The Relationship Between Challenging Behaviour, Cognitions and Stress in Mothers of Individuals with Intellectual Disabilities

Short report: Correlates of behaviours that challenge in children with intellectual disability in special education settings

BACKGROUND

Understanding the correlates of behaviours that challenge (CB) can help in both identifying children with intellectual disabilities (ID) at risk of developing CB and designing support programmes and interventions.

AIMS

This study explores the correlates of CB exhibited by children with ID in special educational settings in the UK.

METHODS AND PROCEDURES

Data on behaviours that challenge were provided by educators of 71 children with ID. Additional measures of adaptive and pro-social behaviours, maternal anxiety, depression, and stress, and demographic variables were included in the cross-sectional binary logistic regression analyses.

OUTCOMES AND RESULTS

Results showed that pro-social behaviours of children with ID were associated negatively with overall CB (OR=0.72, 95% CI [0.62, 0.84], p < 0.001), stereotyped (OR=0.81, 95% CI [0.70, 0.94], p = 0.005), self-injurious (OR=0.80, 95% CI [0.70, 0.90], p < 0.001), and aggressive/destructive behaviours (OR=0.79, 95% CI [0.69, 0.90], p < 0.001). Stereotyped behaviours were associated with lower adaptive skills (OR=0.95, 95% CI [0.91, 0.99], p = 0.026) and male gender (OR=9.20, 95% CI [1.07, 79.44], p = 0.044). Aggressive/Destructive behaviours were associated with maternal stress (OR=0.82, 95% CI [0.70, 0.97], p = 0.022), and increased maternal anxiety (OR=1.21, 95% CI [1.00, 1.47], p = 0.050) was a marginally significant predictor of self-injurious behaviours.

CONCLUSIONS AND IMPLICATIONS

The findings of this study emphasise the potential role of pro-social and adaptive behaviours, gender of children with ID, and maternal stress, as factors associated with CB in special education settings. Therefore, the present study contributes to extending the literature on correlates of CB for children with ID in special education settings while adopting an evidence-informed methodology for defining and measuring CB that facilitates replicability and allows for comparisons across findings of studies that explore CB thus increasing a more coherent evidence-base regarding assessment of CB.

Assessment of Challenging Behavior Exhibited by People with Intellectual and Developmental Disabilities: A Systematic Review

The assessment of challenging behavior exhibited by people with intellectual and developmental disabilities is essential for the planning of prevention and intervention programs. This review aimed to identify and analyze the standardized instruments that exclusively focus on the assessment of challenging behavior. We identified and organized 141 articles into four categories: original instrument studies, validation studies, relational studies, and intervention studies. The results identified 24 instruments that generally show high-quality psychometric properties and other utilities beyond the observation of the presence of challenging behavior and diagnostic categorization. Age, level of adaptive behavior, disability, presence of autism spectrum disorder, and medication are some of the variables that were found to be possibly related to the occurrence of challenging behavior. Additionally, the results suggest that interventions focused on supporting positive behavior or providing training on behavior to professionals and caregivers significantly reduced the occurrence of these behaviors. Instruments that help us to understand and measure the challenging behavior exhibited by people with intellectual and developmental disabilities are essential for the design of effective evaluation and intervention protocols.

The experiences of mothers of children and young people with intellectual disabilities during the first COVID-19 lockdown period

BACKGROUND

Recent COVID-19 lockdown restrictions resulted in reduced access to educational, professional and social support systems for children with intellectual disabilities and their carers.

AIM

The aim of this study was to gain insight into the ways mothers of children with intellectual disabilities coped during the first 2020 lockdown period.

METHODS

Eight mothers of children with intellectual disabilities were interviewed. The recordings of these interviews were subjected to a thematic analysis.

RESULTS

Three main themes were identified: carrying the burden; a time of stress; and embracing change and looking to the future.

CONCLUSIONS

All mothers experienced increased burden and stress. However, some also described some positive impact of lockdown conditions on them as well as on their child's well-being and behaviour. These findings are discussed in the light of the (Journal of Applied Research in Intellectual Disabilities, 33, 2020, 1523) survey results on parental coping and suggestions for future service provision during pandemic conditions are proposed.

Coping Strategies in Mothers of Children with Intellectual Disabilities Showing Multiple Forms of Challenging Behaviour: Associations with Maternal Mental Health

BACKGROUND

It is well documented that mothers of children with intellectual disabilities experience elevated mental health difficulties and that these are exacerbated by the presence of challenging behaviour. However, comparatively little is known about the effect of specific coping strategies for managing such behaviours.

AIMS

This paper aims to document coping strategies used by mothers of children showing multiple forms of challenging behaviour and to explore how these relate to positive and negative maternal mental health.

METHOD

Eighty-nine mothers of children with intellectual disabilities completed questionnaires assessing maternal mental health (Hospital Anxiety and Depression Scale, Positive and Negative Affect Scale) and maternal coping strategies (Brief COPE).

RESULTS

Coping strategies were not associated with child age or ability, but were associated with maternal mental health. Higher levels of problem- and positive-coping strategies were associated with higher positive affect. Although active-avoidance coping was the least frequently reported, it was associated with higher levels of negative affect and increased anxiety and depression. Moderated mediation analyses identified that active-avoidance coping mediated the relationship between the number of forms of challenging behaviour and poor maternal mental health, but only in mothers with lower levels of problem-focused coping.

CONCLUSIONS

Active-avoidance coping is associated with poorer negative mental health in mothers of children with intellectual disabilities who have average to low levels of problem-focused coping. This is reflective of that noted within a range of populations, highlighting it as a key area for intervention.