problems in autism spectrum disorder with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 33:475-487. [PMID: 31746131 DOI: 10.1111/jar.12689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/06/2019] [Accepted: 10/31/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Behaviour and emotional problems are highly prevalent in children with autism spectrum disorder (ASD). In typically developing children, attachment quality acts as a risk/protective factor for behavioural outcomes and adjustment, warranting investigation in children with ASD. METHOD We investigated the relationship between attachment and child behaviour and emotional problems in children with ASD and comorbid intellectual disability. Data were collected from parent-child dyads where children were diagnosed with ASD and ID (n = 28) or other developmental disabilities (n = 20). RESULTS Children with ASD had higher levels of behaviour and emotional problems and more attachment difficulties than children with other developmental disabilities. Poorer attachment quality contributed uniquely to the variance in child behaviour and emotional problems. CONCLUSIONS Interventions targeting behaviour and emotional problems in children with ASD may benefit from an attachment model which addresses the child's difficulty in using caregivers as a coregulatory agent of emotions.
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Affiliation(s)
- Samantha J Teague
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Louise K Newman
- Centre for Women's Health, Department of Psychiatry, University of Melbourne, Melbourne, Vic., Australia
| | - Bruce J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
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Bailey T, Totsika V, Hastings RP, Hatton C, Emerson E. Developmental trajectories of behaviour problems and prosocial behaviours of children with intellectual disabilities in a population-based cohort. J Child Psychol Psychiatry 2019; 60:1210-1218. [PMID: 31225660 DOI: 10.1111/jcpp.13080] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND The study examined developmental trajectories of prosocial behaviours, internalising and externalising behaviour problems in children with intellectual disabilities (ID) between pre-school and middle childhood. METHOD Growth models examined the best-fitting trajectories for internalising and externalising behaviour problems, as well as prosocial behaviours, in 555 children with ID between the ages of three and 11 years from the UK Millennium Cohort Study. Models were also fitted to examine the association of child outcomes with time-varying maternal psychological distress and life satisfaction. Finally, models were extended to compare trajectories with typically developing children. RESULTS Externalising behaviour problems and prosocial behaviours generally improved, whereas internalising problems did not change systematically over time. A cubic trend indicated a slowing down of improvement between ages 5 and 7 for prosocial behaviours and externalising problems. Maternal psychological distress positively co-varied with internalising and externalising behaviour problems over time. Life satisfaction was not related to changes in child behaviours over time. Compared to behavioural trajectories in typical development, intercepts were worse and trajectories also differed in the ID group. CONCLUSIONS Over an 8-year period, externalising behaviour problems and prosocial behaviours of children with ID tended to improve. These behavioural improvements slowed between five and seven years, possibly coinciding with school-related environmental changes. Children with ID significantly differ from children with typical development in both the initial level of difficulties (exhibiting higher externalising and internalising behaviours, and lower prosocial behaviours) and subsequent development as they age, showing comparatively lower decreases in both externalising and internalising behaviours, and lower increases in prosocial behaviours. Findings also highlight the significant role of maternal mental health problems in the trajectory of child behaviour problems.
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Affiliation(s)
- Tom Bailey
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Division of Psychiatry, University College London, London, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Chris Hatton
- Centre for Disability Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Eric Emerson
- Centre for Disability Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.,Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
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Davies K, Eagleson C, Weise J, Cvejic RC, Trollor JN. Clinical capacity of Australian and New Zealand psychiatrists who work with people with intellectual and developmental disabilities. Australas Psychiatry 2019; 27:506-512. [PMID: 31294611 DOI: 10.1177/1039856219859286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe the characteristics and clinical capacity of Australian and New Zealand psychiatrists working in intellectual and developmental disability mental health (IDDMH). METHOD Consultant psychiatrists (n=71) with an interest or expertise in IDDMH completed an online survey about their roles, experience and time spent in intellectual developmental disability (IDD)-related activities. RESULTS Psychiatrists had worked in IDDMH for a median of 11.34 years and half (53.5%) reported expertise in the area. One-fifth of psychiatrists reported IDDMH as their main area of practice. The majority of respondents (85.1%) reported that they were working clinically with people with IDD. Respondents practicing clinically worked a median of 8 hours in clinical and 3 hours in non-clinical IDD-related work per week. CONCLUSIONS Surveyed psychiatrists had considerable experience in IDDMH. However, their work in IDDMH represented a relatively small proportion of their overall work hours, and a minority of respondents were responsible for a large proportion of clinical work. Exploring ways to broaden capacity is crucial to ensuring the mental health needs of people with IDD are met.
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Affiliation(s)
- Kimberley Davies
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Claire Eagleson
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Janelle Weise
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Rachael C Cvejic
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, NSW, Australia
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Ruane A, Carr A, Moffat V, Finn T, Murphy A, O'Brien O, Groarke H, O'Dwyer R. A randomised controlled trial of the Group Stepping Stones Triple P training programme for parents of children with developmental disabilities. Clin Child Psychol Psychiatry 2019; 24:728-753. [PMID: 30764646 DOI: 10.1177/1359104519827622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The central aim of this study was to examine the effectiveness of Group Stepping Stones Triple P (GSSTP) in an Irish context for families of children with both developmental disabilities and internalising and externalising behavioural problems. Parents of 84 children (mean age = 5.73; SD = 2.06) with developmental disabilities and co-occurring behaviour problems attending Irish public health services were randomly assigned to a 9-week GSSTP group or a waiting list control (WLC) group. All parents completed self-report measures before (Time 1) and after (Time 2) the programme and parents in the GSSTP group were assessed at 3- to 5-month follow-up (Time 3). At Time 2, clinical improvement and reliable change rates on the primary dependent variables (summary scales of the Developmental Behaviour Checklist and Strengths and Difficulties Questionnaire) were significantly higher in the GSSTP group than in the WLC group. At Time 2, mean scores of the GSSTP group showed significant, small to medium improvements relative to the WLC group on parent-reported child behaviour problems, parenting skills and confidence, and parental adjustment. Most of these improvements were maintained at 3- to 5-month follow-up. These results indicate that GSSTP is a promising intervention for improving child behaviour and parenting outcomes in a mixed-disability group in an Irish context.
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Affiliation(s)
- Ailbhe Ruane
- School of Psychology, University College Dublin, Ireland.,Health Service Executive, Ireland
| | - Alan Carr
- School of Psychology, University College Dublin, Ireland
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Werner S. Service use and perceptions of service effectiveness by parents of individuals with intellectual disabilities: comparing Jewish and Arab Israeli parental caregivers. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:957-968. [PMID: 30775831 DOI: 10.1111/jir.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The relationship between ethnicity, service use and perceptions of service effectiveness is inconclusive. This study examined differences in service use and perceptions of service effectiveness between Israeli Jewish (Jewish) and Israeli Arab (Arab) parental caregivers of individuals with intellectual disabilities and dual diagnosis of psychopathology. METHODS Parental caregivers (n = 186) of individuals with intellectual disabilities or dual diagnosis, aged 10 to 30 years, completed a self-report questionnaire. RESULTS Arab parental caregivers perceived health services to be more accessible than did Jewish caregivers, but there was no difference between the two groups in the use of the services. Overall, greater enabling factors and accessibility were associated with higher use of education and social services. No differences were found between the groups in their perceptions of service effectiveness. CONCLUSION Arab family caregivers use education and social services less than do their Jewish peers, possibly because they have fewer enabling resources. The finding that both groups reported similar use of health services may be explained by a shared perception that informal help may not be suitable for dealing with situations of psychopathology. The similar perceptions of service effectiveness may be explained by extensive services available in Israel, to the satisfaction of both groups, or by the fact that participants perceived these services as their only alternative, and therefore fear losing them.
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Affiliation(s)
- S Werner
- Paul Baerwald School of Social Work and Social Welfare and the Center for Disability Studies, Hebrew University of Jerusalem, Jerusalem, Israel
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Barisnikov K, Straccia C. Social adaptive skills and psychopathology in adults with intellectual disabilities of non-specific origin and those with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 87:31-42. [PMID: 30731418 DOI: 10.1016/j.ridd.2019.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 01/11/2019] [Accepted: 01/25/2019] [Indexed: 06/09/2023]
Abstract
The present study aimed to assess the psychometric proprieties of a new social adaptive skills questionnaire and examine the impact of maladaptive behaviour on social functioning in adults with ID of non-specific aetiology and those with Down syndrome. The results of an exploratory factor analysis led to the exclusion of 20 items out of 48 and yielded a four-factor structure. The Confirmatory Factor Analysis conducted on 28 remaining items confirmed a four-factor structure explaining 43% of the total variance. The results computed on the global sample (n = 567) showed a "very good" internal consistency for the global score (.89) for all four factors with a very good fit (.97). Thus, this new assessment tool presented a good conceptual validity for assessing social-adaptive skills in adults with ID. The results also showed that participants with DS (no = 92) exhibited a higher global score of social adaptive skills on three subscales (sociability, social relating and respect for social rules) compared to adults with ID of non-specific aetiology (no = 328), and presented a lower level of psychopathology problems. Although aetiology was significantly related to these group differences even after controlling for level of ID and chronological age, the general level of psychopathology fully mediated these relations. In conclusion, the regression coefficient analyses showed that the general level of psychopathology fully mediated the relationship between aetiology and social adaptive skills. A combined assessment of these dimensions should provide information about their predictive value for social functioning in ID adults and target specific remediation goals.
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Affiliation(s)
- Koviljka Barisnikov
- Child Clinical Neuropsychology Unit, Department of Psychology, University of Geneva, Switzerland.
| | - Claudio Straccia
- Child Clinical Neuropsychology Unit, Department of Psychology, University of Geneva, Switzerland; Department of Special Education, University of Fribourg, Switzerland
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Ruane AI, Carr A. Systematic Review and Meta-analysis of Stepping Stones Triple P for Parents of Children with Disabilities. FAMILY PROCESS 2019. [PMID: 29520764 DOI: 10.1111/famp.12352] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The aim of this systematic review and meta-analysis was to examine the effectiveness of Stepping Stones Triple P (SSTP) parent training programs on child behavior problems and parenting outcomes in families of children with developmental disabilities. Sixteen suitable studies including data from over 900 families were identified in a search for English language published and unpublished controlled outcome studies. SSTP has five levels on a graded continuum of increasing intensity targeting families with differing degrees of treatment need from low intensity media-based parenting information campaigns at level 1, through brief interventions at levels 2 and 3, to more intensive parent training and family therapy interventions at levels 4 and 5. Analyses were conducted on the combination of all levels of SSTP and separately for each level. For combined levels, significant overall effect sizes were found for parent-reported child problems (d = 0.46), researcher observed child behavior (d = 0.51), parenting style (d = 0.70), parenting satisfaction/self-efficacy (d = 0.44), parental adjustment (d = 0.27), and coparental relationship (d = 0.26), but not researcher-observed parent behavior. Strong support was found for level 4 SSTP as an effective intervention for improving child and parent outcomes in families of children with disabilities who have clinically significant problems. Less intensive SSTP interventions for cases with circumscribed difficulties yielded fewer significant treatment effects, and there were relatively few studies of such interventions.
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Affiliation(s)
- AIlbhe Ruane
- Clinical Psychology, School of Psychology, University College Dublin, Dublin 4, Ireland
| | - Alan Carr
- Clinical Psychology, School of Psychology, University College Dublin, Dublin 4, Ireland
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Halvorsen M, Mathiassen B, Myrbakk E, Brøndbo PH, Sætrum A, Steinsvik OO, Martinussen M. Neurodevelopmental correlates of behavioural and emotional problems in a neuropaediatric sample. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 85:217-228. [PMID: 30580152 DOI: 10.1016/j.ridd.2018.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/26/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
Most research does not address the overlap between neurodevelopmental disorders when investigating concomitant mental health problems. The purpose of the present study was to examine the association of intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) with the presence of behavioural and emotional problems after controlling for other well-known correlates and risk factors. The sample included 4- to 18-year-old children who attended neuropaediatric clinics (N = 331). After controlling for adversity, age, gender, other developmental/neurological disorders, parental emotional problems, and parenting strategies, the presence of ADHD but not ASD or ID was uniquely associated with behaviour problems. Neither ADHD nor ASD nor ID was significantly associated with emotional problems after controlling for other risk factors. However, ADHD, ASD and behavioural/emotional disorders but not ID were significantly associated with functional impairment in everyday activities after controlling for other risk factors. Because children with neurodevelopmental disorders have complex needs, a holistic approach to diagnosis and interventions is highly warranted, including the assessment and treatment of behavioural and emotional disorders.
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Affiliation(s)
- Marianne Halvorsen
- Department of Paediatric Rehabilitation, University Hospital of North Norway, Tromsø, Norway.
| | - Børge Mathiassen
- Department of Child and Adolescent Psychiatry, University Hospital of North Norway, Tromsø, Norway
| | | | - Per Håkan Brøndbo
- RKBU-Nord, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ane Sætrum
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Oddmar Ole Steinsvik
- Department of Paediatric Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Monica Martinussen
- RKBU-Nord, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Marquis S, Hayes MV, McGrail K. Factors Affecting the Health of Caregivers of Children Who Have an Intellectual/Developmental Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12283] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sandra Marquis
- School of Public Health and Social PolicyUniversity of Victoria Victoria BC Canada
| | - Michael V. Hayes
- School of Public Health and Social PolicyUniversity of Victoria Victoria BC Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy ResearchUniversity of British Columbia Vancouver BC Canada
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