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Webb K, Cuskelly M, Owen C. The use of proxy measurement of internal states in people with intellectual disability: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13241. [PMID: 38747131 DOI: 10.1111/jar.13241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/15/2024] [Accepted: 04/16/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND The measurement of internal states of people with an intellectual disability is challenging. Given these difficulties, proxy respondents are sometimes used. However, the literature provides some caution about the validity of the use of proxy respondents. AIMS This review aims to identify the available evidence regarding the use of proxy respondents in the measurement of internal states of people with intellectual disabilities. METHOD The Arksey and O'Malley scoping review framework was used for this review, refined with the Joanna Briggs Institute Methodology. RESULTS Results indicate there are some differences in the findings reported with respect to the efficacy of the use of proxy respondents. These may be due to a number of inconsistencies and weaknesses in examinations of their utility. CONCLUSIONS If proxy-reports are to be useful in understanding the internal states of people with intellectual disability, researchers need to address the shortcomings revealed by this review.
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Affiliation(s)
- Kristen Webb
- College of Arts, Law and Education, University of Tasmania, Applied Research Centre for Disability and Wellbeing, Hobart, Australia
| | - Monica Cuskelly
- College of Arts, Law and Education, University of Tasmania, Applied Research Centre for Disability and Wellbeing, Hobart, Australia
| | - Ceridwen Owen
- College of Sciences and Engineering University or Tasmania, Hobart, Australia
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2
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Tanabe H, Shiraishi T, Sato H, Nihei M, Inoue T, Kuwabara C. A concept for emotion recognition systems for children with profound intellectual and multiple disabilities based on artificial intelligence using physiological and motion signals. Disabil Rehabil Assist Technol 2024; 19:1319-1326. [PMID: 36695503 DOI: 10.1080/17483107.2023.2170478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 11/28/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE This study proposes a concept for emotion recognition systems for children with profound intellectual and multiple disabilities (PIMD) based on artificial intelligence (AI) using physiological and motion signals. METHODS First, the heartbeat interval (R-R interval, RRI) of a child with PIMD was measured, and the correlation between the RRI and emotion was briefly tested in a preliminary experiment. Then, a concept based on AI for emotion recognition systems for children with PIMD was created using physiological and motion signals, and an emotion recognition system based on the proposed concept was developed using a random forest classifier taking as inputs the RRI, eye gaze, and other data acquired using low physical burden sensors. Subsequently, the developed emotion recognition system was evaluated, validating the proposed concept. Finally, we proposed a validated concept for emotion recognition systems. RESULTS A correlation was found between the RRI and emotion. The emotion recognition system was created based on the proposed concept and tested. According to the results, the recognition rate of "negative" and "not negative" of 70.4% ± 6.1% (Mean ± S.D.) of the developed emotion recognition system was higher than 48.5% ± 5.0% of an unfamiliar person used as a control. CONCLUSION The results indicate that the proposed concept for emotion recognition systems is useful for communicating with children with PIMD.
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Affiliation(s)
- Hiroki Tanabe
- Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Japan
| | - Toshihiko Shiraishi
- Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Japan
| | - Haruhiko Sato
- Department of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Misato Nihei
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Japan
| | - Takenobu Inoue
- Department of Assistive Technology, Research Institute of National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Chika Kuwabara
- Center for Developmental Disabilities of Yokosuka, Yokosuka, Japan
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Stasolla F, Passaro A, Di Gioia M, Curcio E, Zullo A. Combined extended reality and reinforcement learning to promote healthcare and reduce social anxiety in fragile X syndrome: a new assessment tool and a rehabilitative strategy. Front Psychol 2023; 14:1273117. [PMID: 38179497 PMCID: PMC10765535 DOI: 10.3389/fpsyg.2023.1273117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Affiliation(s)
| | - Anna Passaro
- University “Giustino Fortunato” of Benevento, Benevento, Italy
| | | | - Enza Curcio
- University “Giustino Fortunato” of Benevento, Benevento, Italy
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Song X, Ma M, Ma X, Zhao K, Gao L, Wang T. Application of the positive and negative affect scale in Chinese children with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231208399. [PMID: 37897741 DOI: 10.1177/17446295231208399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/30/2023]
Abstract
The purpose is to test the applicability of the Positive and Negative Affect Scale (PANAS) to Chinese children with intellectual disabilities. The study was done by distributing the questionnaire to the parents through teachers online. Asked the parents to fill out the scale based on their observations of their children's daily life. The correlation coefficients between each item and the total score of the corresponding dimension ranged from 0.52 to 0.77. Factor analysis confirmed the establishment of the PA-NA two-factor structure of affect. A significant positive correlation existed between the NA and the challenging behavior. The Cronbach's α coefficient and split-half reliability of the PA scale were 0.87 and 0.85, and the Cronbach's α coefficient and split-half reliability of the NA scale were 0.85 and 0.83, respectively, higher than 0.80. It was concluded that PANAS has good applicability in Chinese children with intellectual disabilities.
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Affiliation(s)
- Xiaoyu Song
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
| | - Minjie Ma
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
- Xi'an School for the Blind and Deaf, Xi'an, China
| | - Xue Ma
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
| | - Ke Zhao
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
| | - Long Gao
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
- Xi'an QiZhi School, Xi'an, China
| | - Tingzhao Wang
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
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Sáez-Suanes GP, García-Villamisar D, Del Pozo Armentia A. The role of intellectual disability and emotional regulation in the autism-depression relationship. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1960-1967. [PMID: 36967538 DOI: 10.1177/13623613231161881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
LAY ABSTRACT Many people with autism and intellectual disability have significant levels of depressive symptoms. However, this relationship is not clear. For this reason, knowing the factors that are associated with having depression in autism and intellectual disability is important. Emotion regulation is associated with depression in autism spectrum disorder and intellectual disability. After evaluating a group of people with autism and intellectual disability, we found that people with mild intellectual disability have problems regulating their emotions which lead them to develop depressive symptoms. These findings suggest that interventions designed to prevent or reduce depressive symptoms in people with autism spectrum disorder and mild intellectual disability should include among their goals emotional regulation.
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Fynn G, Porter M, Pellicano E. 'Playing a guessing game': Recognising and responding to anxiety in children with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1150-1161. [PMID: 37381992 DOI: 10.1111/jar.13136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/21/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Children with intellectual disability are at greater risk of developing anxiety than the general population. Limited research has examined the challenges associated with recognising and responding to anxiety in children with intellectual disability, and its perceived impact. AIM This study aimed to explore anxiety in children with intellectual disability, from the child and parent perspective to better understand how parents and children recognise and respond to anxiety. METHOD AND PROCEDURES Six children with an intellectual disability (age range: 12-17, four boys) and their mothers participated in a semi-structured interview online. Interviews were transcribed verbatim and interpreted using thematic analysis. OUTCOME AND RESULTS Mothers elaborated on the difficulties with recognising signs of anxiety due to the impact of the child's primary diagnosis and the overlap of symptoms with co-occurring conditions. Mothers and children discussed the 'contagious' effect of anxiety within the household and how this influenced mothers' approaches to managing their child's anxiety. They reported that anxiety limited the meaningful activities in which children and families could engage. CONCLUSIONS AND IMPLICATIONS These findings highlight the importance of supporting mothers to recognise their children's anxiety and to assist them with strategies on how best to respond and cope. These findings have implications for future research, and practitioners working in this field.
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Affiliation(s)
- Gabrielle Fynn
- Macquarie School of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Melanie Porter
- Macquarie School of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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De Blasio C, Dind J, Petitpierre G. Odor hedonic responses in children and young people with profound intellectual and multiple disabilities. Front Psychiatry 2023; 14:1066286. [PMID: 37692315 PMCID: PMC10484511 DOI: 10.3389/fpsyt.2023.1066286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 07/21/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Odors are closely linked to emotions, play an important role in the well-being of individuals and can influence mood. Despite these crucial properties, the hedonic responses to odors of people with profound intellectual and multiple disabilities (PIMD) remain little explored. Aim This within-subjects study aims to examine whether children and young people with PIMD react in a differentiated way to odors evaluated as pleasant or unpleasant by neurotypical adults and, if so, with which behaviors. The influence of their global mood on their emotional responses to odors is also examined. Method Twenty children and young people (7-18 years old) with PIMD were exposed to four pairs of hedonically contrasted odors. A control stimulus was presented before each odorant. Five emotional responses, one physiological reaction (nausea reactions), and three responses reflecting approach toward or avoidance of the stimulus were recorded throughout the duration of the stimulus exposure. The participants' global mood status was measured before the start of the research with the French version of the Mood, Interest and Pleasure Questionnaire (Ross and Oliver, 2003). Results The results show that when exposed to pleasant odorants, participants kept their heads aligned with the odorant source longer, smiled longer, and produced more positive vocalizations. In contrast, unpleasant odorants elicit more pouts and grimaces. Nausea reactions occurred in the presence of unpleasant odorants. The hedonic responses were more marked during the second presentation of the stimuli. Participants with a higher MIPQ score showed significantly more emotional reactions to odors. Conclusion The results confirm the presence of olfactory preferences in participants with PIMD and the existence of a link between their mood, emotions and olfactory hedonic processing. They prompt the use of odors to support not only the cognitive development of this population, but also their mood and their emotional regulation abilities.
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Noyek S, Davies C, Champagne M, Batorowicz B, Fayed N. Emotional Well-Being of Children and Youth with Severe Motor and Communication Impairment: A Conceptual Understanding. Dev Neurorehabil 2022; 25:554-575. [PMID: 35900109 DOI: 10.1080/17518423.2022.2099997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Children and youth with severe motor and communication impairment (SMCI) have difficulty providing self-expression through typical speech, writing with a paper and pencil, or using a standard keyboard. Their emotional expressions can be missed by peers and novel caregivers. PURPOSE To describe the indicators and components of emotional experiences for children/youth with SMCI. METHODS Primary guardians of nine children/youth with SMCI were involved in photo/video data collection and follow-up qualitative interviews. Twenty-one familiar people (e.g., friends, family members, and/or care team) participated in semi-structured qualitative interviews. RESULTS A conceptual understanding of emotional well-being specific to the population has been developed consisting of nine themes, encompassed by four domains i) Core Attributes, ii) Personal Experiences, iii) Surroundings, iv) Expression and Reception. CONCLUSIONS Emotional experiences of children/youth with SMCI are diversely expressed. Primary guardian and familiar person insight can be amplified to positively impact care and participation.
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Affiliation(s)
- Samantha Noyek
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Claire Davies
- Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - Maude Champagne
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Beata Batorowicz
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Nora Fayed
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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Ng-Cordell E, Kolesnik-Taylor A, O'Brien S, Astle D, Scerif G, Baker K. Social and emotional characteristics of girls and young women with DDX3X-associated intellectual disability: a descriptive and comparative study. J Autism Dev Disord 2022:10.1007/s10803-022-05527-w. [PMID: 35536379 PMCID: PMC9087164 DOI: 10.1007/s10803-022-05527-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
DDX3X variants are a common cause of intellectual disability (ID) in females, and have been associated with autism spectrum disorder and emotional-behavioural difficulties. In this study, we compared phenotypic data for 23 females with DDX3X variants, to 23 females with ID and other genetic diagnoses. We found a wide range of adaptive, social and emotional function within the DDX3X group. Autism characteristics did not differ between DDX3X and comparison groups, while levels of anxiety and self-injurious behaviour (SIB) were significantly higher in the DDX3X group. Within the DDX3X group, adaptive function, autism characteristics, anxiety and SIB scores were positively correlated, with evidence for group-specific associations with SIB. Future work is warranted to explore the multilevel mechanisms contributing to social and emotional development in individuals with DDX3X variants.
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Affiliation(s)
- Elise Ng-Cordell
- Department of Psychology, University of British Columbia, Vancouver, Canada.,MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Anna Kolesnik-Taylor
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Sinéad O'Brien
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Duncan Astle
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Kate Baker
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom. .,Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom.
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10
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Oliver C. Distress in people with severe disability: the unmet challenge. Dev Med Child Neurol 2022; 64:401-402. [PMID: 35239192 DOI: 10.1111/dmcn.15143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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11
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Utilising Interview Methodology to Inform the Development of New Clinical Assessment Tools for Anxiety in Autistic Individuals Who Speak Few or no Words. J Autism Dev Disord 2022; 53:2328-2348. [PMID: 35304663 PMCID: PMC10229722 DOI: 10.1007/s10803-022-05509-y] [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: 02/26/2022] [Indexed: 10/18/2022]
Abstract
Autistic individuals with intellectual disability who speak few or no words are at high risk of anxiety but are underrepresented in research. This study aimed to describe the presentation of anxiety in this population and discuss implications for the development of assessments. Interviews were conducted with 21 parents/carers of autistic individuals and nine clinicians. Data were analysed using content analysis and interpretative phenomenological analysis. Anxiety behaviours described by parents/carers included increased vocalisation, avoidance and behaviours that challenge. Changes to routine were highlighted as triggering anxiety. Clinicians discussed the importance of identifying an individual's baseline of behaviour, knowing an individual well and ruling out other forms of distress. This study raises considerations for early identification of anxiety and for subsequent support.
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12
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Tarver J, Vitoratou S, Mastroianni M, Heaney N, Bennett E, Gibbons F, Fiori F, Absoud M, Ramasubramanian L, Simonoff E, Santosh P. Development and Psychometric Properties of a New Questionnaire to Assess Mental Health and Concerning Behaviors in Children and Young People with Autism Spectrum Disorder (ASD): The Assessment of Concerning Behavior (ACB) Scale. J Autism Dev Disord 2021; 51:2812-2828. [PMID: 33051784 PMCID: PMC8254716 DOI: 10.1007/s10803-020-04748-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 01/29/2023]
Abstract
Although 70% of autistic children and young people meet criteria for co-occurring psychiatric conditions, there are few screening measures specifically for autistic individuals. We describe the development and validation of the Assessment of Concerning Behavior (ACB), an instrument co-developed with the autistic community to assess mental health and problematic/risky behaviors. Items include descriptions to facilitate symptom recognition by autistic people, and carers/professionals. The ACB was completed by 255 parents, 149 autistic children and young people and 30 teachers. Internal consistency, stability and validity was assessed. The ACB parent-version fit a two-factor model (internalizing and externalizing problems) and showed adequate test-retest reliability, internal consistency and construct validity. The ACB is a promising new measure for research and clinical use in autism.
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Affiliation(s)
- Joanne Tarver
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Silia Vitoratou
- Department of Biostatistics and Health Informatics, Psychometrics and Measurement Lab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Mathilde Mastroianni
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Natalie Heaney
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Eleanor Bennett
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Felicity Gibbons
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Federico Fiori
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Ltd, Gillingham, Kent, UK
| | - Michael Absoud
- Children's Neurosciences, Evelina London Children' Hospital, St Thomas' Hospital, King's Health Partners Academic Health Science Centre, London, UK
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Lakshmi Ramasubramanian
- Child and Adolescent Mental Health Services, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK.
- HealthTracker Ltd, Gillingham, Kent, UK.
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Schlomann A, Wahl HW, Zentel P, Heyl V, Knapp L, Opfermann C, Krämer T, Rietz C. Potential and Pitfalls of Digital Voice Assistants in Older Adults With and Without Intellectual Disabilities: Relevance of Participatory Design Elements and Ecologically Valid Field Studies. Front Psychol 2021; 12:684012. [PMID: 34276507 PMCID: PMC8282355 DOI: 10.3389/fpsyg.2021.684012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/01/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anna Schlomann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Institute for Educational Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Hans-Werner Wahl
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Peter Zentel
- Institute of Prevention, Integration and Rehabilitation Research, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Vera Heyl
- Institute for Special Needs Education, Heidelberg University of Education, Heidelberg, Germany
| | - Leonore Knapp
- Institute for Educational Sciences, Heidelberg University of Education, Heidelberg, Germany
| | | | - Torsten Krämer
- Institute for Educational Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Christian Rietz
- Institute for Educational Sciences, Heidelberg University of Education, Heidelberg, Germany
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Van keer I, Vandesande S, Dhondt A, Maes B. Changes in the social-emotional functioning of young children with a significant cognitive and motor developmental delay across a two-year period. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:867-879. [PMID: 36568628 PMCID: PMC9788725 DOI: 10.1080/20473869.2021.1904772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/25/2021] [Accepted: 03/12/2021] [Indexed: 06/17/2023]
Abstract
Children with a significant cognitive and motor developmental delay (SDD) are vulnerable for the development of (future) behavioral and mental health problems. To support children within this target group, knowledge on their social-emotional development is necessary. Therefore, in this paper, an explorative assessment of the changes in the social-emotional functioning of children with SDD over a two-year period was done. Yearly semi-structured interviews with one or more primary caregiver(s) of 25 children were conducted and analyzed on 13 domains of social-emotional functioning, according to an adapted version of the Scale for Emotional Development - Revised (SED-R). This study showed a lot of variation in individual and group patterns of change across the two-year period. Charting the social-emotional development in this target group is challenging and requires further in-depth analysis of individual trajectories as well as more fine-grained and long-term data collection.
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Affiliation(s)
- Ines Van keer
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, University of Leuven, Leuven, Belgium
| | - Sien Vandesande
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, University of Leuven, Leuven, Belgium
| | - Ann Dhondt
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, University of Leuven, Leuven, Belgium
| | - Bea Maes
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, University of Leuven, Leuven, Belgium
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15
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Eaton C, Tarver J, Shirazi A, Pearson E, Walker L, Bird M, Oliver C, Waite J. A systematic review of the behaviours associated with depression in people with severe-profound intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:211-229. [PMID: 33426741 DOI: 10.1111/jir.12807] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/09/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
The assessment of depression in people with severe to profound intellectual disability (severe-profound ID) is challenging, primarily due to inability to report internal states such as mood, feelings of worthlessness and suicidal ideation. This group also commonly presents with challenging behaviours (e.g. aggression and self-injury) with debate about whether these behaviours should be considered 'depressive equivalents' or are sensitive for, but not specific to, depression in severe-profound ID. We conducted a systematic review exploring behaviours associated with depression and low mood in individuals with severe-profound ID. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2009) guidelines. Three electronic databases were searched (Embase, PsycINFO and Ovid MEDLINE), and 13 studies were included and rated for quality. Few studies were rated as having high methodological quality. Behaviours captured by standard diagnostic schemes for depression (e.g. Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases) showed a relationship with depression in severe-profound ID, including the two core symptoms (depressed affect and anhedonia), as well as irritability, sleep disturbance, psychomotor agitation, reduced appetite and fatigue. Challenging behaviours such as aggression, self-injury, temper tantrums, screaming and disruptive behaviour were associated with depression. Challenging behaviours show a robust relationship with depression. Whilst these behaviours may suggest an underlying depression, study limitations warrant caution in labelling them as 'depressive equivalents'. These limitations include not controlling for potential confounds (autism, other affective disorders and pain) and bias associated with comparing depressed/non-depressed groups on the same behavioural criteria used to initially diagnose and separate these groups. Future studies that use depressive measures designed for ID populations, which control for confounds and which explore low mood irrespective of psychiatric diagnosis, are warranted to better delineate the behaviours associated with depression in this population (PROSPERO 2018: CRD42018103244).
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Affiliation(s)
- C Eaton
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
- Department of Child Life and Health, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Tarver
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - A Shirazi
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - E Pearson
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - L Walker
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - M Bird
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - C Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - J Waite
- School of Life and Health Sciences, Aston University, Birmingham, UK
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Walton C, Antaki C, Finlay WML. Orienting to affect in services for people with severe or profound intellectual disabilities: A UK-based investigation. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:876-886. [PMID: 32307856 DOI: 10.1111/jar.12707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/23/2019] [Accepted: 01/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study argues for displays of affect by people with severe or profound intellectual disabilities to be analysed in the course of everyday interactions with the people who support them. METHOD Conversation analysis is applied to the affective displays of residents of a social care service for people with severe or profound intellectual disabilities to identify how such displays are taken up and form the basis for further action. RESULTS Three types of orientations to affect are identified: where the cause of the affect is unknown; where there is a proximal cause; and where the proximal cause is a prior action by a member of staff. Staff orient to affect as expressions of both feelings and cognitions, thereby providing the basis for self-determination. CONCLUSIONS Displays of affect are a communicative resource for those with severe or profound impairments and must be studied in situ if they are to inform policy and everyday practice.
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Affiliation(s)
- Chris Walton
- Department of Psychology, Lancaster University, Lancaster, UK
| | - Charles Antaki
- Department of Social Sciences, Loughborough University, Loughborough, UK
| | - W M L Finlay
- Department of Psychology, Anglia Ruskin University, Cambridge, UK
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17
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Family accommodation of anxiety in a community sample of children on the autism spectrum. J Anxiety Disord 2020; 70:102192. [PMID: 31972299 DOI: 10.1016/j.janxdis.2020.102192] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/22/2019] [Accepted: 01/15/2020] [Indexed: 12/28/2022]
Abstract
Anxiety is recognised as one of the most common co-occurring conditions for individuals with a diagnosis on the autism spectrum, with approximately 40 % of children on the spectrum receiving a clinical diagnosis of an anxiety disorder. To date, research has tended to focus upon understanding presentation and evaluating treatment, with little focus on assessing systemic factors, such as the way that family members accommodate the anxiety. This study aimed to investigate the relationship between parent and child anxiety levels and child autism characteristics on the four domains of family accommodation; Participation, Modification, Distress, and Consequence. A community sample (n = 132) of parents of children on the spectrum completed questionnaires on their child's autism characteristics and anxiety symptomatology as well as their own levels of anxiety and family accommodation behaviours. Regression models identified specific aspects of child anxiety as well as parent anxiety as predictive of family accommodation, with the child's difficulties with uncertainty being a consistent predictor of all four domains. Clinical and research implications of this study, including the importance of understanding similarities or differences in the nature and consequence of family accommodation in children on the autism spectrum, are discussed.
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Wheeler AC, Okoniewski KC, Wylie A, DeRamus M, Hiruma LS, Toth D, Christian RB. Anxiety-associated and separation distress-associated behaviours in Angelman syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1234-1247. [PMID: 31134691 DOI: 10.1111/jir.12635] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/21/2019] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Anxiety is considered a 'frequent' feature in the clinical criteria for Angelman syndrome; however, the nature and severity of anxiety symptoms have not been well characterised in this population. Anxiety behaviours, especially in response to separation from a preferred caregiver, have been described clinically but have not yet been explored empirically. METHOD This study used a combination of standardised and clinician-derived survey items to assess the frequency, nature and severity of behaviours associated with anxiety and separation distress in 100 individuals with Angelman syndrome. Family (e.g. income and maternal education) and individual (e.g. age, sex, genetic subtype, sleep difficulties and aggressive behaviours) variables were also gathered to assess possible predictors of higher anxiety levels. Approximately half of the sample was seen in clinic and assessed with standardised measures of development and daily functioning, allowing for an additional exploration of the association between anxiety symptoms and extent of cognitive impairment. RESULTS Anxiety concerns were reported in 40% of the sample, almost 70% were reported to have a preferred caregiver and over half displayed distress when separated from that caregiver. Individuals with the deletion subtype and individuals who are younger were less likely to have anxiety behaviours. Sleep difficulties and aggressive behaviour consistently significantly predicted total anxiety, the latter suggesting a need for future studies to tease apart differences between anxiety and aggression or anger in this population. CONCLUSIONS Anxiety concerns, especially separation distress, are common in individuals with Angelman syndrome and represent an area of unmet need for this population.
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Affiliation(s)
- A C Wheeler
- Center for Newborn Screening, Ethics and Disability Studies, RTI International, Durham, NC, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K C Okoniewski
- Center for Newborn Screening, Ethics and Disability Studies, RTI International, Durham, NC, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A Wylie
- Center for Newborn Screening, Ethics and Disability Studies, RTI International, Durham, NC, USA
| | - M DeRamus
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - L S Hiruma
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D Toth
- Center for Newborn Screening, Ethics and Disability Studies, RTI International, Durham, NC, USA
| | - R B Christian
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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19
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Martínez-González AE, Veas A. Identification of emotions and physiological response in individuals with moderate intellectual disability. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:397-402. [PMID: 34925769 PMCID: PMC8676681 DOI: 10.1080/20473869.2019.1651142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 06/14/2023]
Abstract
According to Ekman's model, the basic emotions are anger, disgust, fear, happiness, sadness, and surprise. These emotions are universal and have an adaptative function. However, studies on these emotions among individuals with moderate intellectual disability (MID) are limited, mainly owing to issues in sample size and sample homogeneity. The present study aimed to explore differences between a MID group (n = 10) and a non-MID control group (n = 10) in 1) the identification of basic emotions; and 2) the physiological response with images related to fear, happiness, sadness, anger, and disgust, as well as images with neutral and sexual content. A total of 29 images from The International Affective Picture System and a biofeedback measurement system were used. The results showed no statistically significant differences in the identification of the basic emotions of fear, sadness, and disgust. However, statistically significant differences were found for happiness (p = .008), anger (p = .02), and neutral images (p = .02), and minor statistically significant differences were found for images with sexual content (p < .01) in MID individuals with respect to the control group. The MID group's physiological response was lower compared with the control group, with statistically significant differences for all emotional visual stimuli. This preliminary study showed important and interesting results for the study of emotions and sexuality in MID. Future studies should consider the sample size, sex and age comparisons, and the different levels of intellectual disability.
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Affiliation(s)
| | - Alejandro Veas
- Department of Developmental Psychology and Didactics, University of Alicante, Spain
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20
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Anxiety in Children with Autism at School: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00172-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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21
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Ramey D, Healy O, Lang R, Gormley L, Pullen N. Mood as a Dependent Variable in Behavioral Interventions for Individuals with ASD: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00169-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Adams D, MacDonald L, Keen D. Teacher responses to anxiety-related behaviours in students on the autism spectrum. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 86:11-19. [PMID: 30622014 DOI: 10.1016/j.ridd.2018.12.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND At least 50% of students on the autism spectrum experience clinical or subclinical levels of anxiety but there is scant research on how teachers respond to anxiety in children on the spectrum. AIMS To compare teacher responses to anxiety-related behaviour in students who do and do not have a diagnosis on the spectrum using the Teacher Responses to Anxiety in Children (TRAC). METHODS AND PROCEDURES Teachers (N = 64), predominantly from mainstream primary schools, completed an online survey comprised of a demographic questionnaire and two versions of the TRAC, one for students without autism and one for students with autism. OUTCOMES AND RESULTS Teachers report differences in the way they would likely respond to anxiety-related behaviours observed in students with and without autism. Teachers reported being more likely to use anxiety-promoting responses for students with autism who are showing behaviours indicative of general and separation anxiety, but not when they are showing behaviours indicative of social anxiety. Whilst there was no significant difference in the overall likelihood of use of autonomy-promoting responses between groups, there were differences in the likelihood of using specific autonomy-promoting responses dependent upon diagnosis and type of anxiety. CONCLUSIONS AND IMPLICATIONS Teachers report they are likely to respond differently to anxiety-related behaviours of students on the autism spectrum but the impact of this on the behaviour of these students is yet to be determined. Professional development is a priority to increase teacher knowledge about anxiety-related behaviours in students with autism and the ways in which teachers' responses may promote or reduce anxiety and autonomy.
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Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Australia; Griffith Institute of Educational Research, Griffith University, Brisbane, Australia.
| | - Libby MacDonald
- Griffith Institute of Educational Research, Griffith University, Brisbane, Australia
| | - Deb Keen
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Australia; Griffith Institute of Educational Research, Griffith University, Brisbane, Australia
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Adams D, Simpson K, Keen D. School-related anxiety symptomatology in a community sample of primary-school-aged children on the autism spectrum. J Sch Psychol 2018; 70:64-73. [DOI: 10.1016/j.jsp.2018.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 06/07/2018] [Accepted: 07/26/2018] [Indexed: 12/28/2022]
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24
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Adams D, Young K, Simpson K, Keen D. Parent descriptions of the presentation and management of anxiousness in children on the autism spectrum. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:980-992. [DOI: 10.1177/1362361318794031] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The complex interaction between anxiety and autism has led to debate about the presentation of anxiety in individuals on the spectrum and questions about the extent to which traditional checklists assess the entire range of symptomatology. Moreover, studies to date have not explored how the presentation of anxiety may differ between settings. Through a combination of open-ended questions, closed questions and standardised measures, parents of 173 children (aged 6–13) on the autism spectrum provided (1) descriptors of their child’s anxiety at home, school and in the community and (2) strategies used to reduce their child’s anxiety in each setting. Over half (52.6%) felt their child was anxious at home, 77.6% at school and 76.2% in the community. Parents reported differing presentations of anxiety between settings, with the majority of descriptions relating to observable, behavioural changes (e.g. hides/shuts down, repetitive behaviours) rather than cognitive or physiological signs. Parents also reported using different strategies across settings. The use of open-ended questions allowed the identification of signs of anxiety not explored within traditional questionnaires and highlighted the potential for signs to vary across settings. This knowledge is critical to inform the development or adaptations of anxiety measures and interventions.
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Affiliation(s)
- Dawn Adams
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | - Kate Simpson
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Deb Keen
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Roemer M, Verheul E, Velthausz F. Identifying perception behaviours in people with profound intellectual and multiple disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:820-832. [PMID: 29266636 DOI: 10.1111/jar.12436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND To support people with profound intellectual and multiple disabilities (PIMD), it is essential to understand how they experience their environment. Insight into perception behaviour may provide an entry point for improved understanding. MATERIALS AND METHODS A random sample of a 30-min video registration of five participants with PIMD was used to code behaviours per second based on an ethogram containing 157 different perception behaviours in nine categories. RESULTS Eighty-nine different perception behaviours were observed, of which movements with eyes, head and arms were most common. The senses used most were seeing, hearing and touching. Finally, the function of five perception patterns was established in relation to their function:awareness, focusing attention and tension regulation. CONCLUSIONS Close observation using an observation ethogram provides insight into how people with PIMD perceive their environment.
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Affiliation(s)
- Miriam Roemer
- Esdégé-Reigersdaal, Broek op Langedijk, The Netherlands
| | - Ellen Verheul
- Esdégé-Reigersdaal, Broek op Langedijk, The Netherlands
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26
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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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27
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Summers J, Shahrami A, Cali S, D'Mello C, Kako M, Palikucin-Reljin A, Savage M, Shaw O, Lunsky Y. Self-Injury in Autism Spectrum Disorder and Intellectual Disability: Exploring the Role of Reactivity to Pain and Sensory Input. Brain Sci 2017; 7:brainsci7110140. [PMID: 29072583 PMCID: PMC5704147 DOI: 10.3390/brainsci7110140] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/11/2017] [Accepted: 10/23/2017] [Indexed: 12/27/2022] Open
Abstract
This paper provides information about the prevalence and topography of self-injurious behavior in children and adults with autism spectrum disorder and intellectual disability. Dominant models regarding the etiology of self-injury in this population are reviewed, with a focus on the role of reactivity to pain and sensory input. Neuroimaging studies are presented and suggestions are offered for future research.
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Affiliation(s)
- Jane Summers
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Ali Shahrami
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Stefanie Cali
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Chantelle D'Mello
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Milena Kako
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | | | - Melissa Savage
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Olivia Shaw
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Yona Lunsky
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
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28
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Enhanced Nociception in Angelman Syndrome Model Mice. J Neurosci 2017; 37:10230-10239. [PMID: 28931574 DOI: 10.1523/jneurosci.1018-17.2017] [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] [Received: 04/14/2017] [Revised: 09/07/2017] [Indexed: 01/22/2023] Open
Abstract
Angelman syndrome (AS) is a severe neurodevelopmental disorder caused by mutation or deletion of the maternal UBE3A allele. The maternal UBE3A allele is expressed in nearly all neurons of the brain and spinal cord, whereas the paternal UBE3A allele is repressed by an extremely long antisense transcript (UBE3A-ATS). Little is known about expression of UBE3A in the peripheral nervous system, where loss of maternal UBE3A might contribute to AS phenotypes. Here we sought to examine maternal and paternal Ube3a expression in DRGs neurons and to evaluate whether nociceptive responses were affected in AS model mice (global deletion of maternal Ube3a allele; Ube3am-/p+). We found that most large-diameter proprioceptive and mechanosensitive DRG neurons expressed maternal Ube3a and paternal Ube3a-ATS In contrast, most small-diameter neurons expressed Ube3a biallelically and had low to undetectable levels of Ube3a-ATS Analysis of single-cell DRG transcriptomes further suggested that Ube3a is expressed monoallelically in myelinated large-diameter neurons and biallelically in unmyelinated small-diameter neurons. Behavioral responses to some noxious thermal and mechanical stimuli were enhanced in male and female AS model mice; however, nociceptive responses were not altered by the conditional deletion of maternal Ube3a in the DRG. These data suggest that the enhanced nociceptive responses in AS model mice are due to loss of maternal Ube3a in the central, but not peripheral, nervous system. Our study provides new insights into sensory processing deficits associated with AS.SIGNIFICANCE STATEMENT Angelman syndrome (AS) is a neurodevelopmental disorder caused by loss or mutation of the maternal UBE3A allele. While sensory processing deficits are frequently associated with AS, it is currently unknown whether Ube3a is expressed in peripheral sensory neurons or whether maternal deletion of Ube3a affects somatosensory responses. Here, we found that Ube3a is primarily expressed from the maternally inherited allele in myelinated large-diameter sensory neurons and biallelically expressed in unmyelinated small-diameter neurons. Nociceptive responses to select noxious thermal and mechanical stimuli were enhanced following global, but not sensory neuron-specific, deletion of maternal Ube3a in mice. These data suggest that maternal loss of Ube3a affects nociception via a central, but not peripheral mechanism, with implications for AS.
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Amor-Salamanca A, Menchon JM. Pain underreporting associated with profound intellectual disability in emergency departments. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:341-347. [PMID: 28054733 DOI: 10.1111/jir.12355] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/24/2016] [Accepted: 10/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Little information is available regarding the visits made by persons with profound intellectual disability (PID) to general hospital emergency departments (ED). This study aims to know whether persons with PID who attend ED are given the same type of diagnoses as people with no such disability. METHODS Over a period of 18 months, we gathered data from all non-scheduled visits to an ED by persons with PID to identify the reason for consultation (according to the classification used by the Spanish Society for Emergency Nursing) and the final diagnosis upon discharge. The results were compared with data obtained from a control group of people with no ID who attended an ED for any reason during the same period. RESULTS Somatic complaints were the main reason for ED attendance among persons with PID (90% of consultations). These complaints were more often related to the central nervous system than was the case among non-ID patients (16 vs. 4.7%), whereas other kinds of non-central nervous system somatic complaint were less common among persons with PID (74 vs. 91%). A diagnosis implying physical pain was given less often to people with PID than to controls (3 vs. 20%). CONCLUSIONS The results suggest that persons with PID are less able to conceptualise and communicate information about their symptoms, especially as regards pain, and that this influences the diagnosis they are given when attending an ED. Professionals working in this environment need to be aware of this possibility so as not to underestimate or overlook such symptoms and the illnesses related to them.
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Affiliation(s)
- A Amor-Salamanca
- Fundación Vallparadís, Department of Psychiatry, Mutua Terrassa University Hospital, Spain
| | - J M Menchon
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Spain
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Lyons G, De Bortoli T, Arthur-Kelly M. Triangulated Proxy Reporting: a technique for improving how communication partners come to know people with severe cognitive impairment. Disabil Rehabil 2016; 39:1814-1820. [PMID: 27684651 DOI: 10.1080/09638288.2016.1211759] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This paper explains and demonstrates the pilot application of Triangulated Proxy Reporting (TPR); a practical technique for enhancing communication around people who have severe cognitive impairment (SCI). METHODS AND RESULTS An introduction explains SCI and how this impacts on communication; and consequently on quality of care and quality of life. This is followed by an explanation of TPR and its origins in triangulation research techniques. An illustrative vignette explicates its utility and value in a group home for a resident with profound multiple disabilities. The Discussion and Conclusion sections propose the wider application of TPR for different cohorts of people with SCIs, their communication partners and service providers. CONCLUSIONS TPR presents as a practical technique for enhancing communication interactions with people who have SCI. The paper demonstrates the potential of the technique for improving engagement amongst those with profound multiple disabilities, severe acquired brain injury and advanced dementia and their partners in and across different care settings. Implications for Rehabilitation Triangulated Proxy Reporting (TPR) shows potential to improve communications between people with severe cognitive impairments and their communication partners. TPR can lead to improved quality of care and quality of life for people with profound multiple disabilities, very advanced dementia and severe acquired brain injury, who otherwise are very difficult to support. TPR is a relatively simple and inexpensive technique that service providers can incorporate into practice to improving communications between clients with severe cognitive impairments, their carers and other support professionals.
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Affiliation(s)
- Gordon Lyons
- a School of Education , The University of Newcastle , Australia
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31
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Cheung S, Han E, Kushki A, Anagnostou E, Biddiss E. Biomusic: An Auditory Interface for Detecting Physiological Indicators of Anxiety in Children. Front Neurosci 2016; 10:401. [PMID: 27625593 PMCID: PMC5003931 DOI: 10.3389/fnins.2016.00401] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 08/15/2016] [Indexed: 11/13/2022] Open
Abstract
For children with profound disabilities affecting communication, it can be extremely challenging to identify salient emotions such as anxiety. If left unmanaged, anxiety can lead to hypertension, cardiovascular disease, and other psychological diagnoses. Physiological signals of the autonomic nervous system are indicative of anxiety, but can be difficult to interpret for non-specialist caregivers. This paper evaluates an auditory interface for intuitive detection of anxiety from physiological signals. The interface, called "Biomusic," maps physiological signals to music (i.e., electrodermal activity to melody; skin temperature to musical key; heart rate to drum beat; respiration to a "whooshing" embellishment resembling the sound of an exhalation). The Biomusic interface was tested in two experiments. Biomusic samples were generated from physiological recordings of typically developing children (n = 10) and children with autism spectrum disorders (n = 5) during relaxing and anxiety-provoking conditions. Adult participants (n = 16) were then asked to identify "anxious" or "relaxed" states by listening to the samples. In a classification task with 30 Biomusic samples (1 relaxed state, 1 anxious state per child), classification accuracy, sensitivity, and specificity were 80.8% [standard error (SE) = 2.3], 84.9% (SE = 3.0), and 76.8% (SE = 3.9), respectively. Participants were able to form an early and accurate impression of the anxiety state within 12.1 (SE = 0.7) seconds of hearing the Biomusic with very little training (i.e., < 10 min) and no contextual information. Biomusic holds promise for monitoring, communication, and biofeedback systems for anxiety management.
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Affiliation(s)
- Stephanie Cheung
- Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation HospitalToronto, ON, Canada
| | - Elizabeth Han
- Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation HospitalToronto, ON, Canada
| | - Azadeh Kushki
- Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation HospitalToronto, ON, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation HospitalToronto, ON, Canada; Department of Paediatrics, University of TorontoToronto, ON, Canada
| | - Elaine Biddiss
- Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation HospitalToronto, ON, Canada
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32
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Pruijssers A, van Meijel B, Maaskant M, Teerenstra S, van Achterberg T. The Diagnostic Guideline for Anxiety and Challenging Behaviour for Persons with Intellectual Disabilities: Preliminary Outcomes on Internalizing Problems, Challenging Behaviours, Quality of Life and Clients' Satisfaction. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:242-254. [PMID: 26810713 DOI: 10.1111/jar.12235] [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: 11/26/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with intellectual disabilities are vulnerable to develop psychopathology (in particular anxiety) and related challenging behaviour. A diagnostic guideline was developed to support professionals to better diagnose and thus treat psychopathology and related CB. This study examined preliminary outcomes from the application of this guideline. METHOD A comparative multiple case study with an experimental and a control condition. RESULTS The application of the guideline showed a trend of decreases of internalizing problems (P = 0.07) and anxiety/depressed problems (P = 0.09). We found no statistically significant decreases of externalizing problems and no increases in perceived quality of life as compared with care as usual. Clients were not more satisfied with the support they received for coping with their emotional and behaviour problems. CONCLUSION The application of the Diagnostic Guideline for Anxiety and Challenging Behaviour did not show statistically significant changes in externalizing problems and Quality of Life. Despite the small sample size of n = 59, we did find a trend in decreasing internalizing problems and anxiety/depressed problems. Further research into either or not confirming these trends is recommended.
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Affiliation(s)
- Addy Pruijssers
- Research Group Mental Health Nursing, Department of Health, Sports & Welfare/Cluster Nursing, Inholland University for Applied Sciences, Amsterdam, The Netherlands.,Esdégé-Reigersdaal (a service provider for people with (intellectual) disabilities), Broek op Langedijk, The Netherlands.,Inholland University, Alkmaar, The Netherlands
| | - Berno van Meijel
- Research Group Mental Health Nursing, Department of Health, Sports & Welfare/Cluster Nursing, Inholland University for Applied Sciences, Amsterdam, The Netherlands.,Inholland University, Alkmaar, The Netherlands.,Department of Psychiatry, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.,Parnassia Academy, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Marian Maaskant
- Department of Health Services Research, Maastricht University, The Netherlands.,Stichting Pergamijn (service provider for people with intellectual disabilities), Echt, The Netherlands
| | - Steven Teerenstra
- Section Biostatistics, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theo van Achterberg
- Quality of Care, Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium.,Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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Đorđević M, Glumbić N, Brojčin B. Paralinguistic abilities of adults with intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:211-219. [PMID: 26625206 DOI: 10.1016/j.ridd.2015.11.001] [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] [Received: 07/23/2015] [Revised: 11/01/2015] [Accepted: 11/02/2015] [Indexed: 06/05/2023]
Abstract
The aim of this research was to determine the ability level of paralinguistic production and comprehension in adults with intellectual disability (ID) with regard to the level of their intellectual functioning and presence of co-morbid psychiatric conditions or dual diagnosis (DD). The sample consisted of 120 participants of both genders, ranging in age between 20 and 56 years (M=31.82, SD=8.702). Approximately 50% of the sample comprised participants with a co-existing psychiatric condition. Each of these two sub-samples (those with ID only and those with DD) consisted of 25 participants with mild ID and 35 participants with moderate ID. The paralinguistic scale from The Assessment Battery for Communication (ABaCo; Sacco et al., 2008) was used to assess the abilities of comprehension and production of paralinguistic elements. The results showed that the participants with mild ID are more successful than the participants with moderate ID both in paralinguistic comprehension tasks (p=.000) and in paralinguistic production tasks (p=.001). Additionally, the results indicated the presence of separate influences of both ID levels on all of the paralinguistic abilities (F [116]=42.549, p=.000) and the existence of DD (F [116]=18.215, p=.000).
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Affiliation(s)
- Mirjana Đorđević
- University of Belgrade Faculty of Special Education and Rehabilitation, Serbia.
| | - Nenad Glumbić
- University of Belgrade Faculty of Special Education and Rehabilitation, Serbia
| | - Branislav Brojčin
- University of Belgrade Faculty of Special Education and Rehabilitation, Serbia
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Deep Assessment: A Novel Framework for Improving the Care of People with Very Advanced Alzheimer's Disease. BIOMED RESEARCH INTERNATIONAL 2015; 2015:749451. [PMID: 26688817 PMCID: PMC4672100 DOI: 10.1155/2015/749451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/02/2015] [Accepted: 11/02/2015] [Indexed: 11/18/2022]
Abstract
Best practice in understanding and caring for people with advanced Alzheimer's disease presents extraordinary challenges. Their severe and deteriorating cognitive impairments are such that carers find progressive difficulty in authentically ascertaining and responding to interests, preferences, and needs. Deep assessment, a novel multifaceted framework drawn from research into the experiences of others with severe cognitive impairments, has potential to empower carers and other support professionals to develop an enhanced understanding of people with advanced Alzheimer's disease and so deliver better calibrated care in attempts to maximize quality of life. Deep assessment uses a combination of techniques, namely, Behaviour State Observation, Triangulated Proxy Reporting, and Startle Reflex Modulation Measurement, to deliver a comprehensive and deep assessment of the inner states (awareness, preferences, likes, and dislikes) of people who cannot reliably self-report. This paper explains deep assessment and its current applications. It then suggests how it can be applied to people with advanced Alzheimer's disease to develop others' understanding of their inner states and to help improve their quality of life. An illustrative hypothetical vignette is used to amplify this framework. We discuss the potential utility and efficacy of this technique for this population and we also propose other human conditions that may benefit from research using a deep assessment approach.
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Flynn S, Hulbert-Williams N, Hulbert-Williams L, Bramwell R. Psychosocial experiences of chronic illness in individuals with an intellectual disability: A systematic review of the literature. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2015; 19:178-194. [PMID: 25567097 DOI: 10.1177/1744629514565680] [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] [Accepted: 11/21/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Increased life expectancy has led to an increase in diagnoses of chronic illness in people with an intellectual disability; despite this increase, research about the psychological impact is rare. This review explored the psychosocial experiences of chronic illness in adults with an intellectual disability, revealing potential predictors and moderators of these experiences. METHODS Online databases were systematically searched to identify relevant literature, using predefined inclusion criteria. Of the 25,058 titles initially identified, 4 were included, that is, those collecting data on people with an intellectual disability and diagnosed with cancer (n = 2), chronic pain (n = 1) and diabetes (n = 1). RESULTS Narrative synthesis of the data identified six themes, namely, (1) delayed diagnosis, (2) information, communication and understanding, (3) negative psychological consequences, (4) negative physical consequences, (5) social perception and (6) social support. CONCLUSIONS There are unmet needs within this population, including a lack of assistance in understanding their illness. A substantial gap in the literature should be addressed through further empirical work.
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Adams D, Horsler K, Mount R, Oliver C. Brief Report: A Longitudinal Study of Excessive Smiling and Laughing in Children with Angelman Syndrome. J Autism Dev Disord 2015; 45:2624-7. [DOI: 10.1007/s10803-015-2404-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zhou Y, Black R, Freeman R, Herron D, Humphris G, Menzies R, Quinn S, Scott L, Waller A. Applying the Verona coding definitions of emotional sequences (VR-CoDES) in the dental context involving patients with complex communication needs: An exploratory study. PATIENT EDUCATION AND COUNSELING 2014; 97:180-187. [PMID: 25085550 DOI: 10.1016/j.pec.2014.07.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/01/2014] [Accepted: 07/13/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The VR-CoDES has been previously applied in the dental context. However, we know little about how dental patients with intellectual disabilities (ID) and complex communication needs express their emotional distress during dental visits. This is the first study explored the applicability of the VR-CoDES to a dental context involving patients with ID. METHODS Fourteen dental consultations were video recorded and coded using the VR-CoDES, assisted with the additional guidelines for the VR-CoDES in a dental context. Both inter- and intra-coder reliabilities were checked on the seven consultations where cues were observed. RESULTS Sixteen cues (eight non-verbal) were identified within seven of the 14 consultations. Twenty responses were observed (12 reducing space) with four multiple responses. Cohen's Kappa were 0.76 (inter-coder) and 0.88 (intra-coder). CONCLUSION With the additional guidelines, cues and responses were reliably identified. Cue expression was exhibited by non-verbal expression of emotion with people with ID in the literature. Further guidance is needed to improve the coding accuracy on multiple providers' responses and to investigate potential impacts of conflicting responses on patients. PRACTICE IMPLICATIONS The findings provided a useful initial step towards an ongoing exploration of how healthcare providers identify and manage emotional distress of patients with ID.
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Affiliation(s)
- Yuefang Zhou
- School of Medicine, University of St Andrews, St Andrews, UK.
| | - Rolf Black
- School of Computing, University of Dundee, Dundee, UK
| | - Ruth Freeman
- School of Dentistry, University of Dundee, Dundee, UK
| | - Daniel Herron
- School of Computing, University of Dundee, Dundee, UK
| | - Gerry Humphris
- School of Medicine, University of St Andrews, St Andrews, UK
| | | | - Sandra Quinn
- School of Dentistry, University of Dundee, Dundee, UK
| | - Lesley Scott
- School of Computing, University of Dundee, Dundee, UK
| | - Annalu Waller
- School of Computing, University of Dundee, Dundee, UK
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Ishitobi M, Kawatani M, Asano M, Kosaka H, Goto T, Hiratani M, Wada Y. Quetiapine responsive catatonia in an autistic patient with comorbid bipolar disorder and idiopathic basal ganglia calcification. Brain Dev 2014; 36:823-5. [PMID: 24434185 DOI: 10.1016/j.braindev.2013.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 12/02/2013] [Accepted: 12/17/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Bipolar disorder (BD) has been linked with the manifestation of catatonia in subjects with autism spectrum disorders (ASD). Idiopathic basal ganglia calcification (IBGC) is characterized by movement disorders and various neuropsychiatric disturbances including mood disorder. CASE We present a patient with ASD and IBGC who developed catatonia presenting with prominent dystonic feature caused by comorbid BD, which was treated effectively with quetiapine. CONCLUSION In addition to considering the possibility of neurodegenerative disease, careful psychiatric interventions are important to avoid overlooking treatable catatonia associated with BD in cases of ASD presenting with both prominent dystonic features and apparent fluctuation of the mood state.
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Affiliation(s)
- Makoto Ishitobi
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan; Department of Neuropsychiatry, University of Fukui, Japan.
| | | | - Mizuki Asano
- Department of Neuropsychiatry, University of Fukui, Japan.
| | - Hirotaka Kosaka
- Research Center for Child Mental Development, University of Fukui, Japan.
| | - Takashi Goto
- Department of Neuropsychiatry, University of Fukui, Japan.
| | | | - Yuji Wada
- Department of Neuropsychiatry, University of Fukui, Japan.
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Haig D. Troubled sleep: A response to commentaries. Evol Med Public Health 2014; 2014:57-62. [PMID: 24632049 PMCID: PMC3982903 DOI: 10.1093/emph/eou011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- David Haig
- *Corresponding author. Department of Organismic and Evolutionary Biology, Harvard University, 26 Oxford Street, Cambridge, MA 02138, USA. Tel: +1-617-496-5125; Fax: +1-617-495-5667; E-mail:
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Findlay L, Williams ACDC, Scior K. Exploring experiences and understandings of pain in adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:358-367. [PMID: 23356659 DOI: 10.1111/jir.12020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) are at risk that their health problems, many of which cause pain, go unrecognised and untreated. Their understanding and personal experiences of pain have received little research attention. METHOD Information was collected from 15 adults with ID using semi-structured interviews about their experiences and understanding of pain. Transcripts were analysed using content analysis. RESULTS Participants described pain using negative meanings and strong imagery, with various causes of pain suggested, but said little about how they coped with pain. Participants varied in whether they reported pains to carers, some choosing to hide the experience. There seemed a general belief that others can tell when someone is in pain. CONCLUSIONS Conversations regarding pain with adults with ID are a real challenge; health-care staff need to think carefully about the questions they ask. Possessing verbal skills cannot be taken as an indication that pain will be communicated.
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Affiliation(s)
- L Findlay
- Buckinghamshire Community Learning Disability Team, Southern Health NHS Foundation Trust, Aylesbury, UK
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41
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Donadon MF, Osório FDL. Recognition of facial expressions by alcoholic patients: a systematic literature review. Neuropsychiatr Dis Treat 2014; 10:1655-63. [PMID: 25228806 PMCID: PMC4161523 DOI: 10.2147/ndt.s65376] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Alcohol abuse and dependence can cause a wide variety of cognitive, psychomotor, and visual-spatial deficits. It is questionable whether this condition is associated with impairments in the recognition of affective and/or emotional information. Such impairments may promote deficits in social cognition and, consequently, in the adaptation and interaction of alcohol abusers with their social environment. The aim of this systematic review was to systematize the literature on alcoholics' recognition of basic facial expressions in terms of the following outcome variables: accuracy, emotional intensity, and latency time. METHODS A systematic literature search in the PsycINFO, PubMed, and SciELO electronic databases, with no restrictions regarding publication year, was employed as the study methodology. RESULTS The findings of some studies indicate that alcoholics have greater impairment in facial expression recognition tasks, while others could not differentiate the clinical group from controls. However, there was a trend toward greater deficits in alcoholics. Alcoholics displayed less accuracy in recognition of sadness and disgust and required greater emotional intensity to judge facial expressions corresponding to fear and anger. CONCLUSION The current study was only able to identify trends in the chosen outcome variables. Future studies that aim to provide more precise evidence for the potential influence of alcohol on social cognition are needed.
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Affiliation(s)
- Mariana Fortunata Donadon
- Department of Neurosciences and Behavior, Medical School of Ribeirão Preto, University of São Paulo, Brazil ; Coordination for the Improvement of Higher Level Personnel-CAPS, Brazil
| | - Flávia de Lima Osório
- Department of Neurosciences and Behavior, Medical School of Ribeirão Preto, University of São Paulo, Brazil ; Technology Institute for Translational Medicine, Ribeirão Preto, São Paulo, Brazil ; Agency of São Paulo Research Foundation, São Paulo, Brazil
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Lyons GS, Walla P, Arthur-Kelly M. Towards improved ways of knowing children with profound multiple disabilities: introducing startle reflex modulation. Dev Neurorehabil 2013; 16:340-4. [PMID: 24020879 DOI: 10.3109/17518423.2012.737039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To propose startle reflex modulation (SRM) as an objective measure of emotions of children with profound multiple disabilities (PMD). Knowledge about emotion states of children with PMD is crucial to their individualised care and support. Proxy reporting, observational and physiological measures of emotion are reported in the literature. Despite advances in this science, the rigour of the findings and methods are contested. In this article, we introduce SRM; a neurophysiological measure untried with children with PMD, despite its well-known sensitivity to even subtle changes in affective processing without depending on explicit responses. RESULTS We propose a research agenda that aims to deliver a more comprehensive and accurate profile of the inner states of these children, based upon previous research undertaken using SRM. CONCLUSION It is suggested that this objective measure has potential to provide useful information about the inner emotional states of children with PMD.
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Vos P, De Cock P, Petry K, Van Den Noortgate W, Maes B. See me, feel me. Using physiology to validate behavioural observations of emotions of people with severe or profound intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:452-461. [PMID: 23464864 DOI: 10.1111/jir.12030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND Behavioural observations are the most frequently used source of information about emotions of people with severe or profound intellectual disabilities but have not yet been validated against other measures of emotion. In this study we wanted to validate the behavioural observations of emotions using respiration (rib cage contribution, total breath duration, inspiratory time, expiratory time, tidal volume, mean inspiratory flow, minute ventilation) and heart rate variability. METHOD Twenty-seven participants were presented with four negative and four positive stimuli. During the presentation the participants' respiration and heart rate variability was measured. Each behaviour of the participant was coded as emotive or not. RESULTS We found the hypothesised higher percentage rib cage contribution, marginal lower mean inspiratory flow and lower heart rate variability when the expressed emotions became more positive. CONCLUSIONS These results validate the use of behavioural observations to make inferences about emotions.
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Affiliation(s)
- P Vos
- Parenting and Special Education Research Unit, Katholieke Universiteit Leuven, Leuven, Belgium.
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Vos P, De Cock P, Petry K, Van Den Noortgate W, Maes B. Investigating the relationship between observed mood and emotions in people with severe and profound intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:440-451. [PMID: 23419208 DOI: 10.1111/jir.12021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND The measurement of subjective well-being in people with severe and profound intellectual disabilities (ID) is a difficult challenge. As they cannot self-report about their life satisfaction, because of severe communicative and cognitive limitations, behavioural observations of their emotions and moods are important in the measurement of their subjective well-being. It is, however, not known if observations of mood and emotion can be differentiated in people with severe and profound ID and if mood and emotions can give unique information about their affect. Therefore, the aim of this study is to examine the relationship between mood and emotions in people with severe and profound ID, using behavioural observations. As recommended in the literature, we investigated the frequency and intensity of the emotion separately. METHOD In a period of 3 weeks 27 participants with severe and profound ID were presented with four staff-selected negative and four staff-selected positive stimuli. During the presentation participants were videotaped using the observational method of Petry & Maes where each behaviour is coded on a 5-point scale, ranging from indicating a very negative emotion to indicating a very positive emotion. As a measure of mood, the staff completed the MIPQ in the beginning of the 3 weeks. RESULTS We found a positive relationship between mood and respectively the total emotion score and the frequency of the emotion when the stimuli were positive but not when the stimuli were negative. There was no relationship between mood and the intensity of the emotion. CONCLUSIONS Our results indicate that mood and emotions can be distinguished from each other using behavioural observations. Both can give specific information about the affective life of people with severe or profound ID. Moreover, if further research could replicate the results of this study, an implication is that the direct support workers should be aware of a decline in the frequency of their clients reactions to positive stimuli as this could indicate a decline in their mood.
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Affiliation(s)
- P Vos
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium.
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Vos P, De Cock P, Munde V, Neerinckx H, Petry K, Van Den Noortgate W, Maes B. The role of attention in the affective life of people with severe or profound intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:902-909. [PMID: 23287537 DOI: 10.1016/j.ridd.2012.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/15/2012] [Accepted: 11/15/2012] [Indexed: 06/01/2023]
Abstract
Although it is shown that attention plays an important role both in the onset and in the regulation of emotions in people without disabilities there is no information about how attention is related to emotions in people with severe or profound intellectual disability (ID). Therefore, in our study, we investigated the role of attention in the onset and regulation of the emotions of persons with severe or profound ID. We presented 27 participants with 4 staff-selected negative and 4 staff-selected positive stimuli. The situations were videotaped and their heart rate and attention was measured. Contrary to the expected higher attention to negative stimuli during the onset of negative emotions, we did not find differences in attention in the fourth to sixth second of stimulus presentation. However, in support of the emotion regulation theory of Gross (2008) we did find less attention to the negative stimuli than to the positive stimuli after these first 6s of stimuli presentation. As expected from research in people without disabilities, there was also a negative relationship between the heart rate and the probability of being attentive. Our results suggest that people with severe and profound ID use attentional deployment to regulate their emotions and that, as in people without disabilities, a low heart rate is associated with attention.
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Affiliation(s)
- Pieter Vos
- Katholieke Universiteit Leuven, Parenting and Special Education Research Unit, Leuven, Belgium.
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Bergström-Isacsson M, Lagerkvist B, Holck U, Gold C. How facial expressions in a Rett syndrome population are recognised and interpreted by those around them as conveying emotions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:788-794. [PMID: 23220055 DOI: 10.1016/j.ridd.2012.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 10/19/2012] [Accepted: 10/24/2012] [Indexed: 06/01/2023]
Abstract
Rett syndrome (RTT) is a neurodevelopmental disorder, including autonomic nervous system dysfunctions and severe communication impairment with an extremely limited ability to use verbal language. These individuals are therefore dependent on the capacity of caregivers to observe and interpret communicative signals, including emotional expressions. People in general, including therapists tend to focus on changes in facial expressions to interpret a person's emotional state or choices, but with this population it is difficult to know if the interpretations are correct. The aims of this study were to investigate if the Facial Action Coding System (FACS) could be used to identify facial expressions, and differentiate between those that expressed emotions and those that were elicited by abnormal brainstem activation in RTT. The sample comprised 29 participants with RTT and 11 children with a normal developmental pattern, exposed to six different musical stimuli during non-invasive registration of autonomic brainstem functions. The results indicate that FACS makes it possible both to identify facial expressions and to differentiate between those that stem from emotions and those caused by abnormal brainstem activation. This knowledge may be a great help to an uninitiated observer, who otherwise might incorrectly interpret the latter as an expression of emotion.
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Egger JI, Wingbermühle E, Verhoeven WM, Dijkman M, Radke S, de Bruijn ER, de Vries B, Kessels RP, Koolen D. Hypersociability in the behavioral phenotype of 17q21.31 microdeletion syndrome. Am J Med Genet A 2012; 161A:21-6. [DOI: 10.1002/ajmg.a.35652] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 08/13/2012] [Indexed: 11/12/2022]
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Lancioni GE, Singh NN, O'Reilly MF, Green V, Oliva D, Buonocunto F, Sacco V, Biancardi EM, Di Nuovo S. Technology-based programs to support forms of leisure engagement and communication for persons with multiple disabilities: two single-case studies. Dev Neurorehabil 2012; 15:209-18. [PMID: 22582852 DOI: 10.3109/17518423.2012.666766] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To extend the assessment of technology-based programs for promoting stimulus choice and staff/caregiver calls or radio operation and text messaging. METHOD In Study I, the program involved a portable computer, commercial software, and a microswitch to allow a man with motor impairment and moderate intellectual disability to choose among preferred stimuli (e.g., songs and film clips) and persons to call. In Study II, the programs involved (a) a radio device and an electronic control unit or (b) a net-book computer and a global system for mobile communication. A woman with blindness and moderate intellectual disability used a microswitch to operate the radio or send and listen to text messages. RESULTS The participants succeeded in using the technology-aided programs through simple microswitch activations involving partial hand closure (Study I) or hand pressure (Study II). CONCLUSION Technology-based programs can provide persons with multiple disabilities relevant leisure and communication opportunities.
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Affiliation(s)
- Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Italy.
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Lima M, Silva K, Magalhães A, Amaral I, Pestana H, de Sousa L. Can you Know me Better? An Exploratory Study Combining Behavioural and Physiological Measurements for an Objective Assessment of Sensory Responsiveness in a Child with Profound Intellectual and Multiple Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2012; 25:522-30. [DOI: 10.1111/j.1468-3148.2012.00698.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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50
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Vos P, De Cock P, Munde V, Petry K, Van Den Noortgate W, Maes B. The tell-tale: what do heart rate; skin temperature and skin conductance reveal about emotions of people with severe and profound intellectual disabilities? RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1117-1127. [PMID: 22502837 DOI: 10.1016/j.ridd.2012.02.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 02/06/2012] [Accepted: 02/07/2012] [Indexed: 05/31/2023]
Abstract
Identifying emotions in people with severe and profound intellectual disabilities is a difficult challenge. Since self-reports are not available, behaviour is the most used source of information. Given the limitations and caveats associated with using behaviour as the sole source of information about their emotions, it is important to supplement behavioural information with information from another source. As it is accepted that emotions consist of language, behaviour and physiology, in this article we investigated if physiology could give information about the emotions of people with severe and profound intellectual disabilities. To this aim we tested hypotheses derived from the motivational model of Bradley, Codispoti, Cuthbert, and Lang (2001) about the relation between heart rate and the valence of emotions and between heart rate, skin conductance and skin temperature and behavioural expressions of emotions of people with severe and profound intellectual disability. We presented 27 participants with 4 staff-selected negative and 4 staff-selected positive stimuli. The situations were videotaped and their heart rate, skin conductance and skin temperature was measured. Each behaviour of the participant was coded using the observational method developed by Petry and Maes (2006). As hypothesized, we found a lower heart rate when participants were presented with negative stimuli than when they were presented with positive stimuli in the first 6s of stimuli presentation. Their skin temperature was higher for the expression of low intensity negative emotions compared to the expression of low intensity positive emotions. The results suggest that, as with people without disability, heart rate and skin temperature can give information about the emotions of persons with severe and profound ID.
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Affiliation(s)
- Pieter Vos
- Parenting and Special Education Research Unit, Leopold Vanderkelenstraat 32, P.O. Box 3765, B-3000 Leuven, Belgium.
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