[Clinical diagnostics of psycho-social and cognitive standard of performance in youth with mental disabilities.]

Clinical diagnostics of psycho-social and cognitive standard of performance in youth with mental disabilities. Abstract. The clinical diagnostics of cognitive limitations and the resulting problems of social development occurring in childhood and adolescence are essential for further stimulation as well as for possible treatment strategies for comorbid mental diseases. This complex process should be carried out on several levels and with different methods. The resulting praxis-oriented question is defined via the pros and cons of the current procedure for the recording of psycho-social and cognitive stage of development of young people with mental disabilities. The online-based research in relevant databases was conducted systematically and yielded 3,324 articles. After fully reviewing the disqualifying criteria, 30 procedures remained. Twenty-four procedures could be assigned to "tests of development and intelligence" and six to "observer rating and self-report methods". It becomes clear that the majority of treatments have been standardized for children and adolescents of average intelligence. Meaning, only inaccurate information regarding the participation of children and adolescents with intelligence impairments in the standardized sample were given. This goes hand in hand with qualifying criteria that were not tested in consideration of the needs of people with intelligence impairment. Despite the current unsatisfactory situation, there is a demand for diagnostic instruments of the psycho-social and cognitive standard of performance in youth with mental disabilities. Currently, K-ABC II and ADOS-2 are recommended in combination with the observer rating methods ADI-R, VFE, and SRS.

Mental health needs and availability of mental health care for children and adolescents with intellectual disability in Berlin

BACKGROUND

The increased risk of mental health problems in children and adolescents with intellectual disability (ID) has been reported in several studies. However, almost no research has been conducted on parents' experiences with the general mental health system. We have investigated the prevalence of emotional and behavioural problems in children with ID as well as the availability and quality of mental health care from the parents' point of view.

METHODS

Teachers of specialised schools for ID in Berlin were asked to complete the Teacher's Report Form (TRF) of the Child Behavior Checklist. Information was collected for 1226 children and adolescents aged 6-18 years with mild to profound ID (response 70.5%). The availability and quality of mental health care was assessed by a questionnaire given to parents who had already been seeking help for their children. A total of 330 parents completed the questionnaires (response 62.0%). In addition to univariate analysis, we conducted multiple logistic regressions regarding the psychopathology reported by teachers (TRF-syndrome scales) and difficulties concerning mental health care reported by parents for a paired sample of 308 children.

RESULTS

Overall, 52.4% of the children and adolescents with ID had a total problem score on the TRF in the deviant range (47.1% when eliminating four items reflecting cognitive deficits). Compared with the general population normative sample of children, this is a three-time higher prevalence. The most striking problems were thought problems (schizoid and obsessive-compulsive), aggressive behaviour, attention problems and social problems. Parents whose children had more severe behavioural or emotional dysfunction reported more difficulties with the mental health system. From the parents' point of view, mental health professionals frequently did not feel responsible or were not sufficiently skilled for the treatment of children with ID. As a consequence, 96% of all parents were longing for specialised in- and outpatient services.

CONCLUSIONS

This study confirms the findings from other studies regarding the high rate of co-occurrence of ID and mental health problems in youths. Results indicate that both are strongly requested by parents: specialised in- and outpatient services, as well as more professional general services and equitable treatment for all children, with and without ID.

[Psychiatric disorders and neurological comorbidity in children with intellectual disability]

INTRODUCTION

This article gives an overview of the consultant child and adolescent psychiatric services in the region of Upper Bavaria (Germany).

METHOD

The data of 257 children and adolescents with intellectual disability and psychiatric disorders were evaluated.

RESULTS

About 14% of the children with ID in special schools or day care centers, and 40% of the children with ID in residential care showed a definite psychiatric disorder. The most frequently diagnosed disorders were adjustment disorders, hyperkinetic disorders and conduct disorders, as well as emotional problems and pervasive developmental disorders. Children with severe intellectual disability had more additional somatic disorders and were more impaired in their psychosocial functions.

CONCLUSIONS

The results show the need for psychiatric services for children and adolescents with intellectual disability and psychiatric disorders. The development and implementation of integrative and interdisciplinary models is necessary to allow for adequate medical care for these patients.