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Bhat B, Dar S, Qadir W, Pandith M. Clinical profile and maternal depression and anxiety in children and adolescents with intellectual disability: A study from outpatient child psychiatry. ACTA MEDICA INTERNATIONAL 2019. [DOI: 10.4103/ami.ami_25_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Delforterie M, Hesper B, Didden R. Psychometric properties of the Dynamic Risk Outcome Scales (DROS) for individuals with mild intellectual disability or borderline intellectual functioning and externalizing behaviour problems. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 33:662-672. [PMID: 30460720 DOI: 10.1111/jar.12546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 07/25/2018] [Accepted: 10/16/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The present study examined the psychometric properties of the Dynamic Risk Outcome Scales (DROS), an instrument developed to measure dynamic risk factors in individuals with mild intellectual disabilities or borderline intellectual functioning (MID-BIF) and externalizing (including offending-like) behaviour problems. METHOD The sample consisted of 606 clients (86% male) from inpatient treatment wards at a facility for individuals with MID-BIF and externalizing behaviour problems. RESULTS The DROS showed an acceptable factor structure, good internal consistency, significant test-retest reliability and fair to excellent inter-rater reliabilities for most subscales and total score. Compared to the Adult Behavior Checklist (ABCL; Achenbach & Rescorla, 2003 Manual for the ASEBA adult forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families), the DROS showed convergent and divergent validity, concurrent and longitudinal validity. CONCLUSIONS The DROS is a reliable and valid instrument to measure dynamic risk factors in clients with MID-BIF. Future research on the DROS will focus on the assessment of recidivism and the inclusion of internalizing problems.
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Affiliation(s)
| | | | - Robert Didden
- Trajectum, Zwolle, The Netherlands.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
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Cvejic RC, Trollor JN. Transition to adult mental health services for young people with an intellectual disability. J Paediatr Child Health 2018; 54:1127-1130. [PMID: 30294982 DOI: 10.1111/jpc.14197] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 02/05/2023]
Abstract
People with intellectual disabilities (ID) experience high rates of mental health problems, particularly during the period of transition to adulthood. It is therefore important that the transition from child- to adult-oriented health services for people with ID is well managed to ensure appropriate orientation to ongoing adult mental health care. The purpose of this paper is to summarise the impact and experience of transition to adult mental health care for people with ID and those who support them, as well as issues related to current policy and practice in this area. Several opportunities for improvement are identified in the broad areas of policy, service structure and organisation, research and workforce capacity. Enhancements in these areas will lead to improved outcomes for young people with ID transitioning from child- to adult-oriented mental health care.
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Affiliation(s)
- Rachael C Cvejic
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
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Trollor JN, Eagleson C, Turner B, Tracy J, Torr JJ, Durvasula S, Iacono T, Cvejic RC, Lennox N. Intellectual disability content within tertiary medical curriculum: how is it taught and by whom? BMC MEDICAL EDUCATION 2018; 18:182. [PMID: 30071847 PMCID: PMC6090866 DOI: 10.1186/s12909-018-1286-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 07/19/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Individuals with intellectual disability experience higher rates of physical and mental health conditions compared with the general population, yet have inequitable access to health care services. Improving the workplace capacity of medical professionals to meet the needs of this population is one way to reduce barriers to care and improve health outcomes. Using diverse pedagogy appropriate to learning outcomes to teach medical students about intellectual disability is a necessary step in improving future workplace capacity. However, there is a lack of research into how, and by whom, medical students are taught about intellectual disability. The aim of this study was to investigate this through an audit of Australian medical school curricula. METHODS The Deans of Australian universities that provide accredited medical degrees (n = 20) were invited by email to participate in a two-phase audit of intellectual disability content in the curricula. Phase 1 (n = 14 schools) involved the Dean's delegate completing a telephone interview or questionnaire regarding medical course structure. If intellectual disability content was identified, a unit coordinator was invited to complete a survey regarding how this content was taught and by whom (Phase 2; n = 12 schools). RESULTS There was considerable variability across Australian medical schools regarding methods used to teach content about intellectual disability. Didactic teaching methods were most frequently used (62% of units included some form of lecture), but workshops and tutorials were reasonably well represented (34% of units contained one or both). Thirty-six percent of units included two or more teaching methods. Almost all schools (83%) used some problem- and/or enquiry-based learning. Educator backgrounds included medicine, nursing, and allied health. A majority of schools (n = 9, 75%) involved people with intellectual disability designing and teaching content, but the extent to which this occurred was inconsistent. CONCLUSIONS Renewing curricula around intellectual disability across all medical schools by introducing varied teaching methods and the inclusion of people with intellectual disability would assist students to develop knowledge, skills, attitudes, and confidence in intellectual disability health. Such renewal offers the potential to reduce barriers to service this population regularly face, thereby improving their health outcomes.
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Affiliation(s)
- Julian N. Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), 34 Botany Street, UNSW, Sydney, NSW 2052 Australia
| | - Claire Eagleson
- Department of Developmental Disability Neuropsychiatry (3DN), 34 Botany Street, UNSW, Sydney, NSW 2052 Australia
| | - Beth Turner
- Department of Developmental Disability Neuropsychiatry (3DN), 34 Botany Street, UNSW, Sydney, NSW 2052 Australia
| | - Jane Tracy
- Centre for Developmental Disability Health Victoria (CDDHV), Monash Health, 122 Thomas Street, Dandenong, VIC 3175 Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168 Australia
| | - Jennifer J. Torr
- Department of Psychiatry, Monash University, Monash Medical Centre, Block P, Level 3 246 Clayton Rd, Clayton, VIC 3168 Australia
| | - Seeta Durvasula
- Centre for Disability Studies, Sydney Medical School, The University of Sydney, Level 1, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2050 Australia
| | - Teresa Iacono
- La Trobe Rural Health School, La Trobe University, 102 Arnold Street, Bendigo, VIC 3550 Australia
| | - Rachael C. Cvejic
- Department of Developmental Disability Neuropsychiatry (3DN), 34 Botany Street, UNSW, Sydney, NSW 2052 Australia
| | - Nicolas Lennox
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute, The University of Queensland, Level 2 Aubigny Place, Mater Hospitals, South Brisbane, QLD 4101 Australia
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Borghus A, Dokkedahl S, Elklit A. Pilot study: undetected post-traumatic stress disorder symptoms among intellectually disabled. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2018; 66:36-45. [PMID: 34141365 PMCID: PMC8115620 DOI: 10.1080/20473869.2018.1475539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background: Individuals with intellectual disability respond differently to traumatic events, compared to the general population, which makes post-traumatic stress disorder (PTSD) symptoms difficult to recognize. The current study aims to examine the presence of undetected PTSD among individuals with intellectual disability and a known history of trauma exposure. Method: Nine individuals, who have not previously been diagnosed with PTSD, were evaluated for PTSD symptoms through case reports, which include descriptions of medical history, symptoms and behavior described in the former diagnostic reports, potential traumatic experiences, current symptoms and behavior in accordance to the Lancaster and North Gate Trauma Scale, and PTSD criteria from DM-ID. Results: Four out of the nine participants met the DM-ID criteria for PTSD. Conclusions: The current findings highlight the importance of including cognitive impairment and developmental level in the screening, referral and treatment process of PTSD.
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Affiliation(s)
- A. Borghus
- Department of Psychology, National Center for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - S. Dokkedahl
- Department of Psychology, National Center for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - A. Elklit
- Department of Psychology, National Center for Psychotraumatology, University of Southern Denmark, Odense, Denmark
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Haddad F, Bourke J, Wong K, Leonard H. An investigation of the determinants of quality of life in adolescents and young adults with Down syndrome. PLoS One 2018; 13:e0197394. [PMID: 29897903 PMCID: PMC5999114 DOI: 10.1371/journal.pone.0197394] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/01/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Young people with Down syndrome experience varying abilities in activities of daily living, cognitive functioning, behaviour and social skills. The aim of this research was to investigate, from a carer's perspective, the factors that influenced the quality of life of these young people. METHODS Families of young people with Down syndrome (n = 197), aged 16-31 years, living in Western Australia, took part in a questionnaire study regarding young person daily functioning, family characteristics, medical background and quality of life measured by the Kidscreen 27-item scale. Kidscreen-10 total score was used as an outcome in the investigation of determinants with higher scores indicating better quality of life. RESULTS After adjustment for confounders including carer's mental health measured by the Depression and Anxiety Scale (DASS), global impact of illness as well as impact of mental health and bowel conditions were all negatively associated with the young person's quality of life. Young people who had three or more friends had better quality of life than those with no friends. Scores were lower (reflecting poor quality of life) in individuals who had more behavioural problems but these relationships were attenuated after adjustment for confounders and DASS. CONCLUSIONS Overall, our findings revealed that quality of life of young people with Down syndrome was most negatively associated with burden of medical conditions, but also with lack of friendships. We were somewhat surprised to find the effect of medical problems on quality of life persisting into adolescence and adulthood where in general the burden of medical comorbidities is much less than in childhood.
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Affiliation(s)
- Fatma Haddad
- University of Western Australia, Perth Western Australia, Australia
| | - Jenny Bourke
- Telethon Kids Institute, University of Western Australia, Perth Western Australia, Australia
| | - Kingsley Wong
- Telethon Kids Institute, University of Western Australia, Perth Western Australia, Australia
| | - Helen Leonard
- University of Western Australia, Perth Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth Western Australia, Australia
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Hronis A, Roberts L, Kneebone I. Assessing the Confidence of Australian Mental Health Practitioners in Delivering Therapy to People With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 56:202-211. [PMID: 29782234 DOI: 10.1352/1934-9556-56.3.202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research supports the use of psychological therapies among people with mild to moderate intellectual disability (ID). One barrier to people with ID accessing psychological treatments is the confidence of mental health practitioners. This article explores the confidence of Australian clinicians in providing therapy to people with ID. One hundred and fifty-two psychologists and counselors in Australia completed a survey exploring self-reported confidence when working with clients who have ID and mental health difficulties. Clinicians were most confident with generic counseling skills, but less confident with elements of assessments and interventions. The use of treatment protocols was endorsed as helpful particularly among those with low confidence. This highlights the need for dissemination of treatment guides and training to help increase clinician confidence.
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Affiliation(s)
- Anastasia Hronis
- Anastasia Hronis, Lynette Roberts, and Ian Kneebone, University of Technology Sydney
| | - Lynette Roberts
- Anastasia Hronis, Lynette Roberts, and Ian Kneebone, University of Technology Sydney
| | - Ian Kneebone
- Anastasia Hronis, Lynette Roberts, and Ian Kneebone, University of Technology Sydney
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Early vulnerabilities for psychiatric disorders in elementary schoolchildren from four Brazilian regions. Soc Psychiatry Psychiatr Epidemiol 2018; 53:477-486. [PMID: 29511791 DOI: 10.1007/s00127-018-1503-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 02/28/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE The purpose of the study is to identify early vulnerabilities for psychiatric disorders among Brazilian elementary school children, controlling for familial and community adversities. METHODS This is a cross-sectional study examining the association between child psychiatric disorders and potential early vulnerabilities (disability, low intellectual quotient, and negative dimensions of the temperament trait self-directedness (low resourcefulness, low purposefulness, low enlightened second nature), controlling for the potential confounders: familial and community adversities. SAMPLE Four probabilistic samples of second-to-sixth grade students from public schools in four towns from different Brazilian regions (N = 1620). The following instruments were applied: the K-SADS-PL (to assess child/adolescent psychiatric disorders); the Ten-Question Screen (to measure child disability); three structured questions used as proxy of self-directedness; and the reduced version of the WISC-III to measure IQ. To evaluate familial/community adversities: Self-Report Questionnaire-SRQ-20 (to assess maternal/primary caretaker anxiety/depression); questions derived from structured questionnaires (to measure child abuse, marital physical violence, neighborhood violence); Brazilian Association of Research Companies questionnaire (to evaluate poverty/socioeconomic status). Trained psychologists interviewed mothers/primary caretakers and evaluated children/adolescents individually. RESULTS A final logistic regression model showed that children/adolescents with low resourcefulness, low purposefulness, low enlightened second nature, lower IQ and disability were more likely to present any child psychiatric disorders. CONCLUSION Early vulnerabilities such as low IQ, presence of disability, and dimensions of temperament were associated with psychiatric disorders among Brazilian elementary school children, after controlling for familial and ecological confounders. These early vulnerabilities should be considered in mental health prevention/intervention programs in low-middle-income countries like Brazil.
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Austin KL, Hunter M, Gallagher E, Campbell LE. Depression and anxiety symptoms during the transition to early adulthood for people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:407-421. [PMID: 29473259 DOI: 10.1111/jir.12478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 12/12/2017] [Accepted: 01/18/2018] [Indexed: 05/07/2023]
Abstract
BACKGROUND The transition to adulthood is a major developmental milestone; a time of self-discovery and increased independence. For young adults (YA) with intellectual disabilities (ID), however, this period is especially challenging. The increased incidence of mental health disorders in this population, such as depression and anxiety, make this transition even more difficult, increasing caregiver burden at a time when the young adult would traditionally be gaining independence. It is not clear, however, why YA with ID are more susceptible and what factors may predict mental health symptoms. METHOD Potential risk and protective factors (demographic variables, coping styles, sense of hopelessness, unmet achievement of adulthood milestones, self-reflection and insight) of anxiety and depression symptoms were assessed in 55 YA with ID and a sample of age-matched controls. RESULTS Insight was the strongest predictor of anxiety (with gender in the controls) for YA with and without ID, with increased insight predicting fewer anxiety symptoms. However, YA with ID had significantly less insight than their aged-matched counterparts and significantly higher levels of anxiety. They were also less likely to have achieved traditional adulthood milestones. Maladaptive coping was the strongest predictor of depression for YA with ID. In comparison, both maladaptive coping and insight predicted depression in controls. More maladaptive coping predicted increased depressive symptoms in both populations, whilst increased insight predicted fewer depressive symptoms in controls. CONCLUSIONS Insight and maladaptive coping are potential targets in the treatment of anxiety and depression among YA with ID. Longitudinal intervention studies exploring the efficacy of such targeted programmes in reducing mental health symptoms and improving the transition to adulthood for these young people are recommended.
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Affiliation(s)
- K L Austin
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - M Hunter
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - E Gallagher
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - L E Campbell
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, New South Wales, Australia
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Roberts L, Kwan S. Putting the C into CBT: Cognitive challenging with adults with mild to moderate intellectual disabilities and anxiety disorders. Clin Psychol Psychother 2018; 25:662-671. [DOI: 10.1002/cpp.2196] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 12/22/2017] [Accepted: 03/12/2018] [Indexed: 01/25/2023]
Affiliation(s)
- Lynette Roberts
- Centre for Disability Studies; affiliate of the University of Sydney; New South Wales Australia
| | - Sophia Kwan
- School of Psychology; UNSW Sydney; New South Wales Australia
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Caregiver Mental Health, Parenting Practices, and Perceptions of Child Attachment in Children with Autism Spectrum Disorder. J Autism Dev Disord 2018; 48:2642-2652. [DOI: 10.1007/s10803-018-3517-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Autistic, Aberrant, and Food-Related Behaviors in Adolescents and Young Adults with Prader-Willi Syndrome: The Effects of Age and Genotype. Behav Neurol 2018; 2017:4615451. [PMID: 29440778 PMCID: PMC5758853 DOI: 10.1155/2017/4615451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 12/05/2017] [Indexed: 11/17/2022] Open
Abstract
The effects of age and genotype were examined, with regard to the severity of aberrant, autistic, and food-related behaviors in Prader-Willi syndrome (PWS), with an emphasis on the contrast between adolescents and young adults. The Aberrant Behavior Checklist Japanese version (ABC-J), the Food Related Problem Questionnaire (FRPQ), and the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS) were administered to 65 PWS patients, including 20 adolescents (ages 12 to 17) and 45 young adults (ages 18 to 29). Significant differences (Mann-Whitney U tests) were found in ABC-J (p = 0.004) and PARS (p = 0.021), with lower scores in adolescents than in young adults. While DEL subgroups showed no significant differences between the two age groups in ABC-J (p = 0.063) and PARS (p = 0.134), mUPD subgroups showed a statistically significant difference in terms of ABC-J (p = 0.007). No significant differences were found between adolescents and young adults, in terms of FRPQ (p = 0.163). These results suggest that aberrant and autistic behaviors follow a marked worsening trend from around the age of 18. On the other hand, food-related behaviors give no sign of change at this transitory stage. Young adults with mUPD were found to be significantly more severe than adolescents with mUPD, in terms of aberrant behaviors.
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Rice LJ, Emerson E, Gray KM, Howlin P, Tonge BJ, Warner GL, Einfeld SL. Concurrence of the strengths and difficulties questionnaire and developmental behaviour checklist among children with an intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:150-155. [PMID: 28980362 DOI: 10.1111/jir.12426] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 08/28/2017] [Accepted: 09/06/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The Strengths and Difficulties Questionnaire (SDQ) is widely used to measure emotional and behavioural problems in typically developing young people, although there is some evidence that it may also be suitable for children with intellectual disability (ID). The Developmental Behaviour Checklist - Parent version (DBC-P) is a measure of emotional and behavioural problems that was specifically designed for children and adolescents with an ID. The DBC-P cut-off has high agreement with clinical diagnosis. The aim of this study was to estimate the relationship between DBC-P and SDQ scores in a sample of children with ID. METHOD Parents of 83 young people with ID aged 4-17 years completed the parent versions of the SDQ and the DBC-P. We evaluated the concurrent validity of the SDQ and DBC-P total scores, and the agreement between the DBC-P cut-off and the SDQ cut-offs for 'borderline' and 'abnormal' behaviour. RESULTS The SDQ total difficulties score correlated well with the DBC-P total behaviour problem score. Agreement between the SDQ borderline cut-off and the DBC-P cut-off for abnormality was high (83%), but was lower for the SDQ abnormal cut-off (75%). Positive agreement between the DBC-P and the SDQ borderline cut-off was also high, with the SDQ borderline cut-off identifying 86% of those who met the DBC-P criterion. Negative agreement was weaker, with the SDQ borderline cut-off identifying only 79% of the participants who did not meet the DBC-P cut-off. CONCLUSION The SDQ borderline cut-off has some validity as a measure of overall levels of behavioural and emotional problems in young people with ID, and may be useful in epidemiological studies that include participants with and without ID. However, where it is important to focus on behavioural profiles in children with ID, a specialised ID instrument with established psychometric properties, such as the DBC-P, may provide more reliable and valid information.
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Affiliation(s)
- L J Rice
- Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - E Emerson
- Centre for Disability Research and Policy, University of Sydney, Lidcombe, 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, Victoria, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - P Howlin
- Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - B J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - G L Warner
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - S L Einfeld
- Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
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Morrison J, Chunsuwan I, Bunnag P, Gronholm PC, Lockwood Estrin G. Thailand's national universal developmental screening programme for young children: action research for improved follow-up. BMJ Glob Health 2018; 3:e000589. [PMID: 29564160 PMCID: PMC5859813 DOI: 10.1136/bmjgh-2017-000589] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 12/01/2017] [Accepted: 12/12/2017] [Indexed: 11/22/2022] Open
Abstract
Introduction In low-income and middle-income countries, it is estimated that one in every three preschool-age children are failing to meet cognitive or socioemotional developmental milestones. Thailand has implemented a universal national developmental screening programme (DSPM) for young children to enable detection of developmental disorders and early intervention that can improve child health outcomes. DSPM implementation is being hampered by low attendance at follow-up appointments when children fail the initial screening. Methods Action research, using qualitative methods was conducted with 19 caregivers, 5 health workers and 1 chief at two Health Promotion Hospitals to explore the factors affecting attendance at follow-up appointments. Transcripts and notes were analysed using descriptive content analysis. Findings were then discussed with 48 health workers, managers, researchers and policymakers. Results The high workload of health workers during busy vaccination clinics, and inadequate materials prevented clear communication with caregivers about the screening, how to stimulate child development and the screening result. Caregivers, particularly grandparents, had a lack of understanding about how to stimulate child development, and did not fully understand failed screening results. Caregivers felt blamed for not stimulating their child’s development, and were either worried that their child was severely disabled, or they did not believe the screening result and therefore questioned its usefulness. This led to a lack of attendance at follow-up appointments. Conclusion Task-sharing, mobile health (mhealth), community outreach and targeted interventions for grandparent caregivers might increase awareness about child development and screening, and allow health workers more time to communicate effectively. Sharing best practices, communication training and mentoring of DSPM workers coupled with mhealth job aids could also improve caregiver attendance at follow-up. Engagement of caregivers in understanding the barriers to attendance at follow-up and engagement of stakeholders in the design and implementation of interventions is important to ensure their effectiveness.
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Affiliation(s)
- Joanna Morrison
- Institute for Global Health, University College London, London, UK
| | - Issarapa Chunsuwan
- Department of Pediatrics, Faculty of Medicine, Developmental and Behavioral Pediatrics, Thammasat University, Pathum Thani, Thailand
| | - Petch Bunnag
- Department of Family Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Petra C Gronholm
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Georgia Lockwood Estrin
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Lee S, Rudd S, Gratten J, Visscher PM, Prins JB, Dawson PA. Gene networks associated with non-syndromic intellectual disability. J Neurogenet 2017; 32:6-14. [PMID: 29199528 DOI: 10.1080/01677063.2017.1404058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Non-syndromic intellectual disability (NS-ID) is a genetically heterogeneous disorder, with more than 200 candidate genes to date. Despite the increasing number of novel mutations detected, a relatively low number of recurrently mutated genes have been identified, highlighting the complex genetic architecture of the disorder. A systematic search of PubMed and Medline identified 245 genes harbouring non-synonymous variants, insertions or deletions, which were identified as candidate NS-ID genes from case reports or from linkage or pedigree analyses. From this list, 33 genes are common to syndromic intellectual disability (S-ID) and 58 genes are common to certain neurological and neuropsychiatric disorders that often include intellectual disability as a clinical feature. We examined the evolutionary constraint and brain expression of these gene sets, and we performed gene network and protein-protein interaction analyses using GeneGO MetaCoreTM and DAPPLE, respectively. The 245 NS-ID candidate genes were over-represented in axon guidance, synaptogenesis, cell adhesion and neurotransmission pathways, all of which are key neurodevelopmental processes for the establishment of mature neuronal circuitry in the brain. These 245 genes exhibit significantly elevated expression in human brain and are evolutionarily constrained, consistent with expectations for a brain disorder such as NS-ID that is associated with reduced fecundity. In addition, we report enrichment of dopaminergic and glutamatergic pathways for those candidate NS-ID genes that are common to S-ID and/or neurological and neuropsychiatric disorders that exhibit intellectual disability. Collectively, this study provides an overview and analysis of gene networks associated with NS-ID and suggests modulation of neurotransmission, particularly dopaminergic and glutamatergic systems as key contributors to synaptic dysfunction in NS-ID.
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Affiliation(s)
- Soohyun Lee
- a Mater Research Institute, The University of Queensland , Woolloongabba , Australia
| | - Stephen Rudd
- b QFAB Bioinformatics, Queensland Bioscience Precinct, The University of Queensland , Brisbane , Australia
| | - Jacob Gratten
- c Queensland Brain Institute, The University of Queensland , Brisbane , Australia
| | - Peter M Visscher
- c Queensland Brain Institute, The University of Queensland , Brisbane , Australia
| | - Johannes B Prins
- a Mater Research Institute, The University of Queensland , Woolloongabba , Australia
| | - Paul A Dawson
- a Mater Research Institute, The University of Queensland , Woolloongabba , Australia
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Flynn S, Vereenooghe L, Hastings RP, Adams D, Cooper SA, Gore N, Hatton C, Hood K, Jahoda A, Langdon PE, McNamara R, Oliver C, Roy A, Totsika V, Waite J. Measurement tools for mental health problems and mental well-being in people with severe or profound intellectual disabilities: A systematic review. Clin Psychol Rev 2017; 57:32-44. [DOI: 10.1016/j.cpr.2017.08.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/27/2017] [Accepted: 08/09/2017] [Indexed: 11/29/2022]
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67
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Weise J, Fisher KR, Trollor JN. What makes generalist mental health professionals effective when working with people with an intellectual disability? A family member and support person perspective. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:413-422. [DOI: 10.1111/jar.12420] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Janelle Weise
- Department of Developmental Disability Neuropsychiatry School of Psychiatry UNSW Sydney Sydney NSW Australia
| | - Karen R. Fisher
- Faculty of Arts and Social Sciences Disability Research Program Social Policy Research Centre UNSW Sydney Sydney NSW Australia
| | - Julian N. Trollor
- Department of Developmental Disability Neuropsychiatry School of Psychiatry UNSW Sydney Sydney NSW Australia
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Theodoratos O, McPherson L, Franklin C, Tonge B, Einfeld S, Lennox N, Ware RS. Psychopathology of adolescents with an intellectual disability who present to general hospital services. Australas Psychiatry 2017; 25:481-485. [PMID: 28462590 DOI: 10.1177/1039856217706820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Adolescents with intellectual disability have increased rates of psychopathology compared with their typically developing peers and present to hospital more frequently for ambulant conditions. The aim of this study is to describe the psychopathology and related characteristics of a sample of adolescents with intellectual disability who presented to general hospital services. METHOD We investigated a cohort of adolescents with intellectual disability in South East Queensland, Australia between January 2006 and June 2010. Demographic and clinical data were obtained via mailed questionnaires and from general practice notes. Psychopathology was measured with the Short Form of the Developmental Behaviour Checklist. RESULTS Of 98 individuals presenting to hospital, 71 (72.5%) had significant levels of psychopathology. Unknown aetiology for the intellectual disability was associated with presence of problem behaviours. Adolescents with more severe intellectual disability were more likely to have major problem behaviours. Co-morbid physical health issues were not associated with psychopathology. Only 12 (12.1%) adolescents had undergone specialized mental health intervention. CONCLUSIONS The general hospital environment may offer opportunities for liaison psychiatry services to screen and provide management expertise for adolescent individuals with intellectual disability presenting for physical health issues.
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Affiliation(s)
- Oreste Theodoratos
- Queensland Centre for Intellectual and Developmental Disability, MRI-UQ, The University of Queensland, South Brisbane, QLD, Australia
| | - Lyn McPherson
- Queensland Centre for Intellectual and Developmental Disability, MRI-UQ, The University of Queensland, South Brisbane, QLD, Australia
| | - Catherine Franklin
- Queensland Centre for Intellectual and Developmental Disability, MRI-UQ, The University of Queensland, South Brisbane, QLD, Australia
| | - Bruce Tonge
- Centre for Developmental Psychiatry and Psychology, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne, VIC, Australia
| | - Stewart Einfeld
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia; Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, MRI-UQ, The University of Queensland, South Brisbane, QLD, Australia
| | - Robert S Ware
- Queensland Centre for Intellectual and Developmental Disability, MRI-UQ, The University of Queensland, South Brisbane, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
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Weise J, Fisher KR, Trollor JN. Establishing core mental health workforce attributes for the effective mental health care of people with an intellectual disability and co-occurring mental ill health. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 30 Suppl 1:22-33. [DOI: 10.1111/jar.12407] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Janelle Weise
- Department of Developmental Disability Neuropsychiatry; School of Psychiatry; UNSW Sydney; Sydney NSW Australia
| | - Karen R Fisher
- Faculty of Arts and Social Sciences; Disability Research Program Social Policy Research Centre; UNSW Sydney; Sydney NSW Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry; School of Psychiatry; UNSW Sydney; Sydney NSW Australia
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Bezzina LA, Rice LJ, Howlin P, Tonge BJ, Einfeld SL. Syndrome specific modules to enhance the Stepping Stones Triple P public health intervention. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:836-842. [PMID: 28833838 DOI: 10.1111/jir.12405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 07/11/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Service responses to behaviour phenotypes include care by expert clinicians, syndrome-specific clinics, disability-specific mental health services and generic mental health services. While these services contribute to care, they are often of limited accessibility. METHODS We describe a population-wide public health intervention aimed at increasing the accessibility of services to the target population. Stepping Stones Triple P (SSTP) is a public health intervention of known efficacy in reducing behaviour problems when delivered to parents of children aged 0-12 with mixed developmental disabilities. RESULTS The strategy we discuss involves enhancing SSTP with modules for specific causes of developmental disabilities including Down, Fetal Alcohol, Fragile X, Prader-Willi and Williams syndromes. CONCLUSIONS We propose that enhancing SSTP with syndrome specific modules will increase the accessibility of support to families who have a child with a specific behaviour phenotype. We suggest that future research should confirm the public health impact of the modified SSTP programme using the RE-AIM framework.
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Affiliation(s)
- L A Bezzina
- Faculty of Health Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - L J Rice
- Faculty of Health Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - P Howlin
- Faculty of Health Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - B J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University
| | - S L Einfeld
- Faculty of Health Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
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71
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Naerland T, Bakke KA, Storvik S, Warner G, Howlin P. Age and gender-related differences in emotional and behavioural problems and autistic features in children and adolescents with Down syndrome: a survey-based study of 674 individuals. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:594-603. [PMID: 27862512 DOI: 10.1111/jir.12342] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 08/16/2016] [Accepted: 09/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Recent studies have indicated an increased risk of autism, behavioural and emotional problems and attention-deficit/hyperactivity disorder in individuals with Down syndrome. METHOD In a large-scale survey-based study, we examined the rates of these problems and their relationship to age and gender, in a sample of 674 individuals (4-18 years) with Down syndrome. The relationship with IQ level was also explored in a subsample (n = 175). The Strengths and Difficulties Questionnaire and the Social Communication Questionnaire were used to assess behavioural and emotional problems and autism traits. RESULTS On the Strengths and Difficulties Questionnaire, peer problems were the most frequently reported difficulty (48% > cut-off), followed by hyperactivity/inattention (34% > cut-off). On the Social Communication Questionnaire, 37% scored at or above cut-off (≥15) for autism spectrum disorder; 17% were at or above the suggested cut-off (≥22) for autism. Little association between age and behavioural or emotional problems or with severity of autistic symptomatology was found. However, peer problems were more common in adolescents than in junior school children (P < 0.001); Hyperactivity/inattention was less prevalent among adolescents (P < 0.001). CONCLUSIONS High rates of autistic features, emotional and behavioural problems are documented. These problems are related to age, gender and degree of intellectual disability.
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Affiliation(s)
- T Naerland
- NevSom Department of Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - K A Bakke
- NevSom Department of Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - S Storvik
- NevSom Department of Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - G Warner
- Psychology, Institue of Psychiatry, London, UK
| | - P Howlin
- Psychology, Institue of Psychiatry, London, UK
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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Bourke-Taylor H, Pallant J, Cordier R. Child’s Challenging Behaviour Scale, Version 2 (CCBS–2): Psychometric Evaluation With Young Children. Am J Occup Ther 2017; 71:7104220010p1-7104220010p10. [DOI: 10.5014/ajot.2017.021733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. In this article, we evaluate psychometric properties of the Child’s Challenging Behaviour Scale, Version 2 (CCBS–2) with mothers of young, typically developing children.
METHOD. A cross-sectional mail survey with Australian mothers (N = 337) included the CCBS–2, the Depression Anxiety Stress Scales, and the Parents’ Evaluation of Developmental Status scale.
RESULTS. Internal consistency was good, and no gender differences in CCBS–2 scores were significant. Significant results included differences between CCBS–2 scores: among children grouped according to age, among children grouped according to pre– and post–school entry, among mothers grouped according to extent of any symptom type, and between this sample and a previously collected age-matched sample of children with disabilities.
CONCLUSION. Of the properties tested, results support sound psychometrics. The CCBS–2 can be used to differentiate children according to age, school entry, and disability as well as to identify families for potential services in behavior management and mental health.
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Affiliation(s)
- Helen Bourke-Taylor
- Helen Bourke-Taylor, PhD, is Associate Professor, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia;
| | - Julie Pallant
- Julie Pallant, PhD, is Adjunct Associate Professor, Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, South Brisbane, Queensland, Australia
| | - Reinie Cordier
- Reinie Cordier, PhD, is Associate Professor, School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
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Lai JKY, Weiss JA. Priority service needs and receipt across the lifespan for individuals with autism spectrum disorder. Autism Res 2017; 10:1436-1447. [PMID: 28383156 PMCID: PMC5573942 DOI: 10.1002/aur.1786] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 02/07/2017] [Accepted: 03/03/2017] [Indexed: 01/13/2023]
Abstract
Individuals with Autism Spectrum Disorder (ASD) have a range of health, community, and social support needs across the lifespan that create age‐specific challenges in navigating service sectors. In this study, we set out to identify the priority needs of individuals with ASD across the lifespan, and the factors that predict receiving priority services. Participants included 3,317 individuals with ASD from a Canada‐wide online caregiver survey, stratified into five age groups (preschool, elementary school age, adolescence, emerging adulthood, adulthood). Priority receipt was calculated as a ratio of current services that corresponded to individualized priority need. Age‐stratified Poisson regression analyses were used to identify the sociodemographic, clinical and systemic predictors of priority receipt. Results indicate that the distribution of priority need varied by age, except for social skills programming, which was a high across all groups. The number of high and moderate priority needs diversified with age. Overall, 30% of individuals had none of their priority needs met and priority receipt decreased with age. Systemic factors were most consistently related to priority receipt across the lifespan. Understanding patterns and correlates of priority needs and use that currently exist in different age groups can inform policies to improve service access. Autism Res2017, 10: 1436–1447. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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74
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Faraone SV, Ghirardi L, Kuja-Halkola R, Lichtenstein P, Larsson H. The Familial Co-Aggregation of Attention-Deficit/Hyperactivity Disorder and Intellectual Disability: A Register-Based Family Study. J Am Acad Child Adolesc Psychiatry 2017; 56:167-174.e1. [PMID: 28117063 DOI: 10.1016/j.jaac.2016.11.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/07/2016] [Accepted: 12/01/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Although many studies document an association between attention-deficit/hyperactivity disorder (ADHD) and intellectual disability (ID), little is known about the etiology of this comorbidity and how it should be addressed in clinical settings. We sought to clarify this issue. METHOD All individuals born in Sweden between 1987 and 2006 (n = 2,049,587) were identified using the Medical Birth Register (MBR). From this we selected 7 cohorts of relatives: 1,899,654 parent-offspring pairs, 4,180 monozygotic twin pairs, 12,655 dizygotic twin pairs, 914,848 full sibling pairs, 136,962 maternal half-sibling pairs, 134,502 paternal half-sibling pairs, and 2,790,164 full cousin pairs. We used within-individual and within-family analyses to assess the association between ADHD and ID. RESULTS Individuals with ID were at increased risk for ADHD compared to those without ID, and relatives of participants with ID were at increased risk of ADHD compared with relatives of those without ID. The magnitude of this association was positively associated with the fraction of the genome shared by the relative pair and was lower for severe compared with mild and moderate ID. Model-fitting analyses demonstrated that 91% of the correlation between the liabilities of ADHD and ID was attributable to genetic factors. CONCLUSION These data provide evidence that nearly all of the comorbidity between ADHD and ID can be attributed to genetic factors, which has implications for diagnostic practice.
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Affiliation(s)
- Stephen V Faraone
- State University of New York Upstate Medical University, Syracuse, and K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway.
| | | | | | | | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden
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75
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Thapar A. Intellectual Disability and Attention-Deficit/Hyperactivity Disorder: What Does the Clinical and Genetic Overlap Mean for Practice and Research? J Am Acad Child Adolesc Psychiatry 2017; 56:105-106. [PMID: 28117055 DOI: 10.1016/j.jaac.2016.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Anita Thapar
- Child and Adolescent Psychiatry Section, 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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76
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Ramsay H, Mulryan N, McCallion P, McCarron M. Geographical Barriers to Mental Health Service Care Among Individuals With an Intellectual Disability in the Republic of Ireland. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Niamh Mulryan
- Daughters of Charity Service, Dublin, Ireland
- Trinity College Dublin, The University of Dublin; Dublin Ireland
| | - Philip McCallion
- Center for Excellence in Aging & Community Wellness, University at Albany; Albany New York
| | - Mary McCarron
- Trinity College Dublin, The University of Dublin; Dublin Ireland
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77
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Patton KA, Ware R, McPherson L, Emerson E, Lennox N. Parent-Related Stress of Male and Female Carers of Adolescents with Intellectual Disabilities and Carers of Children within the General Population: A Cross-Sectional Comparison. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 31:51-61. [DOI: 10.1111/jar.12292] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Kiri A. Patton
- School of Psychology; The University of Queensland; St Lucia Brisbane Qld Australia
| | - Robert Ware
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
- School of Population Health; The University of Queensland; Herston Qld Australia
| | - Lyn McPherson
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
| | - Eric Emerson
- Centre for Disability Research & Policy; University of Sydney; Sydney NSW Australia
- Centre for Disability Research; Lancaster University; UK
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
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78
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Trollor JN, Eagleson C, Turner B, Salomon C, Cashin A, Iacono T, Goddard L, Lennox N. Intellectual disability health content within nursing curriculum: An audit of what our future nurses are taught. NURSE EDUCATION TODAY 2016; 45:72-79. [PMID: 27429409 DOI: 10.1016/j.nedt.2016.06.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/01/2016] [Accepted: 06/14/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Individuals with intellectual disability experience chronic and complex health issues, but face considerable barriers to healthcare. One such barrier is inadequate education of healthcare professionals. OBJECTIVE To establish the quantity and nature of intellectual disability content offered within Australian nursing degree curricula. DESIGN A two-phase national audit of nursing curriculum content was conducted using an interview and online survey. SETTING Australian nursing schools offering pre-registration courses. PARTICIPANTS Pre-registration course coordinators from 31 universities completed the Phase 1 interview on course structure. Unit coordinators and teaching staff from 15 universities in which intellectual disability content was identified completed the Phase 2 online survey. METHODS Quantity of compulsory and elective intellectual disability content offered (units and teaching time) and the nature of the content (broad categories, specific topics, and inclusive teaching) were audited using an online survey. RESULTS Over half (52%) of the schools offered no intellectual disability content. For units of study that contained some auditable intellectual disability content, the area was taught on average for 3.6h per unit of study. Units were evenly distributed across the three years of study. Just three participating schools offered 50% of all units audited. Clinical assessment skills, and ethics and legal issues were most frequently taught, while human rights issues and preventative health were poorly represented. Only one nursing school involved a person with intellectual disability in content development or delivery. CONCLUSION Despite significant unmet health needs of people with intellectual disability, there is considerable variability in the teaching of key intellectual disability content, with many gaps evident. Equipping nursing students with skills in this area is vital to building workforce capacity.
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Affiliation(s)
- Julian N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Australia, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Claire Eagleson
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Australia, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Beth Turner
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Australia, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Carmela Salomon
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Australia, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Andrew Cashin
- School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia.
| | - Teresa Iacono
- La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, VIC 3552, Australia.
| | - Linda Goddard
- Department of Mental Health and Learning Disabilities, London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute/The University of Queensland, Mater Hospitals, Raymond Terrace, South Brisbane, QLD 4101, Australia.
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Freeman NC, Gray KM, Taffe JR, Cornish KM. A cross-syndrome evaluation of a new attention rating scale: The Scale of Attention in Intellectual Disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 57:18-28. [PMID: 27348856 DOI: 10.1016/j.ridd.2016.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 05/23/2016] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Abstract
Whilst neuropsychological research has enhanced our understanding of inattentive and hyperactive behaviours among children with intellectual disability (ID), the absence of rating scales developed for this group continues to be a gap in knowledge. This study examined these behaviours in 176 children with autism spectrum disorder (ASD), Down Syndrome (DS), or idiopathic ID using a newly developed teacher rating scale, the Scale of Attention in Intellectual Disability. Findings suggested that children with ASD had a significantly greater breadth of hyperactive/impulsive behaviours than those with DS or idiopathic ID. These findings support existing research suggesting differing profiles of attention and activity across groups. Understanding disorder-specific profiles has implications for developing strategies to support students with ID in the classroom.
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Affiliation(s)
- Nerelie C Freeman
- Centre for Developmental Psychiatry & Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia
| | - Kylie M Gray
- Centre for Developmental Psychiatry & Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia.
| | - John R Taffe
- Centre for Developmental Psychiatry & Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia
| | - Kim M Cornish
- Monash University, School of Psychological Sciences, Faculty of Medicine, Nursing & Health Sciences, Building 17, Clayton campus, Wellington Road, Victoria, 3800, Australia
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Young-Southward G, Philo C, Cooper SA. What Effect Does Transition Have on Health and Well-Being in Young People with Intellectual Disabilities? A Systematic Review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:805-823. [PMID: 27554952 DOI: 10.1111/jar.12286] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Transition to adulthood might be a risk period for poor health in people with intellectual disabilities. However, the present authors could find no synthesis of evidence on health and well-being outcomes during transition in this population. This review aimed to answer this question. METHOD PRISMA/MOOSE guidelines were followed. Search terms were defined, electronic searches of six databases were conducted, reference lists and key journals were reviewed, and grey literature was searched. Papers were selected based on clear inclusion criteria. Data were extracted from the selected papers, and their quality was systematically reviewed. The review was prospectively registered on PROSPERO: CRD42015016905. RESULTS A total of 15 985 articles were extracted; of these, 17 met the inclusion criteria. The results of these articles were mixed but suggested the presence of some health and well-being issues in this population during transition to adulthood, including obesity and sexual health issues. CONCLUSION This review reveals a gap in the literature on transition and health and points to the need for future work in this area.
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Affiliation(s)
| | - Christopher Philo
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, UK
| | - Sally-Ann Cooper
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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81
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Young People with Intellectual Disability Transitioning to Adulthood: Do Behaviour Trajectories Differ in Those with and without Down Syndrome? PLoS One 2016; 11:e0157667. [PMID: 27391326 PMCID: PMC4938609 DOI: 10.1371/journal.pone.0157667] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/02/2016] [Indexed: 01/16/2023] Open
Abstract
Background Young people with intellectual disability exhibit substantial and persistent problem behaviours compared with their non-disabled peers. The aim of this study was to compare changes in emotional and behavioural problems for young people with intellectual disability with and without Down syndrome as they transition into adulthood in two different Australian cohorts. Methods Emotional and behavioural problems were measured over three time points using the Developmental Behaviour Checklist (DBC) for those with Down syndrome (n = 323 at wave one) and compared to those with intellectual disability of another cause (n = 466 at wave one). Outcome scores were modelled using random effects regression as linear functions of age, Down syndrome status, ability to speak and gender. Results DBC scores of those with Down syndrome were lower than those of people without Down syndrome indicating fewer behavioural problems on all scales except communication disturbance. For both groups disruptive, communication disturbance, anxiety and self-absorbed DBC subscales all declined on average over time. There were two important differences between changes in behaviours for these two cohorts. Depressive symptoms did not significantly decline for those with Down syndrome compared to those without Down syndrome. The trajectory of the social relating behaviours subscale differed between these two cohorts, where those with Down syndrome remained relatively steady and, for those with intellectual disability from another cause, the behaviours increased over time. Conclusions These results have implications for needed supports and opportunities for engagement in society to buffer against these emotional and behavioural challenges.
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82
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Emser TS, Mazzucchelli TG, Christiansen H, Sanders MR. Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD): First psychometric evaluation of a new child and parenting assessment tool for children with a developmental disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 53-54:158-77. [PMID: 26921524 DOI: 10.1016/j.ridd.2015.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 07/23/2015] [Accepted: 09/13/2015] [Indexed: 05/12/2023]
Abstract
This study examined the psychometric properties of the Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD), a brief inventory for assessing emotional and behavioral problems of children with developmental disabilities aged 2- to 16-years, as well as caregivers' self-efficacy in managing these problems. A sample of 636 parents participated in the study. Children's ages ranged from 2 to 15. Exploratory and confirmatory factor analyses supported a 21-item, three-factor model of CAPES-DD child adjustment with 13 items describing behavioral (10 items) and emotional (3 items) problems and 8 items describing prosocial behavior. Three additional items were included due to their clinical usefulness and contributed to a Total Problem Score. Factor analyses also supported a 16-item, one factor model of CAPES-DD self-efficacy. Psychometric evaluation of the CAPES-DD revealed scales had satisfactory to very good internal consistency, as well as very good convergent and predictive validity. The instrument is to be in the public domain and free for practitioners and researchers to use. Potential uses of the measure and implications for future validation studies are discussed.
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Affiliation(s)
- Theresa S Emser
- Department of Psychology, Child and Adolescent Psychology, Philipps-Universität Marburg, Gutenbergstr. 18, 35032 Marburg, Germany.
| | - Trevor G Mazzucchelli
- Child and Family Research Group and Brain Behaviour and Mental Health Research Group, School of Psychology and Speech Pathology, Curtin University, Kent St, Bentley, WA 6102, Australia; Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD 4072, Australia.
| | - Hanna Christiansen
- Department of Psychology, Child and Adolescent Psychology, Philipps-Universität Marburg, Gutenbergstr. 18, 35032 Marburg, Germany.
| | - Matthew R Sanders
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD 4072, Australia.
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Weiss JA, Ting V, Perry A. Psychosocial correlates of psychiatric diagnoses and maladaptive behaviour in youth with severe developmental disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:583-593. [PMID: 27073035 DOI: 10.1111/jir.12278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND We know little about the correlates of mental health problems in youth with severe and profound intellectual disability (ID), as most research includes these youth within larger samples that include greater proportions of mild and moderate disability. The purpose of the current study was to identify the child, family and psychosocial characteristics that were associated with the presence of psychiatric diagnoses and maladaptive behaviour in youth with severe ID. METHODS Participants were 141 parents of youth with severe or profound levels of ID, 4 to 18 years of age. The mean age of children was 11.04 years (SD = 3.38), with 68% male and 39% with autism spectrum disorder (ASD). Parents completed a primarily online survey of child and family characteristics, negative life events, family quality of life and their own mental health. RESULTS Logistic regression analyses revealed that youth with a psychiatric diagnosis had higher levels of adaptive behaviour and experienced more negative life events than youth without psychiatric diagnosis, while the presence of clinically significant maladaptive behaviour was related to higher levels of adaptive behaviour, parents' mental health problems and lower family quality of life. Child age, gender, ASD status and financial hardship were not related to either outcome variable. CONCLUSIONS Youth with severe and profound ID who experience psychosocial stressors are more likely reported to have mental health problems than youth without such stressors. It is likely that a combination of child and family based interventions, along with with policies that address larger systemic issues of social adversity, are needed to promote mental health and treat psychopathology when it arises.
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Affiliation(s)
- J A Weiss
- York University, Department of Psychology, Toronto, ON, Canada
| | - V Ting
- York University, Department of Psychology, Toronto, ON, Canada
| | - A Perry
- York University, Department of Psychology, Toronto, ON, Canada
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84
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Chinn D, Abraham E. Using 'candidacy' as a framework for understanding access to mainstream psychological treatment for people with intellectual disabilities and common mental health problems within the English Improving Access to Psychological Therapies service. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:571-582. [PMID: 27097932 DOI: 10.1111/jir.12274] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/09/2015] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The Improving Access to Psychological Therapies (IAPT) service was established to address common mental health problems among the English population in a timely manner in order to counter the social and economic disadvantage accompanying such difficulties. Using the concept of candidacy, we examined how the legitimacy of claims by people with intellectual disabilities to use this service is facilitated or impeded. METHOD We used a sequential mixed methods design. We completed 21 interviews with a range of stakeholders, including people with intellectual disabilities and their carers. Themes from the interviews were used to design an online survey questionnaire that was returned by 452 staff from IAPT and specialist intellectual disability services. RESULTS Using the candidacy framework, we noted that eligibility and access to IAPT were achieved through dynamic and iterative processes of negotiation involving people with intellectual disabilities and their supporters on one side and IAPT staff and service structures on the other. Barriers and facilitators were apparent throughout the seven dimensions of candidacy (identification, navigation, permeability of services, appearances, adjudications, offers and resistance and operating conditions) and were linked to discourses relating to the character and purpose of IAPT and specialist intellectual disability services. CONCLUSIONS Opportunities exist for some people with intellectual disabilities to assert their candidacy for IAPT input, although there are barriers at individual, professional, organisational and structural levels. More attention needs to be paid to how principles of inclusiveness are operationalised within IAPT teams and to the mental health facilitation role of specialist intellectual disability staff.
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Affiliation(s)
- D Chinn
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - E Abraham
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
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85
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Trollor JN, Ruffell B, Tracy J, Torr JJ, Durvasula S, Iacono T, Eagleson C, Lennox N. Intellectual disability health content within medical curriculum: an audit of what our future doctors are taught. BMC MEDICAL EDUCATION 2016; 16:105. [PMID: 27066776 PMCID: PMC4827238 DOI: 10.1186/s12909-016-0625-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 04/02/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND There is a high burden of unmet health needs for people with intellectual disability. Despite experiencing significantly higher rates of morbidity and mortality compared with the general population, this group faces greater barriers to accessing healthcare. While increasing workplace capacity is one way to reduce this inequitable access, previous research indicates a scarcity of undergraduate teaching in intellectual disability. The aim of the study was to determine the extent and nature of intellectual disability content currently offered within medical degree curricula. METHODS All Australian universities (n = 20) providing accredited medical training were invited to participate in a two-phase audit via an email invitation to the Dean of each medical school. The Dean's delegate from 14 medical schools completed Phase 1, which involved a questionnaire or telephone interview about the overall medical course structure. Unit coordinators and/or teaching staff from 12 medical schools completed Phase 2, which involved an online survey about intellectual disability content within the curriculum. RESULTS In Australia, medical school curricula contain a median of 2.55 h of compulsory intellectual disability content. The majority of universities only offer a small amount of compulsory content. Of compulsory units, intellectual disability teaching is minimal in sexual health and emergency medicine (only one unit offered in one school for each). Topics of key relevance in intellectual disability health such as human rights issues, interdisciplinary team work and preventative health are poorly represented in intellectual disability teaching. Elective content varies markedly across universities (1 to 122 h), but emergency medicine, women's health, men's health and many other specialist medicine areas are not represented. Inclusive practice is inconsistent in degree and nature, but a majority of universities (nine) involve people with intellectual disability in the development or delivery of content. CONCLUSIONS There is a mismatch between the considerable unmet health needs of people with intellectual disability and the inconsistent teaching within medical schools. Future doctors will be better equipped to support the health and wellbeing of people with intellectual disability if curricula are enhanced in this area.
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Affiliation(s)
- Julian N. Trollor
- />Department of Developmental Disability Neuropsychiatry (3DN), UNSW Australia, 34 Botany Street, Randwick, NSW 2052 Australia
| | - Beth Ruffell
- />Department of Developmental Disability Neuropsychiatry (3DN), UNSW Australia, 34 Botany Street, Randwick, NSW 2052 Australia
| | - Jane Tracy
- />Centre for Developmental Disability Health Victoria (CDDHV), Monash Health, 122 Thomas Street, Dandenong, VIC 3175 Australia
- />Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, 3800 Australia
| | - Jennifer J. Torr
- />Centre for Developmental Disability Health Victoria (CDDHV), Monash Health, 122 Thomas Street, Dandenong, VIC 3175 Australia
- />Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, 3800 Australia
| | - Seeta Durvasula
- />Centre for Disability Studies, Sydney Medical School, The University of Sydney, Level 1, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2050 Australia
| | - Teresa Iacono
- />La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, VIC 3552 Australia
| | - Claire Eagleson
- />Department of Developmental Disability Neuropsychiatry (3DN), UNSW Australia, 34 Botany Street, Randwick, NSW 2052 Australia
| | - Nicolas Lennox
- />Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute, The University of Queensland, Level 2 Aubigny Place, Mater Hospitals, South Brisbane, QLD 4101 Australia
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Weise J, Fisher KR, Trollor J. Utility of a Modified Online Delphi Method to Define Workforce Competencies: Lessons from the Intellectual Disability Mental Health Core Competencies Project. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Janelle Weise
- Department of Developmental Disability Neuropsychiatry; University of New South Wales, Sydney; Australia
| | - Karen R. Fisher
- Social Policy Research Centre, University of New South Wales, Sydney; Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry; University of New South Wales, Sydney; Australia
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The co-occurrence of mental disorders in children and adolescents with intellectual disability/intellectual developmental disorder. Curr Opin Psychiatry 2016; 29:95-102. [PMID: 26779862 PMCID: PMC4814928 DOI: 10.1097/yco.0000000000000236] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW The study summarizes supportive epidemiological data regarding the true co-occurrence (comorbidity) and course of mental disorders in children with intellectual disability/intellectual developmental disorders (ID/IDD) across the lifespan. RECENT FINDINGS Published studies involving representative populations of children and adolescents with ID/IDD have demonstrated a three to four-fold increase in prevalence of co-occurring mental disorders. The effect of age, sex, and severity (mild, moderate, severe, and profound) and socioeconomic status on prevalence is currently not clearly understood. To date there are no prevalence estimates of co-occurring mental disorders in youth identified using the new DSM-5 (and proposed ICD-11) definition of ID/IDD using measures of intellectual functions and deficits in adaptive functioning with various severity levels defined on the basis of adaptive functioning, and not intellectual quotient scores. SUMMARY The true relationship between two forms of morbidity remains complex and causal relationships that may be true for one disorder may not apply to another. The new conceptualization of ID/IDD offers a developmentally better informed psychobiological approach that can help distinguish co-occurrence of mental disorders within the neurodevelopmental section with onset during the developmental period as well as the later onset of other mental disorders.
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88
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Rice LJ, Gray KM, Howlin P, Taffe J, Tonge BJ, Einfeld SL. The Developmental Trajectory of Self-Injurious Behaviours in Individuals with Prader Willi Syndrome, Autism Spectrum Disorder and Intellectual Disability. Diseases 2016; 4:diseases4010009. [PMID: 28933389 PMCID: PMC5456304 DOI: 10.3390/diseases4010009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 02/01/2016] [Indexed: 01/01/2023] Open
Abstract
In the present study we examined the nature and developmental trajectory of self-injurious behaviour in Prader Willi syndrome (PWS) and autism spectrum disorder (ASD). The development of interventions is greatly aided by understanding gene to behaviour pathways, and this requires an accurate description of the behaviour phenotype, that is, which types and natural history of self-injurious behaviour are more common in PWS and ASD and which are shared with other forms of developmental disability. Self-injury displayed by individuals with PWS and individuals with ASD was compared with that reported in a group of individuals with intellectual disability due to mixed aetiology (ID group). Three self-injurious behaviours (head banging, skin-picking and hitting and/or biting self) were measured on five occasions over 18 years using the Developmental Behaviour Checklist (DBC) a well-validated caregiver report measure. Rates of skin picking were higher in individuals with PWS and hitting and/or biting self was higher in individuals with ASD compared to the ID group. Rates of head banging were similar across the three groups. Over time, skin-picking and head banging increased with age for individuals with ASD and hitting and/or biting self increased for the PWS group. In the PWS and mixed ID groups head banging decreased with age. These findings suggest that the typology and developmental trajectories of self-injurious behaviours differ between those with PWS and ASD.
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Affiliation(s)
- Lauren J Rice
- Brain and Mind Research Centre, University of Sydney, 94 Mallett St, Camperdown NSW 2050, Australia.
- Centre for Disability Research and Policy, University of Sydney, 94 Mallett St, Camperdown NSW 2050, Australia.
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, 270 Ferntree Gully Rd, Notting Hill VIC 3168, Australia.
| | - Patricia Howlin
- Brain and Mind Research Centre, University of Sydney, 94 Mallett St, Camperdown NSW 2050, Australia.
- Centre for Disability Research and Policy, University of Sydney, 94 Mallett St, Camperdown NSW 2050, Australia.
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, 270 Ferntree Gully Rd, Notting Hill VIC 3168, Australia.
| | - John Taffe
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, 270 Ferntree Gully Rd, Notting Hill VIC 3168, Australia.
| | - Bruce J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, 270 Ferntree Gully Rd, Notting Hill VIC 3168, Australia.
| | - Stewart L Einfeld
- Brain and Mind Research Centre, University of Sydney, 94 Mallett St, Camperdown NSW 2050, Australia.
- Centre for Disability Research and Policy, University of Sydney, 94 Mallett St, Camperdown NSW 2050, Australia.
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89
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Woodman AC, Smith LE, Greenberg JS, Mailick MR. Contextual Factors Predict Patterns of Change in Functioning over 10 Years Among Adolescents and Adults with Autism Spectrum Disorders. J Autism Dev Disord 2016; 46:176-189. [PMID: 26319253 PMCID: PMC4707127 DOI: 10.1007/s10803-015-2561-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In the present study, we jointly employ and integrate variable- and person-centered approaches to identify groups of individuals with autism spectrum disorders (ASD) who have similar profiles of change over a period of 10 years across three critical domains of functioning: maladaptive behaviors, autism symptoms, and daily living skills. Two distinct developmental profiles were identified. Above and beyond demographic and individual characteristics, aspects of both the educational context (level of inclusion) and the family context (maternal positivity) were found to predict the likelihood of following a positive pattern of change. Implementing evidence-based interventions that target the school and home environments during childhood and adolescence may have lasting impacts on functioning into adulthood for individuals with ASD.
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Affiliation(s)
- Ashley C. Woodman
- Department of Psychological and Brain Sciences, University of Massachusetts-Amherst, Tobin Hall 509, 135 Hicks Way, Amherst, MA 01003, USA
| | - Leann E. Smith
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA
| | - Jan S. Greenberg
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA
| | - Marsha R. Mailick
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA
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90
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Soltau B, Biedermann J, Hennicke K, Fydrich T. Mental health needs and availability of mental health care for children and adolescents with intellectual disability in Berlin. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:983-994. [PMID: 25716574 DOI: 10.1111/jir.12185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 09/12/2014] [Accepted: 12/07/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND The increased risk of mental health problems in children and adolescents with intellectual disability (ID) has been reported in several studies. However, almost no research has been conducted on parents' experiences with the general mental health system. We have investigated the prevalence of emotional and behavioural problems in children with ID as well as the availability and quality of mental health care from the parents' point of view. METHODS Teachers of specialised schools for ID in Berlin were asked to complete the Teacher's Report Form (TRF) of the Child Behavior Checklist. Information was collected for 1226 children and adolescents aged 6-18 years with mild to profound ID (response 70.5%). The availability and quality of mental health care was assessed by a questionnaire given to parents who had already been seeking help for their children. A total of 330 parents completed the questionnaires (response 62.0%). In addition to univariate analysis, we conducted multiple logistic regressions regarding the psychopathology reported by teachers (TRF-syndrome scales) and difficulties concerning mental health care reported by parents for a paired sample of 308 children. RESULTS Overall, 52.4% of the children and adolescents with ID had a total problem score on the TRF in the deviant range (47.1% when eliminating four items reflecting cognitive deficits). Compared with the general population normative sample of children, this is a three-time higher prevalence. The most striking problems were thought problems (schizoid and obsessive-compulsive), aggressive behaviour, attention problems and social problems. Parents whose children had more severe behavioural or emotional dysfunction reported more difficulties with the mental health system. From the parents' point of view, mental health professionals frequently did not feel responsible or were not sufficiently skilled for the treatment of children with ID. As a consequence, 96% of all parents were longing for specialised in- and outpatient services. CONCLUSIONS This study confirms the findings from other studies regarding the high rate of co-occurrence of ID and mental health problems in youths. Results indicate that both are strongly requested by parents: specialised in- and outpatient services, as well as more professional general services and equitable treatment for all children, with and without ID.
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Affiliation(s)
- B Soltau
- Institute of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - J Biedermann
- Institute of Forensic Psychiatry, Charité - University of Medicine Berlin, Berlin, Germany
| | - K Hennicke
- Institute of Curative Education and Social Therapy, Evangelische Fachhochschule Rheinland-Westfalen-Lippe, Bochum, Germany
| | - T Fydrich
- Institute of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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91
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Stratis EA, Lecavalier L. Informant agreement for youth with autism spectrum disorder or intellectual disability: a meta-analysis. J Autism Dev Disord 2015; 45:1026-41. [PMID: 25253177 DOI: 10.1007/s10803-014-2258-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study investigated informant agreement on emotional and behavior problems and social skills in youth with autism spectrum disorder or intellectual disability using meta-analytic methods. Forty-nine studies were included, consisting of 107 effect sizes. The mean weighted effect size across all raters and all behaviors was .36, reflecting moderate agreement. Consistent with meta-analyses in typically developing youth, pairs of similar informants (e.g., parent-parent) demonstrated higher agreement compared to pairs of different raters (e.g., parent-teacher). With all rater pairs combined, agreement was significantly higher for externalizing problems (r = .42) than either internalizing problems (r = .35) or social skills (r = .30). Several factors appear to moderate the level of agreement among informants, including the youth's diagnosis, age, and IQ.
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Affiliation(s)
- Elizabeth A Stratis
- Department of Psychology, Nisonger Center, Ohio State University, 371D McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210, USA
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92
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Makary AT, Testa R, Tonge BJ, Einfeld SL, Mohr C, Gray KM. Association between adaptive behaviour and age in adults with Down syndrome without dementia: examining the range and severity of adaptive behaviour problems. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:689-702. [PMID: 25414060 DOI: 10.1111/jir.12172] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/22/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Studies on adaptive behaviour and ageing in adults with Down syndrome (DS) (without dementia) have typically analysed age-related change in terms of the total item scores on questionnaires. This research extends the literature by investigating whether the age-related changes in adaptive abilities could be differentially attributed to changes in the number or severity (intensity) of behavioural questionnaire items endorsed. METHODS The Adaptive Behaviour Assessment System-II Adult (ABAS-II Adult) was completed by parents and caregivers of 53 adults with DS aged between 16 and 56 years. Twenty adults with DS and their parents/caregivers were a part of a longitudinal study, which provided two time points of data. In addition 33 adults with DS and their parents/caregivers from a cross-sectional study were included. Random effects regression analyses were used to examine the patterns in item scores associated with ageing. RESULTS Increasing age was found to be significantly associated with lower adaptive behaviour abilities for all the adaptive behaviour composite scores, expect for the practical composite. These associations were entirely related to fewer ABAS-II Adult items being selected as present for the older participants, as opposed to the scores being attributable to lower item severity. CONCLUSIONS This study provides evidence for a differential pattern of age-related change for various adaptive behaviour skills in terms of range, but not severity. Possible reasons for this pattern will be discussed. Overall, these findings suggest that adults with DS may benefit from additional support in terms of their social and conceptual abilities as they age.
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Affiliation(s)
- A T Makary
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
| | - R Testa
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Parkville, Victoria, Australia
| | - B J Tonge
- Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, Victoria, Australia
| | - S L Einfeld
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - C Mohr
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
| | - K M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
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Lennox N, Van Driel ML, van Dooren K. Supporting primary healthcare professionals to care for people with intellectual disability: a research agenda. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 28:33-42. [PMID: 25530572 DOI: 10.1111/jar.12132] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The vast health inequities experienced by people with intellectual disability remain indisputable. Persistent and contemporary challenges exist for primary healthcare providers and researchers working to contribute to improvements to the health and well-being of people with intellectual disability. Over two decades after the only review of supports for primary healthcare providers was published, this paper contributes to an evolving research agenda that aims to make meaningful gains in health-related outcomes for this group. METHODS The present authors updated the existing review by searching the international literature for developments and evaluations of multinational models of care. RESULTS Based on our review, we present three strategies to support primary healthcare providers: (i) effectively using what we know, (ii) considering other strategies that offer support to primary healthcare professionals and (iii) researching primary health care at the system level. CONCLUSIONS Strengthening primary care by supporting equitable provision of health-related care for people with intellectual disability is a much needed step towards improving health outcomes among people with intellectual disability. More descriptive quantitative and qualitative research, as well as intervention-based research underpinned by rigorous mixed-methods evaluating these strategies at the primary care level, which is sensitive to the needs of people with intellectual disability will assist primary care providers to provide better care and achieve better health outcomes. ACCESSIBLE ABSTRACT Many people with intellectual disability have poor health. The authors reviewed what has been written by other researchers about how to improve the health of people with intellectual disability. In the future, people who support adults with intellectual disability should continue doing what they do well, think of other ways to improve health, and do more research about health. At all times, the needs of people with intellectual disability should be the greatest concern for those trying to support them.
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Affiliation(s)
- Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
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El-Kholy T, Elsayed E. Association of physical activity and health status with intelligence quotient of high school students in Jeddah. J Phys Ther Sci 2015; 27:2039-43. [PMID: 26311922 PMCID: PMC4540813 DOI: 10.1589/jpts.27.2039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/17/2015] [Indexed: 01/01/2023] Open
Abstract
[Purpose] The present study investigated the relationships of physical activity and healthiness with the intelligence quotients of high school students in Jeddah. [Subjects and Methods] A total of 135 male and female students were randomly drawn from public and private secondary schools in Jeddah. A self-designed questionnaire was distributed to the students that included demographic, physical activity, and health status sections. Body mass index measurement and an intelligence quotient test were carried out for all students. In addition, samples of blood were collected to estimate hemoglobin and serum iron. [Results] The highest proportions of males and females (39.1% and 51% respectively) had an intelligence quotient score of more than 75%. Moreover, the findings revealed that about 35% of the students were categorized as overweight obesity, and there was aninverse correlation between body mass index and physical activity. Students who shared physical education classes and exercising at and outside school showed a positive correlation with high IQ scores. Regarding hemoglobin and iron levels, there were significant correlations between their levels in blood and IQ. [Conclusion] The intelligence quotient of adolescent students is positively associated with physical activity and health status.
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Affiliation(s)
- Thanaa El-Kholy
- Department of Clinical Nutrition, Faculty of Applied
Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Enas Elsayed
- Department of Physical Therapy, Faculty of Applied Medical
Sciences, King Abdulaziz University, Saudi Arabia
- Department of Physical Therapy for Neuromuscular Disorders
and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt
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95
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Rice LJ, Gray KM, Howlin P, Taffe J, Tonge BJ, Einfeld SL. The developmental trajectory of disruptive behavior in Down syndrome, fragile X syndrome, Prader-Willi syndrome and Williams syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2015; 169:182-7. [PMID: 25983069 DOI: 10.1002/ajmg.c.31442] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The aim of this study was to investigate the developmental trajectories of verbal aggression, physical aggression, and temper tantrums in four genetic syndrome groups. Participants were part of the Australian Child to Adult Development Study (ACAD), which collected information from a cohort of individuals with an intellectual disability at five time points over 18 years. Data were examined from a total of 248 people with one of the four following syndromes: Down syndrome, Fragile X syndrome, Prader-Willi syndrome, or Williams syndrome. Changes in behaviors were measured using validated items from the Developmental Behavior Checklist (DBC). The results indicate that, while verbal aggression shows no evidence of diminishing with age, physical aggression, and temper tantrums decline with age before 19 years for people with Down syndrome, Fragile X syndrome, and William syndrome; and after 19 years for people with Prader-Willi syndrome. These findings offer a somewhat more optimistic outlook for people with an intellectual disability than has previously been suggested. Research is needed to investigate the mechanisms predisposing people with PWS to persistence of temper tantrums and physical aggression into adulthood.
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Foley KR, Bourke J, Einfeld SL, Tonge BJ, Jacoby P, Leonard H. Patterns of depressive symptoms and social relating behaviors differ over time from other behavioral domains for young people with Down syndrome. Medicine (Baltimore) 2015; 94:e710. [PMID: 25984682 PMCID: PMC4602577 DOI: 10.1097/md.0000000000000710] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 03/03/2015] [Accepted: 03/09/2015] [Indexed: 11/22/2022] Open
Abstract
People with intellectual disabilities are at a higher risk for experiencing behavioral, emotional, and psychiatric problems in comparison with the general population. People with Down syndrome have been reported as experiencing fewer behavioral problems than others with intellectual disability, although still at a greater level than the non-intellectually disabled population, except for depression and Alzheimer disease. The aim of this study was to describe the trajectories of subscales of behavior, including depressive symptoms, communication disturbance, anxiety, disruptiveness, and social relating abilities, for young adults with Down syndrome.Families of young adults with Down syndrome living in Perth, Western Australia, participated in a questionnaire study over 8 years, 2004 (n = 255), 2009 (n = 191), and 2011 (n = 188). Questionnaires collected information about young person characteristics and family functioning. The parent-completed Developmental Behavior Checklist-Adult (DBC-A) and Developmental Behavior Checklist-Primary Carer Version (DBC-P) were used to measure emotional and behavioral problems. These measures include the following subscales: disruptive, communication and anxiety disturbances, self-absorbed, antisocial, depressive, and social relating.DBC score declined from 2004 to 2011 reflecting an improvement in behavior in the self-absorbed (coeff -0.011, 95% confidence interval (CI) -0.031, -0.008), anxiety (coef -0.009 95%CI -0.129, -0.006), communication disturbances (coeff -0.008, 95% CI -0.012, -0.005) and disruptive/antisocial behavior (coeff -0.013, 95% CI -0.016, -0.009) subscales. Subscales for depressive symptoms and social relating problems decreased less (coeff -0.003, 95% CI -0.007, -0.0001) (coeff -0.003 95% CI -0.007, 0.001). Young people who were lower functioning were reported as exhibiting significantly more behavioral problems across every subscale when compared with those who were higher functioning.Behavior of young adults with Down syndrome improves over time but depressive symptoms and social relating behavior problems persist into adulthood. It is possible that those with persistent depressive symptoms are at a high risk for developing depressive illness in adulthood. Identifying young people with Down syndrome who are at risk for developing depression in adult life has implications for prevention and early treatment.
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Affiliation(s)
- Kitty-Rose Foley
- From the Telethon Kids Institute, The University of Western Australia, Perth (K-RF, JB, PJ, HL); Department of Developmental Disability Neuropsychiatry, School of Psychiatry, The University of New South Wales (K-RF); Faculty of Health Sciences (SLE); Brain and Mind Research Institute, University of Sydney, Sydney (SLE); Center for Developmental Psychiatry and Psychology, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne, Australia (BJT)
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97
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Freeman NC, Gray KM, Taffe JR, Cornish KM. Development of a New Attention Rating Scale for Children With Intellectual Disability: The Scale of Attention in Intellectual Disability (SAID). AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 120:91-109. [PMID: 25715180 DOI: 10.1352/1944-7558-120.2.91] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Difficulties with attention, impulsivity, and hyperactivity are thought to be as common among children with intellectual disability (ID) as they are in children without ID. Despite this, there is a lack of scales to specifically assess ADHD symptomatology in children and adolescents with ID. This article describes the development and evaluation of a teacher-completed measure; the Scale of Attention in Intellectual Disability (SAID). A community survey of 176 teachers of children 5-13 years of age, with ID at all levels of impairment indicated that the T-SAID is a reliable and valid measure. Integrating this scale with neuropsychological and clinical research holds exciting promise for enhancing our understanding of the nature of attention difficulties within populations with ID.
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98
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Kirk HE, Gray K, Riby DM, Cornish KM. Cognitive training as a resolution for early executive function difficulties in children with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 38:145-160. [PMID: 25561358 DOI: 10.1016/j.ridd.2014.12.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/13/2014] [Accepted: 12/15/2014] [Indexed: 06/04/2023]
Abstract
Core executive functions (EF) such as attention, and working memory have been strongly associated with academic achievement, language development and behavioral stability. In the case of children who are vulnerable to cognitive and learning problems because of an underlying intellectual disability, EF difficulties will likely exacerbate an already compromised cognitive system. The current review examines cognitive training programs that aim to improve EF, specifically focusing on the potential of this type of intervention for children who have intellectual disabilities. We conclude that despite considerable discrepancies regarding reported intervention effects, these inconsistencies can be attributed to flaws in both program and study design. We discuss the steps needed to address these limitations and to facilitate the advancement of non-pharmaceutical interventions for children with intellectual disabilities.
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Affiliation(s)
- H E Kirk
- School of Psychological Sciences, Monash University, Melbourne, Australia.
| | - K Gray
- Centre for Developmental Psychology & Psychiatry, Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - D M Riby
- Department of Psychology, Durham University, England, United Kingdom
| | - K M Cornish
- School of Psychological Sciences, Monash University, Melbourne, Australia.
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99
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Howlett S, Florio T, Xu H, Trollor J. Ambulatory mental health data demonstrates the high needs of people with an intellectual disability: results from the New South Wales intellectual disability and mental health data linkage project. Aust N Z J Psychiatry 2015; 49:137-44. [PMID: 24913247 DOI: 10.1177/0004867414536933] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the ambulatory mental health service profile of persons with intellectual disability (ID) in a representative sample of New South Wales (NSW). METHODS A statistical linkage key was used to link the Disability Services Minimum Data Set (DS-MDS) and a community mental health services dataset (MH-COM) for a representative area of NSW for the period 2005-2010. Linkage was undertaken in four NSW local health districts (LHDs), covering 36.7% of the NSW population. The mental health profiles and service use characteristics of people with an ID were compared to mental health service users without an ID. RESULTS Of the 89,262 people in the MH-COM over this 6-year period, 1,459 people (1.6 %) were identified as having an ID. Compared to those without an ID, people with an ID were more likely to have psychotic disorders, developmental disorders and personality disorders, and more than twice as likely to have an 'unknown' diagnosis. Compared to those without an ID, people with an ID were less likely to have depressive disorders, adjustment disorders and other disorders. Service use profiles revealed that people with an ID had 1.6 times more face-to-face contacts, and a total face-to-face contact time which was 2.5 times longer than people without an ID. CONCLUSIONS Ambulatory mental health data from NSW indicates that people with an ID receive care for a distinct range of mental disorders, and experience uncertainty regarding their diagnosis. People with an ID have higher service needs which require recognition and the allocation of specific resources. Such data provide a suitable baseline for future evaluation of the impact of ambulatory mental health reforms for people with an ID.
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Affiliation(s)
- Sophie Howlett
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, The University of New South Wales, Sydney, Australia
| | - Tony Florio
- South Eastern Sydney Local Health District, Sydney, Australia
| | - Han Xu
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, The University of New South Wales, Sydney, Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, The University of New South Wales, Sydney, Australia
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100
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Woodman AC, Smith LE, Greenberg JS, Mailick MR. Change in autism symptoms and maladaptive behaviors in adolescence and adulthood: the role of positive family processes. J Autism Dev Disord 2015; 45:111-26. [PMID: 25070471 PMCID: PMC4289113 DOI: 10.1007/s10803-014-2199-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Little is known about outcomes for individuals with autism spectrum disorders (ASD) into adulthood. Several characteristics of individuals with ASD predict long-term outcomes, and the family environment may also play a role. The present study uses a prospective, longitudinal design to describe and predict trajectories of autism symptoms and maladaptive behaviors over 8.5 years in a large, community-based sample of adolescents and adults with ASD. Overall, autism symptoms and maladaptive behaviors were observed to improve over the study period. Above and beyond the adult's gender, age, and level of intellectual disability, greater improvements were associated with higher levels of maternal praise (based on maternal speech samples) and higher quality mother-child relationships. Implications for future research and intervention are discussed.
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Affiliation(s)
- Ashley C Woodman
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA,
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