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Maki Y, Fukaya K. Severe Cervical Myelopathy in a Patient With Intellectual Disability Successfully Managed With Combined Anterior and Posterior Fixation Surgery. Cureus 2024; 16:e66251. [PMID: 39238684 PMCID: PMC11375434 DOI: 10.7759/cureus.66251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2024] [Indexed: 09/07/2024] Open
Abstract
Intellectual disability is a disorder characterized by lower developmental abilities in mental and physical performances. Due to advancements in healthcare management for patients with intellectual disabilities, the survival rate of these individuals has increased. Consequently, middle-aged patients with intellectual disabilities may present symptoms related to degenerative cervical spondylosis. However, there appear to be few reports focusing on this topic. A 52-year-old patient with intellectual disability was accompanied by his elderly parents to our hospital. The patient could not stand independently after experiencing motor weakness in the bilateral upper and lower extremities. Radiologically, cervical kyphosis and severe cervical cord compression were identified. After obtaining informed consent from the patient's parents, cervical anterior and posterior fixation surgery was performed in two sessions to resolve cervical myelopathy. The patient was discharged from the hospital 45 days after the second operation. A year post-surgery, the patient could walk independently. With the long life expectancy of patients with intellectual disability, spinal degenerative diseases resulting in cervical myelopathy can significantly impact patients' quality of life. Adequately examining, diagnosing, and surgically managing the patient can lead to improved status for patients with intellectual disability.
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Affiliation(s)
| | - Kenji Fukaya
- Neurosurgery, Ayabe Renaiss Hospital, Ayabe, JPN
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Ito S, Maki Y, Hatsuda N. Delayed Diagnosis of Spinal Cord Injury in a Patient With Intellectual Disability: A Case Report. Cureus 2024; 16:e59588. [PMID: 38827009 PMCID: PMC11144419 DOI: 10.7759/cureus.59588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/04/2024] Open
Abstract
Spinal cord injury (SCI) can cause neurogenic shock accompanied by bradycardia and hypotension. If no preceding traumatic episodes are apparent and the neurological examination is complicated by the patient's intellectual disability, SCI is likely to be overlooked. A 63-year-old man with intellectual disability presented to our hospital. The patient had fallen on the floor; however, no apparent head or neck trauma was observed. The patient returned home after confirming the absence of intracranial hematoma on computed tomography. However, the patient was re-admitted because of hypotension and bradycardia, and sick sinus syndrome was suspected. As the manifestations were motor weakness in the extremities and urinary retention, screening spinal magnetic resonance imaging revealed cervical cord injury and spondylosis. Cervical SCI related to a fall was suspected. Cervical decompression surgery and rehabilitation therapy contributed to the improved patient status. Herein, we report a case of intellectual disability in which SCI was initially overlooked. No severe preceding traumatic episode or intellectual disability of the patient could have led to overlooking SCI in our case. Clinicians should be cautious about this rare condition.
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Affiliation(s)
- Sayaka Ito
- Neurosurgery, Kohka Public Hospital, Kohka, JPN
| | - Yoshinori Maki
- Neurosurgery, Hikone Chuo Hospital, Hikone, JPN
- Rehabilitation, Hikari Hospital, Otsu, JPN
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Morris PO, Hope E, Foulsham T, Mills JP. Parent-reported social-communication changes in children diagnosed with autism spectrum disorder during the COVID-19 pandemic in the UK. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:211-225. [PMID: 37025339 PMCID: PMC10071962 DOI: 10.1080/20473869.2021.1936870] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/23/2021] [Accepted: 05/26/2021] [Indexed: 06/19/2023]
Abstract
Introduction: The coronavirus pandemic has swept across the United Kingdom (UK). Given the ever-evolving situation, little is known about the repercussions of coronavirus and the subsequent lockdowns for children diagnosed with Autism Spectrum Disorder (ASD). Therefore, this study explores the social-communicative impact of the first lockdown (March 2020 - July 2020) in the UK and the return to school period (September 2020 - October 2020), following prolonged disruption to routine, in children diagnosed with ASD. Methods : Parents of autistic children completed 2 separate online surveys following the first lockdown in the UK (n = 176) and also when children returned to school following the summer break (n = 54). Results : The results suggested that self-regulation skills (p < .05) and co-operation skills (p < .05) were most affected over the course of the lockdown. Children's physical activity levels were perceived to significantly increase during the return to school (p < .0001), which was associated with better social-communication outcomes (p < .05). Conclusion : Future work is needed to confirm and explore the findings. Such work could be implemented to protect and improve the social-communicative outcomes of autistic children.
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Affiliation(s)
- Phoebe O. Morris
- School of Sport, Exercise Science and Rehabilitation, University of Essex, Colchester, UK
| | - Edward Hope
- School of Sport, Exercise Science and Rehabilitation, University of Essex, Colchester, UK
| | - Tom Foulsham
- Department of Psychology, University of Essex, Colchester, UK
| | - John P. Mills
- School of Sport, Exercise Science and Rehabilitation, University of Essex, Colchester, UK
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McCauley JB, Pickles A, Huerta M, Lord C. Defining Positive Outcomes in More and Less Cognitively Able Autistic Adults. Autism Res 2020; 13:1548-1560. [PMID: 32851813 DOI: 10.1002/aur.2359] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/19/2020] [Accepted: 06/27/2020] [Indexed: 02/03/2023]
Abstract
Identifying positive outcomes for a wide range of intellectual abilities in autism spectrum disorder (ASD) remains a challenge. Several past studies of autistic adults have used outcome definitions that do not reflect the experiences of less cognitively able adults. The aim of the current study was to (1) define three domains of outcomes: autonomy, social relationships, and purpose, and (2) examine how these outcomes relate to concurrent aspects of adult functioning. Using data from a longitudinal sample of 126 adults (85% diagnosed with ASD at some point), mean age 26, who first entered the study in early childhood, we generated distinct outcomes for less (daily living skills above an 8-year-old level, having regular activities outside the home, and social contacts outside the family) and more cognitively able adults (living independently, having paid employment, and at least one true friend). Verbal IQ, assessed in adulthood, was a significant predictor of more outcomes achieved for individuals within more and less cognitively able groups. For less cognitively able adults, having ever received a formal ASD diagnosis (in contrast to current Autism Diagnostic Observation Schedule [ADOS] CSS scores) was associated with lower odds of positive outcomes. For more cognitively able adults, living skills and happiness measures were positively associated with number of outcomes met; higher ADOS CSS, internalizing and externalizing symptoms, being racially diverse, and having caregiver education below college graduation were all negatively associated with the number of positive outcomes. Tailoring outcomes to ability levels may lead to better identification of goals and service needs. LAY SUMMARY: This article describes the outcomes of autistic adults who are more and less cognitively able. For less cognitively able individuals, an earlier autism diagnosis was negatively related to outcomes. Several factors that were associated with positive outcomes for more cognitively able individuals, including daily living skills, fewer mental health problems, family demographics, and subjective measures of happiness. Our study identifies several important factors for families, individuals, and service providers to consider and discuss when planning the transition to adulthood. Autism Res 2020, 13: 1548-1560. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- James B McCauley
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, California, USA
| | - Andrew Pickles
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marisela Huerta
- Centre for Autism and the Developing Brain, Weill Cornell Medicine, New York City, New York, USA
| | - Catherine Lord
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, California, USA
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Colizzi M, Sironi E, Antonini F, Ciceri ML, Bovo C, Zoccante L. Psychosocial and Behavioral Impact of COVID-19 in Autism Spectrum Disorder: An Online Parent Survey. Brain Sci 2020; 10:brainsci10060341. [PMID: 32503172 PMCID: PMC7349059 DOI: 10.3390/brainsci10060341] [Citation(s) in RCA: 270] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 12/22/2022] Open
Abstract
The 2019 coronavirus disease (COVID-19) outbreak could result in higher levels of psychological distress, especially among people suffering from pre-existing mental health conditions. Young individuals with autism spectrum disorders (ASD) are particularly at risk due to their vulnerability to unpredictable and complex changes. This study aimed to investigate the impact of the COVID-19 pandemic on ASD individuals, whether any pre-pandemic sociodemographic or clinical characteristics would predict a negative outcome, and to narratively characterize their needs. Parents and guardians of ASD individuals filled out an online survey consisting of 40 questions investigating socio-demographic and clinical characteristics of their children, impact of the COVID-19 outbreak on their wellbeing and needs to deal with the emergency. Data were available on 527 survey participants. The COVID-19 emergency resulted in a challenging period for 93.9% of families, increased difficulties in managing daily activities, especially free time (78.1%) and structured activities (75.7%), and, respectively, 35.5% and 41.5% of children presenting with more intense and more frequent behavior problems. Behavior problems predating the COVID-19 outbreak predicted a higher risk of more intense (odds ratio (OR) = 2.16, 95% confidence interval (CI) 1.42–3.29) and more frequent (OR = 1.67, 95% CI 1.13–2.48) disruptive behavior. Even though ASD children were receiving different types of support, also requiring specialist (19.1%) or emergency (1.5%) interventions in a relatively low proportion of cases, a number of needs emerged, including receiving more healthcare support (47.4%), especially in-home support (29.9%), as well as interventions to tackle a potentially disruptive quarantine (16.8%). The COVID-19 outbreak has undoubtedly resulted in increased difficulties among ASD individuals.
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Affiliation(s)
- Marco Colizzi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy; (E.S.); (F.A.); (M.L.C.); (L.Z.)
- Correspondence: ; Tel.: +39-045-812-6832
| | - Elena Sironi
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy; (E.S.); (F.A.); (M.L.C.); (L.Z.)
| | - Federico Antonini
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy; (E.S.); (F.A.); (M.L.C.); (L.Z.)
| | - Marco Luigi Ciceri
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy; (E.S.); (F.A.); (M.L.C.); (L.Z.)
| | - Chiara Bovo
- Medical Direction, Integrated University Hospital of Verona, 37126 Verona, Italy;
| | - Leonardo Zoccante
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy; (E.S.); (F.A.); (M.L.C.); (L.Z.)
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Liu S, Zou X, Huang X, Liu Y, Lu Q, Ling L. The Association between Living Status Transitions, Behavior Changes and Family Relationship Improvement among Methadone Maintenance Treatment Participants in Guangdong, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E119. [PMID: 31877950 PMCID: PMC6981571 DOI: 10.3390/ijerph17010119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/09/2019] [Accepted: 12/20/2019] [Indexed: 01/16/2023]
Abstract
The quality of family relationships is important for individual and family well-being. Improving family relationships is also an important goal in methadone maintenance treatment (MMT). Little is known about factors associated with the improvement of family relationships among MMT clients. This study aimed to identify factors associated with family relationship improvement in MMT. We retrospectively analyzed existing data from 2006 to 2014 at 15 MMT clinics in Guangdong, China, including 2171 subjects with 4691 follow-ups. Generalized estimating equations were used to investigate the association between living status transitions, behavior changes and family relationship improvement, with covariates controlled for. Family relationship improvement was found in 23.1% of all follow-up intervals. Participants who began living with family, living on a regular wage, and gained employment were more likely to have improved family relationships. The quality of family relationships also improved among participants who ceased contact with drug-addicted fellows, ceased drug use, and those who were sexually active. These results suggest that improvement in living status, positive changes in drug use, and sexual activity are associated with family relationship improvement and corresponding interventions may be developed to facilitate clients' recovery.
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Affiliation(s)
| | | | | | | | | | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.L.); (X.Z.); (X.H.); (Y.L.); (Q.L.)
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Grey JM, Totsika V, Hastings RP. Living with family: perceptions of health and subjective well-being of adults with an intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:474-485. [PMID: 29479860 DOI: 10.1111/jir.12479] [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] [Received: 03/28/2016] [Revised: 11/05/2017] [Accepted: 01/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Little is known about the role of living circumstances to the perception of subjective well-being (SWB) and health of adults with intellectual disability (ID). The aim of the present study was to examine whether living circumstances impact differently on the perception of health and SWB and whether potential differences persist after accounting for other variables (e.g. level of support needs and reporting method). METHODS Secondary data analysis was undertaken of a large national survey of adults with an ID in England, aged 16 years and over. Participants were identified as living with family (N = 1528) or living out of home (N = 874). RESULTS The results of t-test and chi-square revealed that levels of health and SWB were perceived as being higher for people living with family than those living in out-of-home settings. Multiple linear regression analyses fitted to explore factors associated with these reported differences revealed that, when controlling for other variables, living with family was highly associated with reports of better SWB. Multiple logistic regression revealed that whilst the health status of people living with families were perceived as better, this was only true when their support needs were low. Poorest health outcomes were found for people with highest support needs who lived with family. CONCLUSIONS On the whole, the health and well-being of adults living with family were perceived more positively than those living out of home. However, potential health disparities exist for those with high support needs who live with family. Further longitudinal research is needed to explore causes and potential solution to these inequalities.
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Affiliation(s)
- J M Grey
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - V Totsika
- Centre for Educational Development, Appraisal and Research (CEDAR), Social Sciences, University of Warwick, Coventry, UK
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), Social Sciences, University of Warwick, Coventry, UK
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Chan Y, Chan YY, Cheng SL, Chow MY, Tsang YW, Lee C, Lin CY. Investigating quality of life and self-stigma in Hong Kong children with specific learning disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 68:131-139. [PMID: 28763755 DOI: 10.1016/j.ridd.2017.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 07/14/2017] [Accepted: 07/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Children with specific learning disabilities (SpLD) are likely to develop self-stigma and have a poor quality of life (QoL) because of their poor academic performance. Although both self-stigma and poor QoL issues are likely to be found in low academic achievers without SpLD, children with SpLD have worse situation because their diagnosis of SpLD suggests that their learning struggles are biological and permanent. Specifically, students' perception of own capabilities may be affected more by the diagnosis of SpLD than their own actual performance. AIMS We examined the self-stigma and QoL of children with SpLD in Hong Kong, a region with an academics-focused culture. METHODS AND PROCEDURES Children with SpLD (n=49,Mage±SD=9.55±1.21; SpLD group) and typically developing children (n=32,Mage±SD=9.81±1.40; TD group) completed a Kid-KINDL to measure QoL and a Modified Self-Stigma Scale to measure self-stigma. All parents completed a parallel Kid-KINDL to measure QoL of their children. OUTCOMES AND RESULTS Compared with the TD group, the SpLD group had a higher level of self-stigma (p=0.027) and lower QoL (child-reported Kid-KINDL: p=0.001; parent-reported Kid-KINDL: p<0.001). CONCLUSIONS AND IMPLICATIONS In the academics-focused environment in Hong Kong, SpLD was associated with impaired QoL and higher self-stigma. Treatments targeting the learning process of children with SpLD may be designed to overcome self-stigma and to improve QoL. In addition, the program may involve parents of the children with SpLD or other people (e.g., the peer of the children with SpLD) for improving their understanding and perceptions of SpLD.
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Affiliation(s)
- Yi Chan
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Yim Yuk Chan
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Sui Lam Cheng
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Man Yin Chow
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Yau Wai Tsang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Clara Lee
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
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Grey JM, Griffith GM, Totsika V, Hastings RP. Families' Experiences of Seeking Out-of-Home Accommodation for Their Adult Child With an Intellectual Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2015. [DOI: 10.1111/jppi.12106] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Vasiliki Totsika
- Centre for Educational Development, Appraisal and Research (CEDAR); University of Warwick; Coventry UK
| | - Richard P. Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR); University of Warwick; Coventry UK
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Kim GE, Chung S. Elderly Mothers of Adult Children with Intellectual Disability: An Exploration of a Stress Process Model for Caregiving Satisfaction. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:160-71. [DOI: 10.1111/jar.12166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Go-en Kim
- Graduate School of Counseling, Welfare & Policy; Kwangwoon University; Seoul Korea
| | - Soondool Chung
- Department of Social Welfare; Ewha Womans University; Seoul Korea
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Woodman AC, Mailick MR, Anderson KA, Esbensen AJ. Residential transitions among adults with intellectual disability across 20 years. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2014; 119:496-515. [PMID: 25354121 PMCID: PMC4215165 DOI: 10.1352/1944-7558-119.6.496] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The present study addresses critical gaps in the literature by examining residential transitions among 303 adults with intellectual disability (ID) over 10 years (Part 1) and 75 adults with Down syndrome over 20 years (Part 2). All adults lived at home at the start of the study, but many moved to a variety of settings. Several characteristics of the adults with ID differed across settings, most notably adaptive behavior and the number of residential transitions, whereas characteristics such as age, type of disability, and behavior problems were less predictive of residential placements. The number of moves over the course of the study varied widely, with critical links to earlier family dynamics, social relationships, and health and adaptive behavior.
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SWAN KARRIEL, RAY DEEC. Effects of Child-Centered Play Therapy on Irritability and Hyperactivity Behaviors of Children With Intellectual Disabilities. JOURNAL OF HUMANISTIC COUNSELING 2014. [DOI: 10.1002/j.2161-1939.2014.00053.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- KARRIE L. SWAN
- Department of Special Education, Counseling, and Student Affairs, Kansas State University
| | - DEE C. RAY
- Department of Counseling and Higher Education, University of North Texas
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Williamson HJ, Perkins EA. Family caregivers of adults with intellectual and developmental disabilities: outcomes associated with U.S. services and supports. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2014; 52:147-159. [PMID: 24725113 DOI: 10.1352/1934-9556-52.2.147] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver outcomes and their association with existing services and supports for family caregivers of adults with IDD. Twenty-four articles were compiled using the PubMed, Web of Knowledge, PsychInfo, and CINAHL databases. Studies report economic, mental, and physical health outcomes from caregiving roles. The need for comprehensive caregiver assessment is discussed. Understanding and responding to the changing needs of family caregivers is vital to the U.S. disability service system to effectively prioritize formal resources and services.
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Wehmeyer ML, Abery BH. Self-determination and choice. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2013; 51:399-411. [PMID: 24303826 DOI: 10.1352/1934-9556-51.5.399] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Promoting self-determination and choice opportunities for people with intellectual and developmental disabilities has become best practice in the field. This article reviews the research and development activities conducted by the authors over the past several decades and provides a synthesis of the knowledge in the field pertaining to efforts to promote self-determination and choice.
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Neece CL. Mindfulness-based stress reduction for parents of young children with developmental delays: implications for parental mental health and child behavior problems. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 27:174-86. [PMID: 23813562 DOI: 10.1111/jar.12064] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Parents of children with developmental delays (DD) typically report elevated levels of parental stress compared with parents of typically developing children. Children with DD are also at high risk for exhibiting significant behaviour problems. Parental stress has been shown to impact the development of these behaviour problems; however, it is rarely addressed in interventions aimed at reducing child behaviour problems. The current study examined the efficacy of mindfulness-based stress reduction (MBSR) for parents of children with DD by investigating whether this intervention is effective in reducing parenting stress and whether decreases in parenting stress lead to reductions in behaviour problems among children with DD. MATERIALS AND METHODS Forty six parents of children with DD were randomly assigned to an immediate treatment or wait list-control group. Participants completed questionnaires assessing parental stress and child behaviour problems at intake and at a second assessment, which took place after only the immediate treatment group had received the MBSR. RESULTS Parents who participated in MBSR reported significantly less stress and depression as well as greater life satisfaction compared with wait list-control parents. Regarding child outcomes, children whose parents participated in MBSR were reported to have fewer behaviour problems following the intervention, specifically in the areas of attention problems and ADHD symptomatology. DISCUSSION Results indicated that MBSR may be an effective intervention for ameliorating parental stress and mental health problems among parents of children with DD. Additionally, these benefits may 'spill over' and improve behaviour challenges among these children.
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Affiliation(s)
- Cameron L Neece
- Department of Psychology, Loma Linda University, Loma Linda, CA, USA
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Hines M, Balandin S, Togher L. The Stories of Older Parents of Adult Sons and Daughters with Autism: A Balancing Act. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 27:163-73. [DOI: 10.1111/jar.12063] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Monique Hines
- The University of Sydney; Sydney New South Wales Australia
| | - Susan Balandin
- Victoria University of Wellington; Wellington New Zealand
| | - Leanne Togher
- The University of Sydney; Sydney New South Wales Australia
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Neece CL, Baker BL, Crnic K, Blacher J. Examining the Validity of ADHD as a Diagnosis for Adolescents with Intellectual Disabilities: Clinical Presentation. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 41:597-612. [DOI: 10.1007/s10802-012-9698-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Foley KR, Dyke P, Girdler S, Bourke J, Leonard H. Young adults with intellectual disability transitioning from school to post-school: A literature review framed within the ICF. Disabil Rehabil 2012; 34:1747-64. [DOI: 10.3109/09638288.2012.660603] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bertelli M, Bianco A, Scuticchio D, Brown I. Individual and Family Quality of Life in Intellectual Disability: A Challenging Relationship. QUALITY OF LIFE IN ITALY 2012. [DOI: 10.1007/978-94-007-3898-0_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Bertelli M, Bianco A, Rossi M, Scuticchio D, Brown I. Relationship between individual quality of life and family quality of life for people with intellectual disability living in Italy. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:1136-1150. [PMID: 21883597 DOI: 10.1111/j.1365-2788.2011.01464.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is substantial literature investigating quality of life (QoL) of individuals with intellectual disability (ID). QoL of families of people with ID is emerging as an important field of research. Despite this, there is a lack of studies regarding their relationship. AIM The present paper aimed to study the relationship between QoL scores of individuals with ID and members of their families. METHODS Twenty-seven parents or relatives of 27 adults with ID were recruited by four different research centres across Tuscany (Italy) to be interviewed through the Italian adaptation of the Family Quality of Life Survey - 2006 (FQoLS-2006), a tool developed for use in a multiple-country study on family QoL. The FQoLS-2006 was translated and adapted to Italian through three revisions. The last was submitted to the authors of the original version, who also maintain an electronic data file and data archive for statistical evaluations in various countries. QoL of persons with ID was assessed through the administration of the Quality of Life - Instrument Package. QoL scores were analysed to describe population characteristics and to examine the relationships among measures of individual and family QoL using correlations (Pearson and Spearman). RESULTS Findings showed that family ratings of QoL were generally low. Families interviewed reported a low level of QoL in 'Support from Others' and 'Community Interaction', while 'Family Relationships' and 'Health of the Family' rated higher. For individual QoL, individuals had the lowest scores in the area of 'Spiritual being' and higher scores in the area of 'Physical being'. Correlations examining possible relationships among Importance, Satisfaction and Opportunities found some statistically significant correlation coefficients between some aspects of the three main areas of individual QoL (Being, Belonging and Becoming) and the nine family domains. Most of these correlations regarded family 'Financial Well-Being', 'Family Relationships, 'Support from Service' and 'Support from Others' areas. CONCLUSIONS The results of this study suggest that QoL is perceived somewhat differently by individuals with ID and by members of their families. This difference could negatively impact QoL of people with ID, if their views are not taken into account when planning for family support. The relationships between individual and family QoL appear to be quite complex, and such complexity needs to be clarified in future research.
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Affiliation(s)
- M Bertelli
- CREA (AMG Centre for Research and Evolution), Firenze, Italy.
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Seltzer MM, Floyd F, Song J, Greenberg J, Hong J. Midlife and aging parents of adults with intellectual and developmental disabilities: impacts of lifelong parenting. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2011; 116:479-99. [PMID: 22126660 PMCID: PMC3263696 DOI: 10.1352/1944-7558-116.6.479] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Using population data, this study included parents of individuals with intellectual and developmental disabilities (n = 220) and parents of individuals without disabilities (n = 1,042). Parents of individuals with intellectual and developmental disabilities were further divided into those who co-resided with their adult child and those whose adult child lived elsewhere, and the 3 groups were compared regarding parental patterns of attainment, social participation, psychological functioning, and health in midlife and early old age. In midlife, parents of individuals with intellectual and developmental disabilities were similar in general to comparison parents. However, by early old age, these parents had poorer health and mental health. Co-residence between the adult with intellectual and developmental disabilities and the parent was prevalent during midlife (51.4%) and in the early years of old age (38.6%), and there were different patterns of parental outcomes, depending on the residential status of the adult with intellectual and developmental disabilities.
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Hines M, Balandin S, Togher L. Buried by autism: older parents’ perceptions of autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2011; 16:15-26. [DOI: 10.1177/1362361311416678] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this study, we explored older parents’ perceptions of their adult sons and daughters with autism in order to gain insights into how parents’ beliefs about autism may influence their coping. Narrative analysis of in-depth interviews held with 16 parents aged 60 years and older of adults with autism revealed that these parents perceived that their son’s or daughter’s intelligence, sense of humour and social personality are blocked by autism. Adherence to these beliefs appeared to comprise important coping strategies that supported these parents in their caregiving roles by assisting them to maintain positive perceptions of their son or daughter with autism. Yet such beliefs also held costs for the parents, including reinforcing the belief that they need to regulate their own behaviour in order to realize the true son or daughter buried by autism.
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Felce D, Perry J, Kerr M. A Comparison of Activity Levels Among Adults with Intellectual Disabilities Living in Family Homes and Out-of-Family Placements. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1468-3148.2010.00620.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Parish SL, Rose RA, Swaine JG. Financial well-being of US parents caring for co-resident children and adults with developmental disabilities: an age cohort analysis. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2010; 35:235-243. [PMID: 21117881 DOI: 10.3109/13668250.2010.519331] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Understanding how financial well-being changes through the life course of caregiving parents of children with developmental disabilities is critically important. METHODS We analyse SIPP (U.S. Census Bureau) data to describe income poverty, asset poverty, income, net worth, and liquid assets of US parents (N = 753) of children with developmental disabilities. RESULTS Income and asset poverty was greatest for the youngest and oldest parents. Liquid assets were relatively flat across cohorts, while net worth declined sharply for elderly parents. Income was highest among parents aged 45-54. CONCLUSION These findings signal significant financial vulnerability among parents of children with developmental disabilities. Policy makers should consider targeted measures to improve the financial well-being of these parents, particularly the youngest and oldest.
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Affiliation(s)
- Susan L Parish
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02454-9110, USA.
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A Comparison of Two Family Quality of Life Measures: An Australian Study. ENHANCING THE QUALITY OF LIFE OF PEOPLE WITH INTELLECTUAL DISABILITIES 2010. [DOI: 10.1007/978-90-481-9650-0_17] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Verdugo MÁ, Córdoba L, Restrepo AM, Cardona J, Peña P. Psychosocial Factors Affecting Adults With Intellectual Disabilities With Psychiatric Disorders in Cali, Colombia. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2009. [DOI: 10.1111/j.1741-1130.2009.00223.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Weeks LE, Nilsson T, Bryanton O, Kozma A. Current and Future Concerns of Older Parents of Sons and Daughters With Intellectual Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2009. [DOI: 10.1111/j.1741-1130.2009.00222.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rasmussen SA, Whitehead N, Collier SA, Frías JL. Setting a public health research agenda for Down syndrome: summary of a meeting sponsored by the Centers for Disease Control and Prevention and the National Down Syndrome Society. Am J Med Genet A 2008; 146A:2998-3010. [PMID: 19006076 DOI: 10.1002/ajmg.a.32581] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
On November 8-9, 2007, a meeting entitled "Setting a Public Health Research Agenda for Down Syndrome" was held to review current knowledge, identify gaps, and develop priorities for future public health research related to Down syndrome. Participants included experts in clinical and molecular genetics, pediatrics, cardiology, psychiatry, psychology, neuroscience, epidemiology, and public health. Participants were asked to identify key public health research questions and discuss potential strategies that could be used to address those questions. The following were identified as priority areas for future public health research: identification of risk and preventive factors for physical health and cognitive outcomes, focusing on understanding the reasons for previously recognized disparities; improved understanding of comorbid conditions, including their prevalence, clinical variability, natural history, and optimal methods for their evaluation and treatment; better characterization of the natural history of cognition, language, and behavior; identification of mental health comorbidities and of risk and protective factors for their development; identification of strategies to improve enrollment in research studies; development of strategies for conveying up-to-date information to parents and health professionals; identification of interventions to improve cognition, language, mental health, and behavior; understanding the impact of educational and social services and supports; identification of improved methods for diagnosis of and interventions for Alzheimer disease; and understanding the effects of different types of health care on outcomes. Participants strongly supported the development of population-based resources for research studies and resources useful for longitudinal studies. This agenda will be used to guide future public health research on Down syndrome.
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Affiliation(s)
- Sonja A Rasmussen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Chou YC, Schalock RL, Tzou PY, Lin LC, Chang AL, Lee WP, Chang SC. Quality of life of adults with intellectual disabilities who live with families in Taiwan. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2007; 51:875-83. [PMID: 17910539 DOI: 10.1111/j.1365-2788.2007.00958.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Little research has been conducted about the quality of life (QOL) of people with intellectual disabilities (ID) in Taiwan, particularly their subjective QOL. This study examined the personal perceptions of these individuals as measured on internationally recognized core QOL domains and indicators. METHODS A census interview survey was conducted in Hsin-Chu City in Taiwan; 233 adults aged over 16 years with mild ID and living with their families participated in the study. Data were collected using the Cross-Cultural QOL Indicators (CCQOLI) together with socio-demographic data that included 'activities of daily living' and 'instrumental activities of daily living' (IADL). The CCQOLI were based on the three most commonly reported indicators of each of the eight QOL domains: emotional well-being, interpersonal relations, material well-being, personal development, physical well-being, self-determination, social inclusion and rights. Each indicator has two sets of questions related to the indicator's 'importance' and 'use'. These are answered by the respondent using a 4-point Likert scale. RESULTS The importance and use of the QOL indicators were evaluated positively by the respondents. The adults' individual characteristics, namely IADL and educational level, were significant predictors for the 'importance' while the adults' perceptions of 'use' for overall QOL were significantly affected by his/her socio-economic data, that is, residence location and father's educational level. CONCLUSIONS The present study addressed the issue of self-reported QOL in people with ID in Taiwanese society, becoming a possible benchmark for similar measurements carried out by disability movements there. These results contribute to current advocacy efforts towards creating a supportive environment for people with ID.
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Affiliation(s)
- Y C Chou
- Institute of Health and Welfare Policy, National Yang-Ming University, Peitou, Taipei, Taiwan.
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Berg K, Arron K, Burbidge C, Moss J, Oliver C. Carer-Reported Contemporary Health Problems in People With Severe and Profound Intellectual Disability and Genetic Syndromes. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2007. [DOI: 10.1111/j.1741-1130.2007.00109.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Perkins EA. Self- and Proxy Reports Across Three Populations: Older Adults, Persons With Alzheimer's Disease, and Persons With Intellectual Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2007. [DOI: 10.1111/j.1741-1130.2006.00092.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jones D, Harvey J, Giza D, Rodican C, Barreira PJ, Macias C. PARENTAL DEATH IN THE LIVES OF PEOPLE WITH SERIOUS MENTAL ILLNESS. JOURNAL OF LOSS & TRAUMA 2003; 8:307-322. [PMID: 20011621 DOI: 10.1080/15325020305883] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Nearly a fourth (22%) of the participants within a research sample of 148 individuals with serious mental illness reported the death of a loved one as a significant loss, and two thirds of these deaths involved the loss of one or both parents. The key determinant of the severity and duration of grief in response to the death of a parent was whether or not there were extenuating circumstances that complicated the death event, such as co-residence with the deceased at the time of death or a lack of regular social contact with anyone other than the deceased. In all instances of severe or prolonged grief, there was no preparation for the parental death, either through preparatory counseling or practical plans for funeral arrangements, financial repercussions, life-style changes, or residential relocation. Mental health agencies serving people with serious mental illness should begin to incorporate financial and emotional preparation for parental deaths and bereavement counseling as essential services.
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Affiliation(s)
- Danson Jones
- McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Lemay JF, Herbert AR, Dewey DM, Innes AM. A rational approach to the child with mental retardation for the paediatrician. Paediatr Child Health 2003; 8:345-56. [PMID: 20052328 PMCID: PMC2795455 DOI: 10.1093/pch/8.6.345] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022] Open
Abstract
Mental Retardation (MR) is a problem encountered in almost all paediatric clinical settings. The assessment of a child with MR is a common diagnostic and management dilemma for paediatricians. The field of MR research is currently in a state of flux regarding not just our understanding of the condition, but also in the language and the processes we use in naming, defining and describing MR. This article will provide a better understanding and a rational approach toward MR. Prevalence rates for MR are variable in the literature and may be attributable to the variation in major classification systems and the diversity in study operation definitions and methodologies. Etiologies of MR are diverse and include many different influences. MR most often presents during infancy or preschool years as developmental delay. There is no universally accepted approach to the etiological work-up of mental retardation. The number of medical conditions associated with MR that are completely treatable by medical means remains small. The paediatrician plays a key role establishing short and long term treatment goals, as well as providing support to families who have children with MR.
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Affiliation(s)
- Jean-François Lemay
- University of Calgary, Developmental Pediatrics, Alberta Children’s Hospital, Calgary, Alberta
| | - Anthony R Herbert
- Registrar in Pediatrics, Mater Children’s Hospital, Brisbane, Australia
| | - Deborah M Dewey
- University of Calgary, Department of Pediatrics and Behavioural Research Unit, Alberta Children’s Hospital, Calgary
| | - A Micheil Innes
- University of Calgary, Alberta Children’s Hospital, Calgary, Alberta
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