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Bjurulf B, Reilly C, Hallböök T. Caregiver reported behavior, sleep and quality of life in children with Dravet syndrome: A population-based study. Epilepsy Behav 2024; 150:109560. [PMID: 38071826 DOI: 10.1016/j.yebeh.2023.109560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/02/2023] [Accepted: 11/21/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE The aim of this population-based study was to assess behavior, sleep, and quality of life, and explore factors associated with these in children with Dravet syndrome. METHODS The Developmental Behavior Checklist, the Insomnia Severity Index, and a global question regarding quality of life from the Epilepsy and Learning Disabilities Quality of Life scale were completed by primary caregivers of 42/48 Swedish children with Dravet syndrome, born 2000-2018. Factors associated with problems with insomnia, behavior and quality of life were analyzed using multivariable linear regression. RESULTS Scores indicating significant behavioral problems were seen in 29/40 (72 %) children, scores indicating moderate or severe clinical insomnia in 18/42 (43 %) and scores indicating poor or very poor quality of life in 7/41 (17 %). On multivariable analysis, autistic symptoms were significantly associated with behavioral problems (p = 0.013), side-effects of anti-seizure medications (ASMs) were associated with insomnia (p = 0.038), whilst insomnia was significantly associated with poor quality of life (p = 0.016). SIGNIFICANCE Dravet syndrome in children is associated with significant problems with behavior, sleep and quality of life. There is a need to optimize treatment via ASMs and develop and evaluate interventions to treat behavioral and sleep difficulties to optimize outcomes.
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Affiliation(s)
- Björn Bjurulf
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden.
| | - Colin Reilly
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden
| | - Tove Hallböök
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden
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2
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Ondruskova T, Royston R, Absoud M, Ambler G, Qu C, Barnes J, Hunter R, Panca M, Kyriakopoulos M, Oulton K, Paliokosta E, Sharma AN, Slonims V, Summerson U, Sutcliffe A, Thomas M, Dhandapani B, Leonard H, Hassiotis A. Clinical and cost-effectiveness of an adapted intervention for preschoolers with moderate to severe intellectual disabilities displaying behaviours that challenge: the EPICC-ID RCT. Health Technol Assess 2024; 28:1-94. [PMID: 38329108 PMCID: PMC11017145 DOI: 10.3310/jkty6144] [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: 02/09/2024] Open
Abstract
Background Stepping Stones Triple P is an adapted intervention for parents of young children with developmental disabilities who display behaviours that challenge, aiming at teaching positive parenting techniques and promoting a positive parent-child relationship. Objective To evaluate the clinical and cost-effectiveness of level 4 Stepping Stones Triple P in reducing behaviours that challenge in children with moderate to severe intellectual disabilities. Design, setting, participants A parallel two-arm pragmatic multisite single-blind randomised controlled trial recruited a total of 261 dyads (parent and child). The children were aged 30-59 months and had moderate to severe intellectual disabilities. Participants were randomised, using a 3 : 2 allocation ratio, into the intervention arm (Stepping Stones Triple P; n = 155) or treatment as usual arm (n = 106). Participants were recruited from four study sites in Blackpool, North and South London and Newcastle. Intervention Level 4 Stepping Stones Triple P consists of six group sessions and three individual phone or face-to-face contacts over 9 weeks. These were changed to remote sessions after 16 March 2020 due to the coronavirus disease 2019 pandemic. Main outcome measure The primary outcome measure was the parent-reported Child Behaviour Checklist, which assesses the severity of behaviours that challenge. Results We found a small non-significant difference in the mean Child Behaviour Checklist scores (-4.23, 95% CI -9.98 to 1.52, p = 0.146) in the intervention arm compared to treatment as usual at 12 months. Per protocol and complier average causal effect sensitivity analyses, which took into consideration the number of sessions attended, showed the Child Behaviour Checklist mean score difference at 12 months was lower in the intervention arm by -10.77 (95% CI -19.12 to -2.42, p = 0.014) and -11.53 (95% CI -26.97 to 3.91, p = 0.143), respectively. The Child Behaviour Checklist mean score difference between participants who were recruited before and after the coronavirus disease 2019 pandemic was estimated as -7.12 (95% CI -13.44 to -0.81) and 7.61 (95% CI -5.43 to 20.64), respectively (p = 0.046), suggesting that any effect pre-pandemic may have reversed during the pandemic. There were no differences in all secondary measures. Stepping Stones Triple P is probably value for money to deliver (-£1057.88; 95% CI -£3218.6 to -£46.67), but decisions to roll this out as an alternative to existing parenting interventions or treatment as usual may be dependent on policymaker willingness to invest in early interventions to reduce behaviours that challenge. Parents reported the intervention boosted their confidence and skills, and the group format enabled them to learn from others and benefit from peer support. There were 20 serious adverse events reported during the study, but none were associated with the intervention. Limitations There were low attendance rates in the Stepping Stones Triple P arm, as well as the coronavirus disease 2019-related challenges with recruitment and delivery of the intervention. Conclusions Level 4 Stepping Stones Triple P did not reduce early onset behaviours that challenge in very young children with moderate to severe intellectual disabilities. However, there was an effect on child behaviours for those who received a sufficient dose of the intervention. There is a high probability of Stepping Stones Triple P being at least cost neutral and therefore worth considering as an early therapeutic option given the long-term consequences of behaviours that challenge on people and their social networks. Future work Further research should investigate the implementation of parenting groups for behaviours that challenge in this population, as well as the optimal mode of delivery to maximise engagement and subsequent outcomes. Study registration This study is registered as NCT03086876 (https://www.clinicaltrials.gov/ct2/show/NCT03086876?term=Hassiotis±Angela&draw=1&rank=1). Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: HTA 15/162/02) and is published in full in Health Technology Assessment; Vol. 28, No. 6. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
| | - Rachel Royston
- Division of Psychiatry, University College London, London, UK
| | - Michael Absoud
- Evelina Hospital, Guys and St Thomas's NHS Foundation Trust, London, UK
| | - Gareth Ambler
- Department of Statistical Science, University College London, London, UK
| | - Chen Qu
- Department of Statistical Science, University College London, London, UK
| | - Jacqueline Barnes
- Department of Psychological Sciences, Birkbeck University, University of London, London, UK
| | - Rachael Hunter
- Research Department of Primary Care and Population Health, University College London, Royal Free Medical School, London, UK
| | - Monica Panca
- Research Department of Primary Care and Population Health, University College London, Royal Free Medical School, London, UK
| | - Marinos Kyriakopoulos
- South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, Maudsley Hospital, London, UK
- National and Kapodistrian University of Athens, Vyronas-Kessariani Community Mental Health Centre, Athens, Greece
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Eleni Paliokosta
- The Tavistock and Portman NHS Foundation Trust, Kentish Town Health Centre, London, UK
| | - Aditya Narain Sharma
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Newcastle University, Walkergate Park Centre for Neurorehabilitation and Neuropsychiatry, Newcastle upon Tyne, UK
| | - Vicky Slonims
- Evelina Hospital, Guys and St Thomas's NHS Foundation Trust, London, UK
| | | | | | - Megan Thomas
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | | | - Helen Leonard
- Great North Children's Hospital, Victoria Wing, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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3
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General Measurement Tools for Assessing Mental Health Problems Among Children and Adolescents with an Intellectual Disability: A Systematic Review. J Autism Dev Disord 2023; 53:132-204. [PMID: 35022944 PMCID: PMC9889433 DOI: 10.1007/s10803-021-05419-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 02/04/2023]
Abstract
There is a need for more knowledge of valid and standardized measures of mental health problems among children and adolescents with intellectual disability (ID). In this study, we systematically reviewed and evaluated the psychometric properties of instruments used to assess general mental health problems in this population. Following PRISMA guidelines, we reviewed empirical research published from 1980 through February 2020 with an updated search in March 2021 in Medline, Embase, PsycINFO, Health and Psychological Instruments, CINAHL, ERIC, and Web of Science databases. Forty-nine empirical articles were included in this review. Overall, the review indicated consistently better documentation of the reliability and validity of instruments designed for the ID population compared to instruments developed for the general child population.
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Shively KB, Tassé MJ. Using a Delphi Process to Update the Nisonger Child Behavior Rating Form. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:455-472. [PMID: 36306412 DOI: 10.1352/1944-7558-127.6.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/28/2021] [Indexed: 06/16/2023]
Abstract
The Nisonger Child Behavior Rating Form (NCBRF) was developed to specifically screen psychopathology and problem behavior in children and adolescents with IDD. This study aimed to update the NCBRF to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and screen for the most prevalent psychopathologies that affect children and adolescents with IDD. The authors re-aligned the existing items to fit within a DSM-5 framework, and then used the Delphi method with a panel of experts in IDD to evaluate the NCBRF items. The revision process included deleting and revising existing items and formulating new items. We obtained a final item pool after three iterations. The Delphi process and resulting item pool are described in this article.
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Affiliation(s)
| | - Marc J Tassé
- Kelsey B. Shively and Marc J. Tassé, The Ohio State University
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5
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Nag HE, Nærland T. Age-related changes in behavioural and emotional problems in Smith-Magenis syndrome measured with the Developmental Behavior Checklist. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 25:429-440. [PMID: 31984836 PMCID: PMC8649468 DOI: 10.1177/1744629519901056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2019] [Indexed: 05/29/2023]
Abstract
Smith-Magenis syndrome (SMS) is a genetic syndrome most often caused by a deletion on chromosome 17 or more rarely by a mutation in the retinoic acid-induced 1 gene. The aim of this study was to investigate the Developmental Behavior Checklist (DBC) profile of persons with SMS and the associations between behavioural and emotional problems, age, gender, adaptive behaviour and autism symptomatology. Twenty-eight persons with SMS were represented by their parents in this study. DBC Total scores are reduced with age, but they still show a mean that is clearly above the cut-off of 46. The differences between the age groups <9 years and 9-17 years (p = 0.024) and between the age groups <9 years and >18 years (p = 0.007) are significant. We found a significant decrease in behavioural and emotional problems with age in SMS. We did not find a relationship between adapted behaviour and communication and behavioural and emotional problems.
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Affiliation(s)
- Heidi Elisabeth Nag
- Heidi Elisabeth Nag, Frambu Resource Centre
for Rare Disorders, Sandbakkveien 18, 1404 Siggerud, Norway; University of
Stavanger, Kjell Arholmsgate 41, 4036 Stavanger, Norway.
| | - Terje Nærland
- Oslo University Hospital, Norway; University of
Oslo, Norway
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6
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Buckley N, Glasson EJ, Chen W, Epstein A, Leonard H, Skoss R, Jacoby P, Blackmore AM, Srinivasjois R, Bourke J, Sanders RJ, Downs J. Prevalence estimates of mental health problems in children and adolescents with intellectual disability: A systematic review and meta-analysis. Aust N Z J Psychiatry 2020; 54:970-984. [PMID: 32475125 DOI: 10.1177/0004867420924101] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Children and adolescents with intellectual disability are at risk of developing psychiatric symptoms and disorders; yet, the estimates reported in the literature have been inconsistent, presenting a potential barrier for service planning and delivery. Sources of variability could arise from differences in measurement instruments as well as subgroup membership by severity of intellectual disability, gender and age. This systematic review aimed to address these gaps. METHOD MEDLINE and PsycINFO databases were searched from inception to 2018 and selected studies were reviewed. Studies were included if they reported point prevalence estimates of mental health symptomology or diagnoses in a general population of 6- to 21-year-old individuals with intellectual disability. The Joanna Briggs Institute Prevalence Critical Appraisal Checklist was applied to eligible papers to appraise their scientific strength. Pooled prevalence for mental health symptomology was determined using a random-effects meta-analysis. RESULTS A total of 19 studies were included, including 6151 children and adolescents. The pooled prevalence estimate captured by the Developmental Behaviour Checklist was 38% (95% confidence interval = [31, 46]), contrasting with 49% (95% confidence interval = [46, 51]) captured by the Child Behaviour Checklist; both rates were higher than a non-intellectual disability population. Severity of intellectual disability did not significantly influence the Developmental Behaviour Checklist risks. Insufficient data were available to conduct statistical analyses on the effects of age, gender and socioeconomic status. Of diagnosed psychiatric disorders, attention deficit/hyperactivity disorder (30%), conduct disorder (3-21%) and anxiety disorders (7-34%) were the most prevalent conditions. CONCLUSION This review consists of the largest sample hitherto evaluated. In the intellectual disability population, mental health comorbidities could be better detected by a symptom phenotype than a psychiatric diagnostic phenotype. Crucially, future research needs to address the effect of measurement validity in the intellectual disability population. Estimated prevalence rates were high compared to the general population, indicating the importance of systematic screening, case detection and appropriate management.
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Affiliation(s)
- Nicholas Buckley
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Emma J Glasson
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Wai Chen
- Mental Health Service, Fiona Stanley Hospital, Department of Health, Perth, WA, Australia.,Centre for Child and Adolescent Related Disorders, Graduate School of Education, The University of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Current affiliations: Mental Health Service, Fiona Stanley Hospital, Department of Health, Perth, WA, Australia; School of Medicine, Notre Dame University, Fremantle, Perth, WA, Australia and College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
| | - Amy Epstein
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Rachel Skoss
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Peter Jacoby
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Amanda Marie Blackmore
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.,Therapy and Other Health Services, Ability Centre, Perth, WA, Australia
| | | | - Jenny Bourke
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | | | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
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Tournier T, Hendriks AH, Jahoda A, Hastings RP, Embregts PJCM. Developing a Logic Model for the Triple‐C Intervention: A Practice‐Derived Intervention to Support People with Intellectual Disability and Challenging Behavior. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12333] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tess Tournier
- Tilburg University Tilburg The Netherlands
- ASVZ Sliedrecht The Netherlands
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Farris O, Royston R, Absoud M, Ambler G, Barnes J, Hunter R, Kyriakopoulos M, Oulton K, Paliokosta E, Panca M, Paulauskaite L, Poppe M, Ricciardi F, Sharma A, Slonims V, Summerson U, Sutcliffe A, Thomas M, Hassiotis A. Clinical and cost effectiveness of a parent mediated intervention to reduce challenging behaviour in pre-schoolers with moderate to severe intellectual disability (EPICC-ID) study protocol: a multi-centre, parallel-group randomised controlled trial. BMC Psychiatry 2020; 20:35. [PMID: 32000729 PMCID: PMC6993328 DOI: 10.1186/s12888-020-2451-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/21/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Children with intellectual disabilities are likely to present with challenging behaviour. Parent mediated interventions have shown utility in influencing child behaviour, although there is a paucity of UK research into challenging behaviour interventions in this population. NICE guidelines favour Stepping Stones Triple P (SSTP) as a challenging behaviour intervention and this trial aims to evaluate its clinical and cost effectiveness in preschool children with moderate to severe intellectual disabilities. METHODS This trial launched in 2017 at four sites across England, with the aim of recruiting 258 participants (aged 30-59 months). The Intervention Group receive nine weeks of SSTP parenting therapy (six group sessions and three individualised face to face or telephone sessions) in addition to Treatment as Usual, whilst the Treatment as Usual only group receive other available services in each location. Both study groups undergo the study measurements at baseline and at four and twelve months. Outcome measures include parent reports and structured observations of behaviour. Service use and health related quality of life data will also be collected to carry out a cost effectiveness and utility evaluation. DISCUSSION Findings from this study will inform policy regarding interventions for challenging behaviour in young children with moderate to severe intellectual disabilities. TRIAL REGISTRATION NUMBER Clinicaltrials.gov, NCT03086876. Registered 22nd March 2017, https://clinicaltrials.gov/ct2/show/NCT03086876.
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Affiliation(s)
- Olayinka Farris
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Rachel Royston
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Michael Absoud
- Evelina London Children’s Hospital, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH and King’s College London, Strand, London, WC2R 2LS UK
| | - Gareth Ambler
- Department of Statistical Science, University College London, Gower Street, London, WC1E 6BT UK
| | - Jacqueline Barnes
- Department of Psychological Sciences, Birbeck University of London, Malet Street, London, WC1E 7HX UK
| | - Rachael Hunter
- Research Department of Primary Care and Population Health, Royal Free Medical School, NW3 2PF, London, UK
| | - Marinos Kyriakopoulos
- South London and Maudsley NHS Foundation Trust and Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, PO66 De Crespigny Park, London, SE5 8AF UK
| | - Kate Oulton
- Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH UK
| | - Eleni Paliokosta
- The Effra Clinic, 4th Floor, 86-90 Paul Street, London, EC2A 4NE UK
| | - Monica Panca
- Research Department of Primary Care and Population Health, Royal Free Medical School, NW3 2PF, London, UK
| | - Laura Paulauskaite
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Michaela Poppe
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Federico Ricciardi
- Department of Statistical Science, University College London, Gower Street, London, WC1E 6BT UK
| | - Aditya Sharma
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE1 7RU UK
| | - Vicky Slonims
- Evelina London Children’s Hospital, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH and King’s College London, Strand, London, WC2R 2LS UK
| | | | | | - Megan Thomas
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool Victoria Hospital, Whinney Heys Road, Blackpool, FY3 8NR UK
| | - Angela Hassiotis
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
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Beresford B, McDaid C, Parker A, Scantlebury A, Spiers G, Fairhurst C, Hewitt C, Wright K, Dawson V, Elphick H, Thomas M. Pharmacological and non-pharmacological interventions for non-respiratory sleep disturbance in children with neurodisabilities: a systematic review. Health Technol Assess 2019; 22:1-296. [PMID: 30382936 DOI: 10.3310/hta22600] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There is uncertainty about the most appropriate ways to manage non-respiratory sleep disturbances in children with neurodisabilities (NDs). OBJECTIVE To assess the clinical effectiveness and safety of NHS-relevant pharmacological and non-pharmacological interventions to manage sleep disturbance in children and young people with NDs, who have non-respiratory sleep disturbance. DATA SOURCES Sixteen databases, including The Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE, were searched up to February 2017, and grey literature searches and hand-searches were conducted. REVIEW METHODS For pharmacological interventions, only randomised controlled trials (RCTs) were included. For non-pharmacological interventions, RCTs, non-randomised controlled studies and before-and-after studies were included. Data were extracted and quality assessed by two researchers. Meta-analysis and narrative synthesis were undertaken. Data on parents' and children's experiences of receiving a sleep disturbance intervention were collated into themes and reported narratively. RESULTS Thirty-nine studies were included. Sample sizes ranged from 5 to 244 participants. Thirteen RCTs evaluated oral melatonin. Twenty-six studies (12 RCTs and 14 before-and-after studies) evaluated non-pharmacological interventions, including comprehensive parent-directed tailored (n = 9) and non-tailored (n = 8) interventions, non-comprehensive parent-directed interventions (n = 2) and other non-pharmacological interventions (n = 7). All but one study were reported as having a high or unclear risk of bias, and studies were generally poorly reported. There was a statistically significant increase in diary-reported total sleep time (TST), which was the most commonly reported outcome for melatonin compared with placebo [pooled mean difference 29.6 minutes, 95% confidence interval (CI) 6.9 to 52.4 minutes; p = 0.01]; however, statistical heterogeneity was extremely high (97%). For the single melatonin study that was rated as having a low risk of bias, the mean increase in TST was 13.2 minutes and the lower CI included the possibility of reduced sleep time (95% CI -13.3 to 39.7 minutes). There was mixed evidence about the clinical effectiveness of the non-pharmacological interventions. Sixteen studies included interventions that investigated the feasibility, acceptability and/or parent or clinician views of sleep disturbance interventions. The majority of these studies reported the 'family experience' of non-pharmacological interventions. LIMITATIONS Planned subgroup analysis was possible in only a small number of melatonin trials. CONCLUSIONS There is some evidence of benefit for melatonin compared with placebo, but the degree of benefit is uncertain. There are various types of non-pharmacological interventions for managing sleep disturbance; however, clinical and methodological heterogeneity, few RCTs, a lack of standardised outcome measures and risk of bias means that it is not possible to draw conclusions with regard to their effectiveness. Future work should include the development of a core outcome, further evaluation of the clinical effectiveness and cost-effectiveness of pharmacological and non-pharmacological interventions and research exploring the prevention of, and methods for identifying, sleep disturbance. Research mapping current practices and exploring families' understanding of sleep disturbance and their experiences of obtaining help may facilitate service provision development. STUDY REGISTRATION This study is registered as PROSPERO CRD42016034067. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Adwoa Parker
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Gemma Spiers
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Caroline Fairhurst
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Heather Elphick
- Department of Respiratory Medicine, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Megan Thomas
- Blenheim House Child Development Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
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10
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Sandjojo J, Zedlitz AMEE, Gebhardt WA, Hoekman J, Dusseldorp E, den Haan JA, Evers AWM. Training staff to promote self-management in people with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:840-850. [PMID: 29479785 DOI: 10.1111/jar.12440] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with intellectual disabilities have increasing difficulties managing their daily affairs. This study examined the effectiveness of a staff training, which teaches staff to promote self-management in people with intellectual disabilities. METHOD Effectiveness was assessed with questionnaires addressing clients' (n = 26) independence and self-reliance, support needs and challenging behaviour, using a pre-posttest control group design. Additionally, focus groups were conducted with trained staff members 6 months after the training. RESULTS In the long term, the intervention group showed a significant increase in independence and self-reliance, in contrast to the comparison group. No effect was found on support needs and challenging behaviour. Trained staff members reported limited benefits of the training, but had noticed changes in their attitude and method of working afterwards. CONCLUSIONS Further self-management research is required to investigate how independence and self-reliance can be promoted more effectively in this population. Future trainings should carefully consider their content, format, and implementation.
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Affiliation(s)
- Janice Sandjojo
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands.,Raamwerk, Noordwijkerhout, The Netherlands
| | - Aglaia M E E Zedlitz
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Winifred A Gebhardt
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Joop Hoekman
- Clinical Child and Adolescent Studies, Institute of Education and Child studies, Leiden University, Leiden, The Netherlands
| | - Elise Dusseldorp
- Methodology and Statistics Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | | | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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11
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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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12
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Kirk H, Gray K, Ellis K, Taffe J, Cornish K. Impact of Attention Training on Academic Achievement, Executive Functioning, and Behavior: A Randomized Controlled Trial. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 122:97-117. [PMID: 28257246 DOI: 10.1352/1944-7558-122.2.97] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Children with intellectual and developmental disabilities (IDD) experience significant difficulties in attention, learning, executive functions, and behavioral regulation. Emerging evidence suggests that computerized cognitive training may remediate these impairments. In a double blind controlled trial, 76 children with IDD (4-11 years) were randomized to either an attention training (n = 38) or control program (n = 38). Both programs were completed at home over a 5-week period. Outcome measures assessed literacy, numeracy, executive functioning, and behavioral/emotional problems, and were conducted at baseline, post-training, and 3-month follow-up. No training effects were observed at post-training; however, children in the training group showed greater improvements in numeracy skills at the 3-month follow-up. These results suggest that attention training may be beneficial for children with IDD; however, the modest nature of the intervention effects indicate that caution should be taken when interpreting clinical significance.
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Affiliation(s)
- Hannah Kirk
- Hannah Kirk, Kylie Gray, Kirsten Ellis, John Taffe, and Kim Cornish, Monash University, Australia
| | - Kylie Gray
- Hannah Kirk, Kylie Gray, Kirsten Ellis, John Taffe, and Kim Cornish, Monash University, Australia
| | - Kirsten Ellis
- Hannah Kirk, Kylie Gray, Kirsten Ellis, John Taffe, and Kim Cornish, Monash University, Australia
| | - John Taffe
- Hannah Kirk, Kylie Gray, Kirsten Ellis, John Taffe, and Kim Cornish, Monash University, Australia
| | - Kim Cornish
- Hannah Kirk, Kylie Gray, Kirsten Ellis, John Taffe, and Kim Cornish, Monash University, Australia
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13
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Azad G, Reisinger E, Xie M, Mandell DS. Parent and Teacher Concordance on the Social Responsiveness Scale for Children with Autism. SCHOOL MENTAL HEALTH 2015; 8:368-376. [PMID: 27617039 DOI: 10.1007/s12310-015-9168-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There are inconsistent findings regarding parent and teacher agreement on behavioral ratings of their children with autism. One possible reason for this inconsistency is that studies have not taken autism severity into account. This study examined parent and teacher concordance of social behavior based on symptom severity for children with autism. Participants were 123 parent-teacher dyads who completed the Social Responsiveness Scale. Symptom severity was assessed using the Autism Diagnostic Observation Schedule (ADOS). Results indicated that parent and teacher ratings were statistically significantly correlated at the beginning and end of the academic year, but only for severely affected children. Teacher report of social deficits was correlated with symptom severity as measured by the ADOS; parent report was not. These findings have implications for improving assessment procedures and parent-teacher collaboration.
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Affiliation(s)
- Gazi Azad
- University of Pennsylvania Perelman School of Medicine, Center for Mental Health Policy & Services Research, 3535 Market Street, 3 Floor, Philadelphia, PA, 19104-3309
| | - Erica Reisinger
- University of Pennsylvania Perelman School of Medicine, Center for Mental Health Policy & Services Research, 3535 Market Street, 3 Floor, Philadelphia, PA, 19104-3309
| | - Ming Xie
- University of Pennsylvania Perelman School of Medicine, Center for Mental Health Policy & Services Research, 3535 Market Street, 3 Floor, Philadelphia, PA, 19104-3309
| | - David S Mandell
- University of Pennsylvania Perelman School of Medicine, Center for Mental Health Policy & Services Research, 3535 Market Street, 3 Floor, Philadelphia, PA, 19104-3309
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14
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Stratis EA, Lecavalier L. Informant agreement for youth with autism spectrum disorder or intellectual disability: a meta-analysis. J Autism Dev Disord 2015; 45:1026-41. [PMID: 25253177 DOI: 10.1007/s10803-014-2258-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study investigated informant agreement on emotional and behavior problems and social skills in youth with autism spectrum disorder or intellectual disability using meta-analytic methods. Forty-nine studies were included, consisting of 107 effect sizes. The mean weighted effect size across all raters and all behaviors was .36, reflecting moderate agreement. Consistent with meta-analyses in typically developing youth, pairs of similar informants (e.g., parent-parent) demonstrated higher agreement compared to pairs of different raters (e.g., parent-teacher). With all rater pairs combined, agreement was significantly higher for externalizing problems (r = .42) than either internalizing problems (r = .35) or social skills (r = .30). Several factors appear to moderate the level of agreement among informants, including the youth's diagnosis, age, and IQ.
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Affiliation(s)
- Elizabeth A Stratis
- Department of Psychology, Nisonger Center, Ohio State University, 371D McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210, USA
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15
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Reardon TC, Gray KM, Melvin GA. Anxiety disorders in children and adolescents with intellectual disability: Prevalence and assessment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:175-190. [PMID: 25462478 DOI: 10.1016/j.ridd.2014.10.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 10/02/2014] [Indexed: 06/04/2023]
Abstract
Children and adolescents with intellectual disability are known to experience mental health disorders, but anxiety disorders in this population have received relatively little attention. Firstly, this paper provides a review of published studies reporting prevalence rates of anxiety disorders in children and adolescents with intellectual disability. Secondly, the paper reviews measures of anxiety that have been evaluated in children/adolescents with intellectual disability, and details the associated psychometric properties. Seven studies reporting prevalence rates of anxiety disorders in this population were identified, with reported rates varying from 3% to 22%. Two-one studies evaluating a measure of anxiety in a sample of children/adolescents with intellectual disability were identified. While these studies indicate that several measures show promise, further evaluation studies are needed; particularly those that evaluate the capacity of measures to screen for anxiety disorders, not only measure symptoms.
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Affiliation(s)
- Tessa C Reardon
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Australia
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Australia.
| | - Glenn A Melvin
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Australia
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16
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Khor AS, Melvin GA, Reid SC, Gray KM. Coping, daily hassles and behavior and emotional problems in adolescents with high-functioning autism/Asperger's Disorder. J Autism Dev Disord 2014; 44:593-608. [PMID: 23933998 DOI: 10.1007/s10803-013-1912-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Although daily hassles and coping are associated with behavior and emotional problems in non-clinical populations, few studies have investigated these relationships in individuals with high-functioning autism/Asperger's Disorder (HFASD). This study examined the relationships between daily hassles, coping and behavior and emotional problems in adolescents with HFASD. Thirty-one adolescents with HFASD completed questionnaires assessing their coping and behavior and emotional problems, and completed an Ecological Momentary Assessment run via a mobile phone application on their coping and daily hassles. Parents completed questionnaires of the adolescents' daily hassles, coping, and behavior and emotional problems. The disengagement coping style was associated with significantly higher levels of behavior and emotional problems regardless of respondent or methodology, suggesting it may be a valuable target for intervention.
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Affiliation(s)
- Angela S Khor
- Centre for Developmental Psychiatry and Psychology, School of Psychology & Psychiatry, Monash University, Early in Life Mental Health Service, Monash Medical Centre, 246 Clayton Rd, Clayton, VIC, 3168, Australia,
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17
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Payakachat N, Tilford JM, Kuhlthau KA, van Exel NJ, Kovacs E, Bellando J, Pyne JM, Brouwer WBF. Predicting health utilities for children with autism spectrum disorders. Autism Res 2014; 7:649-63. [PMID: 25255789 DOI: 10.1002/aur.1409] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 08/01/2014] [Indexed: 11/09/2022]
Abstract
Comparative effectiveness of interventions for children with autism spectrum disorders (ASDs) that incorporates costs is lacking due to the scarcity of information on health utility scores or preference-weighted outcomes typically used for calculating quality-adjusted life years (QALYs). This study created algorithms for mapping clinical and behavioral measures for children with ASDs to health utility scores. The algorithms could be useful for estimating the value of different interventions and treatments used in the care of children with ASDs. Participants were recruited from two Autism Treatment Network sites. Health utility data based on the Health Utilities Index Mark 3 (HUI3) for the child were obtained from the primary caregiver (proxy-reported) through a survey (N = 224). During the initial clinic visit, proxy-reported measures of the Child Behavior Checklist, Vineland II Adaptive Behavior Scales, and the Pediatric Quality of Life Inventory 4.0 (start measures) were obtained and then merged with the survey data. Nine mapping algorithms were developed using the HUI3 scores as dependent variables in ordinary least squares regressions along with the start measures, the Autism Diagnostic Observation Schedule, to measure severity, child age, and cognitive ability as independent predictors. In-sample cross-validation was conducted to evaluate predictive accuracy. Multiple imputation techniques were used for missing data. The average age for children with ASDs in this study was 8.4 (standard deviation = 3.5) years. Almost half of the children (47%) had cognitive impairment (IQ ≤ 70). Total scores for all of the outcome measures were significantly associated with the HUI3 score. The algorithms can be applied to clinical studies containing start measures of children with ASDs to predict QALYs gained from interventions.
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Affiliation(s)
- Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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18
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Gray KM, Piccinin A, Keating CM, Taffe J, Parmenter TR, Hofer S, Einfeld SL, Tonge BJ. Outcomes in young adulthood: are we achieving community participation and inclusion? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:734-745. [PMID: 23865802 DOI: 10.1111/jir.12069] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/24/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Despite recognition of the importance of integrated community living and support, there is evidence that parents remain the primary caregivers of young adults with intellectual disability (ID). In addition, employment rates remain low in this population. This study aimed to investigate the changes in living arrangements and participation in daytime activities over time in a community population of young people with ID. METHOD The sample consisted of 536 participants aged 4.0-18.9 years at Wave 1, followed up at Wave 5 when aged 20.5-37.6 years. Information was collected on their living arrangements and daytime activities at both time points, along with living skills and information on community social inclusion at Wave 5. For parents still caring for their adult child with ID, information was also collected on parental ratings of their own mental and physical health, and their satisfaction with the long-term care arrangements for their adult child. RESULTS A significant proportion of young people were still living with their parents at Wave 5. A greater proportion of those with a severe-profound degree of ID were living in residential care. Parents caring for their adult child reported high levels of mental health problems and dissatisfaction with the long-term care arrangements for their child. A small proportion of young people were in paid employment, and the majority was engaged in structured activities provided for those with an ID. Over one-third of the sample participated in a structured daytime activity for 10 or fewer hours per week, and 7% were not engaged in any structured daytime activity. CONCLUSIONS These results suggest that adequate provision of accommodation and employment services for young adults with an ID is lacking. In many cases the responsibility of care continues to reside with parents as their children transition from childhood to adulthood. Greater attention is needed to address these issues and facilitate social inclusion and integration for young people with ID.
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Affiliation(s)
- K M Gray
- Centre for Developmental Psychiatry & Psychology, School of Psychology & Psychiatry, Monash University, Melbourne, Vic., Australia
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19
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20
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Dumont E, Kroes D, Korzilius H, Didden R, Rojahn J. Psychometric properties of a Dutch version of the behavior problems inventory-01 (BPI-01). RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:603-610. [PMID: 24472503 DOI: 10.1016/j.ridd.2014.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 01/03/2014] [Indexed: 06/03/2023]
Abstract
There are only a limited number of Dutch validated measurement instruments for measuring behavioral problems in people with a moderate to profound intellectual disability. In this study, the psychometric properties of a Dutch version of the behavior Problems Inventory-01 (BPI-01; Rojahn et al., 2001) have been investigated among 195 people with a moderate to profound intellectual disability who live in a residential facility. The BPI-01 was completed by 42 informants (staff members) of 23 care units. The inter-rater reliability, intra-rater reliability and internal consistency turned out to be good. Factor analysis confirmed two of the three a priori factors and the third factor was a mix of self-injurious (SIB) behavior and stereotypic behavior. The BPI-01 was compared to the Aberrant Behavior Checklist (Aman et al., 1985a) and showed a good convergent validity. This study shows that a Dutch version of the BPI-01 has good psychometric properties for measuring behavior problems in individuals with moderate to profound intellectual disability.
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Affiliation(s)
| | | | | | - Robert Didden
- Trajectum and Radboud University Nijmegen, The Netherlands
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21
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Moss AHB, Gordon JE, O’Connell A. Impact of Sleepwise: An Intervention for Youth with Developmental Disabilities and Sleep Disturbance. J Autism Dev Disord 2014; 44:1695-707. [DOI: 10.1007/s10803-014-2040-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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22
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Funcionamiento intelectual límite: guía de consenso y buenas prácticas. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2013; 6:109-20. [DOI: 10.1016/j.rpsm.2012.12.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 11/19/2012] [Accepted: 12/17/2012] [Indexed: 11/20/2022]
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23
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Van Balkom IDC, Vuijk PJ, Franssens M, Hoek HW, Hennekam RCM. Development, cognition, and behaviour in Pitt-Hopkins syndrome. Dev Med Child Neurol 2012; 54:925-31. [PMID: 22712893 DOI: 10.1111/j.1469-8749.2012.04339.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIM The aim of the study was to collect detailed data on behavioural, adaptive, and psychological functioning in 10 individuals with Pitt-Hopkins syndrome (PTHS), with specific attention to manifestations of autism spectrum disorder (ASD). METHOD The participants (four females, six males), residing in the Netherlands and Belgium, were ascertained through the Dutch national PTHS support group. Median age of participants was 10 years, the age range was between 32 and 289 months. They underwent psychiatric examinations and neuropsychological measurements using a comprehensive assessment battery. Additionally, parental information was gathered through standardized interviews and questionnaires. Findings were compared with those from the literature. RESULTS All participants showed profound intellectual disability, amiable demeanour with minimal maladaptive behaviours, severe impairments of communication and language, and intense, frequent motor stereotypies. Impairments in all participants were beyond what would be expected for cognitive abilities, fitting a classification of ASD. INTERPRETATION Patients with PTHS are characterized not only by specific physical and genetic manifestations but also by specific behavioural and cognitive characteristics. Studying behaviour and cognition may improve diagnosis and prognosis, allows recognition of comorbidities, and contributes to adequate counselling of families.
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Affiliation(s)
- Ingrid D C Van Balkom
- Jonx Department of Youth Mental Health, Lentis Psychiatric Institute, Zuidlaren, the Netherlands.
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24
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Vrijmoeth C, Monbaliu E, Lagast E, Prinzie P. Behavioral problems in children with motor and intellectual disabilities: prevalence and associations with maladaptive personality and marital relationship. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1027-1038. [PMID: 22502827 DOI: 10.1016/j.ridd.2012.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 01/24/2012] [Accepted: 01/24/2012] [Indexed: 05/31/2023]
Abstract
Prevalence rates of behavioral problems in children with motor disabilities are commonly based on questionnaires developed for a general population (e.g., Child Behavior CheckList). These questionnaires do not take into account lower levels of intellectual functioning. The first aim of this study was to examine the prevalence of parent-reported and daily caretaker-reported behavioral problems in children with motor and intellectual disabilities (MID) using the Developmental Behavior Checklist. Second, we investigated whether behavioral problems were related to sex and age. Our third and fourth aim were to determine whether behavioral problems are related to maladaptive personality traits and to marital stress and conflict. Participants were 101 Flemish children with MID (mean age=14 years 6 months). For total behavioral problems, we found prevalence rates of 18% and 8% based on parent and daily caretaker reports, respectively. Based on parent reports, twenty seven percent of the children with MID exhibited anxiety problems. Behavioral problems were not related to sex. Older children showed fewer behavioral problems than younger children. Multiple hierarchical regression analyses revealed that lower scores on Compulsivity and higher scores on Emotional Instability and Disagreeableness were related to behavioral problems. In addition to personality traits, stress and conflict in the marital relationship was also positively associated with behavioral problems. Given the importance of behavioral problems in children with MID, this study is of theoretical and clinical interest and has the potential to inform targeted clinical interventions.
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Affiliation(s)
- Cis Vrijmoeth
- Department of Child and Adolescent Studies, Utrecht University, The Netherlands
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25
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Park CJ, Yelland GW, Taffe JR, Gray KM. Brief Report: The Relationship Between Language Skills, Adaptive Behavior, and Emotional and Behavior Problems in Pre-schoolers with Autism. J Autism Dev Disord 2012; 42:2761-6. [DOI: 10.1007/s10803-012-1534-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Gray K, Keating C, Taffe J, Brereton A, Einfeld S, Tonge B. Trajectory of behavior and emotional problems in autism. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 117:121-133. [PMID: 22515827 DOI: 10.1352/1944-7588-117-2.121] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
High rates of behavior and emotional problems have been consistently reported in children and adolescents with autism. Elevated rates of mental health problems have also been reported in adults with autism. Little is known, however, about the longitudinal development of behavior and emotional problems in autism. This study followed a cohort of children and adolescents over 18 years. Outcomes were evaluated in terms of behavior and emotional problems and autism symptomatology. The role of childhood factors (age, gender, IQ, behavior, and emotional problems) and the environment (socioeconomic disadvantage) were considered in terms of adult outcomes. Overall, improvements in comorbid behavior and emotional problems and autism symptomatology were observed. However, rates of comorbid behavior and emotional problems in adulthood remained high.
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Affiliation(s)
- Kylie Gray
- Monash University, Clayton, Victoria, Australia
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Matson JL, Belva BC, Hattier MA, Matson ML. Scaling methods to measure psychopathology in persons with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:549-562. [PMID: 22119704 DOI: 10.1016/j.ridd.2011.10.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 09/15/2011] [Indexed: 05/31/2023]
Abstract
Psychopathology prior to the last four decades was generally viewed as a set of problems and disorders that did not occur in persons with intellectual disabilities (ID). That notion now seems very antiquated. In no small part, a revolutionary development of scales worldwide has occurred for the assessment of emotional problems in persons with ID. The first standardized test to emerge was the Psychopathology Instrument for Mentally Retarded Adults (PIMRA) in 1984. Since that time, an impressive number of measures of general psychopathology have emerged for adults and children as well as for persons across the full range of levels of ID. The purpose of this review was to provide a description of available measures, to review papers published on these measures, and to discuss emerging trends in test development. The trends in this body of information for enhancing differential diagnosis of psychopathology in persons with ID are discussed.
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Affiliation(s)
- Johnny L Matson
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA.
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28
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Poon KK. Challenging behaviors among children with autism spectrum disorders and multiple disabilities attending special schools in Singapore. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:578-582. [PMID: 22119707 DOI: 10.1016/j.ridd.2011.10.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 10/31/2011] [Accepted: 10/31/2011] [Indexed: 05/31/2023]
Abstract
This study sought to understand the profile of and the factors which impact upon challenging behaviors among children with autism spectrum disorders (ASD) and multiple disabilities (MD). Teachers of 322 and 132 children with ASD and MD, respectively, attending special schools in Singapore, completed the Developmental Behavior Checklist, Teacher Version (DBC-T; Einfeld & Tonge, 1995). The findings suggest that children with ASD exhibit elevated levels of challenging behavior in all areas, relative to children with MD. Multiple regression analyses also indicate that diagnostic category was associated with all aspects of challenging behavior measured by the DBC-T. In addition, age was associated with only disruptive/antisocial behaviors in this study. Theoretical and practical implications were discussed.
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Affiliation(s)
- Kenneth K Poon
- National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore.
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29
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Gray KM, Piccinin AM, Hofer SM, Mackinnon A, Bontempo DE, Einfeld SL, Parmenter T, Tonge BJ. The longitudinal relationship between behavior and emotional disturbance in young people with intellectual disability and maternal mental health. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:1194-204. [PMID: 21295442 PMCID: PMC3660029 DOI: 10.1016/j.ridd.2010.12.044] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 12/29/2010] [Indexed: 05/25/2023]
Abstract
Although elevated rates of parent psychosocial distress have been associated with child behavior and emotional problems, little is known about the nature of this relationship over time. This study followed an epidemiological cohort of children and adolescents over 11 years with 4 waves of data collection. Within this cohort, complete data were available on 238 mothers and their children. Behavior and emotional problems were assessed using the DBC, maternal mental health with the GHQ. Multivariate growth curve modelling was used to evaluate the commonality of individual change patterns. High levels of mental health problems were reported, which were stable over time. Higher scores on the DBC were associated with higher rates of mental health problems. Increases in child social relating problems were associated with increases mental health symptoms, particularly depression and anxiety.
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Affiliation(s)
- Kylie M Gray
- Centre for Developmental Psychiatry & Psychology, School of Psychology, Psychiatry & Psychological Medicine, Monash University, Australia.
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30
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Forster S, Gray KM, Taffe J, Einfeld SL, Tonge BJ. Behavioural and emotional problems in people with severe and profound intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:190-198. [PMID: 21199050 DOI: 10.1111/j.1365-2788.2010.01373.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND People with severe and profound levels of intellectual disability (ID) are frequently examined as a single group in research. However, these two groups may be significantly different, particularly in the area of emotional and behavioural difficulties. METHOD The Developmental Behaviour Checklist (DBC) was completed by parents and caregivers of 107 people with severe ID and 22 people with profound ID at four time periods across 12 years. Regression analyses were used to examine trends in sub-scale scores across time and groups. RESULTS Significant differences between the groups of people with severe and profound ID were found. People with profound ID had significantly lower scores across all sub-scales except Social Relating. This was usually related to fewer items being selected as present for people with profound ID, as opposed to the scores being attributable to lower item severity scores. CONCLUSIONS There are significant differences between groups of people with severe and profound ID in scores on the DBC, indicating differences in behavioural and emotional problems. Caution should be exercised by researchers treating these two disparate groups as a single group, and by practitioners translating such findings into practice.
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Affiliation(s)
- S Forster
- Centre for Developmental Psychiatry and Psychology, School of Psychology and Psychiatry, Monash University, Melbourne, Australia.
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31
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Kuhlthau K, Orlich F, Hall TA, Sikora D, Kovacs EA, Delahaye J, Clemons TE. Health-Related Quality of Life in children with autism spectrum disorders: results from the autism treatment network. J Autism Dev Disord 2010; 40:721-9. [PMID: 20033762 DOI: 10.1007/s10803-009-0921-2] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We examined data collected as a part of the Autism Treatment Network, a group of 15 autism centers across the United States and Canada. Mean Health-Related Quality of Life (HRQoL) scores of the 286 children assessed were significantly lower than those of healthy populations (according to published norms). When compared to normative data from children with chronic conditions, children with ASD demonstrated worse HRQoL for total, psychosocial, emotional and social functioning, but did not demonstrate differing scores for physical and school functioning. HRQoL was not consistently related to ASD diagnosis or intellectual ability. However, it was consistently related to internalizing and externalizing problems as well as repetitive behaviors, social responsiveness, and adaptive behaviors. Associations among HRQoL and behavioral characteristics suggest that treatments aimed at improvements in these behaviors may improve HRQoL.
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Affiliation(s)
- Karen Kuhlthau
- Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, MA, USA.
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Hampel OA, Hasmann SE, Schaadt AK, Holl R, Petermann F, Hasmann R. Effekte des Stepping Stones Elterngruppentrainings für Familien mit behinderten Kindern. KINDHEIT UND ENTWICKLUNG 2010. [DOI: 10.1026/0942-5403/a000007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Stepping Stones Triple P wurde als verhaltenstherapeutisch orientiertes Elterngruppentraining bereits in Australien erfolgreich evaluiert. Im Rahmen einer Multicenterstudie in verschiedenen Sozialpädiatrischen Zentren (SPZ) und weiterer Versorgungseinrichtungen wurde Stepping Stones Triple P als Elterngruppentraining eingeführt und auf seine Wirksamkeit im deutschen Sprachraum überprüft. Unsere Daten zeigen eine signifikante Reduktion dysfunktionalen Erziehungsverhaltens, elterlicher Belastungen und kindlicher Verhaltensprobleme. Die vorliegende Analyse zeigt, dass ungünstige psychosoziale Belastungen den Therapieerfolg stark reduzieren. Gute bzw. eingeschränkte elterlicher Mitarbeit beeinflussen dagegen den Therapieerfolg nur leicht.
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Affiliation(s)
| | | | | | | | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Reiner Hasmann
- Sozialpädiatrisches Zentrum der Marienhausklinik Kohlhof, Neunkirchen/Saar
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Hofer SM, Gray KM, Piccinin AM, Mackinnon A, Bontempo DE, Einfeld SL, Hoffman L, Parmenter T, Tonge BJ. Correlated and coupled within-person change in emotional and behavioral disturbance in individuals with intellectual disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2009; 114:307-321. [PMID: 19928014 PMCID: PMC2940276 DOI: 10.1352/1944-7558-114.5.307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Individual change and variation in emotional/behavioral disturbance in children and adolescents with intellectual disability has received little empirical investigation. Based on 11 years of longitudinal data from the Australian Child to Adult Development Study, we report associations among individual differences in level, rate of change, and occasion-specific variation across subscales of the Developmental Behavior Checklist (DBC) with 506 participants who had intellectual disability and were ages 5 to 19 years at study entry. Correlations among the five DBC subscales ranged from .43 to .66 for level, .43 to .88 for rate of change, and .31 to .61 for occasion-specific variation, with the highest correlations observed consistently between disruptive, self-absorbed, and communication disturbance behaviors. These interdependencies among dimensions of emotional/behavioral disturbance provide insight into the developmental dynamics of psychopathology from childhood through young adulthood.
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Affiliation(s)
- Scott M Hofer
- Department of Psychology, University of Victoria, Victoria, BC, Canada.
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Evenhuis HM, Sjoukes L, Koot HM, Kooijman AC. Does visual impairment lead to additional disability in adults with intellectual disabilities? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2009; 53:19-28. [PMID: 18771511 DOI: 10.1111/j.1365-2788.2008.01114.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND This study addresses the question to what extent visual impairment leads to additional disability in adults with intellectual disabilities (ID). METHOD In a multi-centre cross-sectional study of 269 adults with mild to profound ID, social and behavioural functioning was assessed with observant-based questionnaires, prior to expert assessment of visual function. With linear regression analysis the percentage of variance, explained by levels of visual function, was calculated for the total population and per ID level. RESULTS A total of 107/269 participants were visually impaired or blind (WHO criteria). On top of the decrease by ID visual impairment significantly decreased daily living skills, communication & language, recognition/communication. Visual impairment did not cause more self-absorbed and withdrawn behaviour or anxiety. Peculiar looking habits correlated with visual impairment and not with ID. In the groups with moderate and severe ID this effect seems stronger than in the group with profound ID. CONCLUSION Although ID alone impairs daily functioning, visual impairment diminishes the daily functioning even more. Timely detection and treatment or rehabilitation of visual impairment may positively influence daily functioning, language development, initiative and persistence, social skills, communication skills and insecure movement.
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Affiliation(s)
- H M Evenhuis
- Intellectual Disability Medicine, Erasmus Medical Center Rotterdam, Department of General Practice, Rotterdam, The Netherlands.
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de Ruiter KP, Dekker MC, Douma JCH, Verhulst FC, Koot HM. Development of Parent- and Teacher-Reported Emotional and Behavioural Problems in Young People with Intellectual Disabilities: Does Level of Intellectual Disability Matter? JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2007. [DOI: 10.1111/j.1468-3148.2007.00370.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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de Ruiter KP, Dekker MC, Verhulst FC, Koot HM. Developmental course of psychopathology in youths with and without intellectual disabilities. J Child Psychol Psychiatry 2007; 48:498-507. [PMID: 17501731 DOI: 10.1111/j.1469-7610.2006.01712.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to describe similarities and differences in the developmental course of psychopathology between children with and without intellectual disabilities (ID). METHODS Multilevel growth curve analysis was used to analyse the developmental course of psychopathology, using the Child Behavior Checklist (CBCL), in two longitudinal multiple-birth-cohort samples of 6- to 18-year-old children with ID (N = 978) and without ID (N = 2,047) using three repeated measurements across a 6-year period. RESULTS Children with ID showed a higher level of problem behaviours across all ages compared to children without ID. A significant difference between the samples in the developmental courses was found for Aggressive Behaviour and Attention Problems, where children with ID showed a significantly larger decrease. Gender differences in the development of psychopathology were similar in both samples, except for Social Problems where males with ID showed a larger decrease in problem behaviour across time than females with ID and males and females without ID. CONCLUSIONS Results indicate that children with ID continue to show a greater risk for psychopathology compared to typically developing children, although this higher risk is less pronounced at age 18 than it is at age 6 for Aggressive Behaviour. Contrary to our expectations, the developmental course of psychopathology in children with ID was quite similar from age 6 to 18 compared to children without ID. The normative developmental trajectories of psychopathology in children with ID, presented here, can serve as a yardstick against which development of childhood psychopathology can be detected as deviant.
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Affiliation(s)
- Karen P de Ruiter
- Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands
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de Bildt A, Mulder EJ, Scheers T, Minderaa RB, Tobi H. Pervasive developmental disorder, behavior problems, and psychotropic drug use in children and adolescents with mental retardation. Pediatrics 2006; 118:e1860-6. [PMID: 17142506 DOI: 10.1542/peds.2005-3101] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study investigated the interrelationship between psychopharmacotherapy in general and the use of specific psychotropic drugs and pervasive developmental disorder and other behavior problems in children and adolescents with mental retardation. METHODS A total of 862 participants 4 to 18 years of age, including all levels of mental retardation, were recruited through facilities for children with mental retardation in Friesland, The Netherlands. Information on medication was collected through parent interviews. Behavior problems were investigated with a standardized parent questionnaire (Developmental Behavior Checklist). A pervasive developmental disorder classification was based on the Pervasive Developmental Disorder in Mental Retardation Scale, completed by psychologists or teachers. Logistic regression analysis was used to investigate the relationship between the use of psychotropic drugs and pervasive developmental disorder and other behavioral problems, in the presence of possible confounders. RESULTS One of 10 participants used psychotropic medication. The main factors associated with psychotropic drug use were pervasive developmental disorder and disruptive behavior. The level of functioning was also associated. Self-absorbed behavior was statistically significantly associated with clonidine use and disruptive behavior with stimulant use. Pervasive developmental disorder and communication problems were the main factors associated with the use of antipsychotic drugs. Age also played a role, whereas gender, living situation, and level of mental retardation did not. CONCLUSIONS Antipsychotic drugs were associated with pervasive developmental disorder, whereas clonidine and stimulants were associated with self-absorbed and disruptive behavior, respectively. Although clonidine and risperidone are not registered for the problems reported and the other nonstimulants were only sometimes used on-label, their use was associated with specific psychiatric or behavioral problems.
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Affiliation(s)
- Annelies de Bildt
- University Medical Center Groningen/Accare, University Center for Child and Adolescent Psychiatry, PO Box 660, 9700 AR Groningen, The Netherlands.
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Hastings RP, Kovshoff H, Ward NJ, degli Espinosa F, Brown T, Remington B. Systems analysis of stress and positive perceptions in mothers and fathers of pre-school children with autism. J Autism Dev Disord 2006; 35:635-44. [PMID: 16177837 DOI: 10.1007/s10803-005-0007-8] [Citation(s) in RCA: 310] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Systemic analyses of psychological functioning in families of children with autism have typically shown that parents report different experiences (e.g., stress) and that siblings may also be affected. The purpose of the present research was more explicitly to address relationships between child, partner, and parent variables. Parents of 48 children with autism (41 mother-father pairs) reported on child characteristics, and their own stress and mental health. Mothers were found to report both more depression and more positive perceptions than fathers. Regression analyses revealed that paternal stress and positive perceptions were predicted by maternal depression; maternal stress was predicted by their children's behavior problems (not adaptive behavior or autism symptoms) and by their partner's depression. The future testing of the mechanisms underlying these results is discussed. In addition, the need is emphasized for more systemic analyses to understand the psychological functioning of children with autism and their siblings and parents.
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Bhuiyan ZA, Klein M, Hammond P, van Haeringen A, Mannens MMAM, Van Berckelaer-Onnes I, Hennekam RCM. Genotype-phenotype correlations of 39 patients with Cornelia De Lange syndrome: the Dutch experience. J Med Genet 2005; 43:568-75. [PMID: 16236812 PMCID: PMC2564552 DOI: 10.1136/jmg.2005.038240] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Cornelia de Lange syndrome (CdLS) is a multiple congenital anomaly syndrome characterised by a distinctive facial appearance, prenatal and postnatal growth deficiency, psychomotor delay, behavioural problems, and malformations of the upper extremities. Recently mutations in NIPBL, the human homologue of the Drosophila Nipped-B gene, were found to cause CdLS. Mutations have been found in 39% of reported cases. METHODS Patients were enrolled in the study and classified into one of four groups based on clinical examination: classic, mild, possible, or definitively not CdLS. Three dimensional photography was taken of 20 subjects, and compared between groups. Behaviour was assessed with specific attention to autism. We searched for mutations in NIPBL and correlated genotype with phenotype. RESULTS : We found mutations in 56% of cases. CONCLUSIONS Truncating mutations were generally found to cause a more severe phenotype but this correlation was not absolute. Three dimensional facial imaging demonstrated the potential for classifying facial features. Behavioural problems were highly correlated with the level of adaptive functioning, and also included autism. No correlation of behaviour with the type of mutation was found.
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Affiliation(s)
- Z A Bhuiyan
- Department of Clinical Genetics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Steinhausen HC, Winkler Metzke C. Der Verhaltensfragebogen bei Entwicklungsstörungen (VFE). ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2005. [DOI: 10.1026/1616-3443.34.4.266] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Hintergrund: Im deutschsprachigen Bereich besteht ein signifikantes Defizit an Verhaltensfragebögen zur Diagnostik bei Kindern mit schweren Entwicklungsstörungen, speziell geistiger Behinderung. Fragestellung: Die aus Australien stammende Developmental Behaviour Checklist (DBC) ist ein in der Verhaltensdiagnostik bei Kindern und Jugendlichen mit schweren Entwicklungsstörungen international breit eingesetzter Fragebogen zur Erfassung von Problemen des Verhaltens und der Emotionen. Die DBC wurde als Verhaltensfragebogen bei Entwicklungsstörungen (VFE) übersetzt und anhand der Daten einer umfangreiche Stichprobe von N = 721 Kindern und Jugendlichen mit geistiger Behinderung in Deutschland hinsichtlich ihrer psychometrischen Eigenschaften überprüft. Methode: Die psychometrischen Analysen umfassten verschiedene Analysen zur Validität und Reliabilität. Für die Normierung wurden Effekte von Alter, Geschlecht und Behinderungsgrad überprüft. Ergebnisse: Die fünf Faktoren der DBC konnten für den VFE repliziert werden. Neben der faktoriellen konnte auch die diskriminante und die kriteriumsbezogene Validität nachgewiesen werden. Die internen Konsistenzen waren für vier der fünf Subskalen gut bis sehr gut. Die Retest-Reliablität war nach einem beträchtlichen Intervall von 1.8 Jahren sehr hoch. Die Normierung berücksichtigt den Grad der Behinderung. Schlussfolgerungen: Mit der VFE in Übersetzung der DBC liegt ein sorgfältig konstruiertes Verhaltensinventar für Kinder und Jugendliche mit schweren Entwicklungsstörungen vor, das angemessene psychometrische Kennwerte aufweist und über deutsche Normwerte verfügt.
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Hastings RP, Beck A, Daley D, Hill C. Symptoms of ADHD and their correlates in children with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2005; 26:456-68. [PMID: 16168883 DOI: 10.1016/j.ridd.2004.10.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2004] [Revised: 09/28/2004] [Accepted: 10/15/2004] [Indexed: 05/04/2023]
Abstract
Existing research suggests that children with intellectual disabilities are at increased risk for ADHD, and that the symptoms of the disorder might successfully be treated with stimulant drugs. However, there has been little exploration of ADHD symptoms and their correlates in children with intellectual disabilities. Analyses of three samples of children with intellectual disabilities are presented (total N=338). Correlational analyses showed that younger children, and those with a diagnosis of Autism were rated as having more ADHD/hyperactivity symptoms. There was little evidence of a sex difference, and no strong associations with domains of adaptive behavior (socialization, communication, and daily living skills). However, there was a small but significant negative association between mental age and ratings of symptoms. Finally, an increased prevalence of ADHD/hyperactivity symptoms was confirmed in the children with intellectual disabilities compared to their siblings. This effect remained after controlling for chronological and mental age differences between the siblings. These findings support those from previous research and suggest that ADHD/Hyperkinesis may be a valid psychiatric diagnosis for children with intellectual disabilities. However, a great deal more research is needed to explore the phenomenology of ADHD in intellectual disability and to develop an evidence base for psychosocial intervention.
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Affiliation(s)
- Richard P Hastings
- School of Psychology, University of Wales Bangor, Bangor, Gwynedd, Wales LL57 2AS, UK.
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Baker BL, Blacher J, Olsson MB. Preschool children with and without developmental delay: behaviour problems, parents' optimism and well-being. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2005; 49:575-90. [PMID: 16011551 DOI: 10.1111/j.1365-2788.2005.00691.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Children with intellectual disability are at heightened risk for behaviour problems, and these are known to increase parenting stress. This study explored the relation of behaviour problems to less child-related domains of parent well-being (depression and marital adjustment), as well as the moderating effect of a personality trait, dispositional optimism. METHOD Participating children (N = 214) were classified as developmentally delayed, borderline, or nondelayed. Mothers' and fathers' well-being and child behaviour problems were assessed at child ages 3 and 4 years. RESULTS Parents of delayed and nondelayed preschoolers generally did not differ on depression or marital adjustment, but child behaviour problems were strongly related to scores on both measures. Optimism moderated this relationship, primarily for mothers. When child behaviour problems were high, mothers who were less optimistic reported lower scores on measures of well-being than did mothers who were more optimistic. CONCLUSIONS Interventions for parents that aim to enhance both parenting skills and psychological well-being should be available in preschool. It may be beneficial for such programmes to focus not only on behaviour management strategies aimed at child behaviour change, but also on parents' belief systems, with the aim of increasing dispositional optimism.
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Affiliation(s)
- B L Baker
- Department of Psychology, University of California, Los Angeles, CA 90095, USA.
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de Bildt A, Kraijer D, Sytema S, Minderaa R. The Psychometric Properties of the Vineland Adaptive Behavior Scales in Children and Adolescents with Mental Retardation. J Autism Dev Disord 2005; 35:53-62. [PMID: 15796122 DOI: 10.1007/s10803-004-1033-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The psychometric properties of the Vineland Adaptive Behavior Scales Survey Form were studied in a total population of children and adolescents with MR, and in the specific levels of functioning (n=826, age 4-18 years). The original division into (sub)domains, as assigned by the authors, was replicated in the total population and in the mild and moderate levels of functioning. In the severe and profound levels of functioning the structure was less well recognized. The reliability of the instrument proved to be good in the total population and the subgroups. The construct validity was high in all groups. The implications of these findings are discussed with respect to the usefulness of the Vineland for the population with MR.
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Affiliation(s)
- Annelies de Bildt
- Child and Adolescent Psychiatry, University of Groningen, The Netherlands.
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Emerson E, Robertson J, Wood J. Emotional and behavioural needs of children and adolescents with intellectual disabilities in an urban conurbation. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2005; 49:16-24. [PMID: 15634308 DOI: 10.1111/j.1365-2788.2005.00658.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Over the past decade, increased attention has been paid to identifying and responding to the emotional and behavioural needs of children and adolescents with intellectual disability (ID). The aims of the present study were to add to this body of knowledge by identifying factors associated with emotional and behavioural needs among a sample of children with ID drawn from a large urban conurbation. METHOD Information was collected by postal questionnaire (or interview for family carers who did not have English as their first language) from teachers and from family carers of 615 children administratively identified as having ID (47% of all children with ID). RESULTS Results indicated that: (1) the administrative prevalence of moderate but not severe ID was associated with social deprivation whereas the prevalence of severe but not moderate ID appeared to be associated with ethnicity; (2) 54% of children scored above the threshold on the Developmental Behaviour Checklist (DBC)-primary family carer, and 37% of children scored above the threshold on the DBC-teacher; (3) social deprivation, male gender, less severe ID and having fewer physical or sensory impairments were associated with antisocial and disruptive behaviour; and (4) more severe ID and additional impairments were associated with anxiety, communication disturbance, social relating and self-absorbed behaviours. CONCLUSIONS These results identify a range of risk factors associated with behavioural and emotional problems experienced by children with ID.
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Affiliation(s)
- E Emerson
- Institute for Health Research, Lancaster University, UK.
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Emerson E, Robertson J, Wood J. Levels of Psychological Distress Experienced by Family Carers of Children and Adolescents with Intellectual Disabilities in an Urban Conurbation. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2004. [DOI: 10.1111/j.1360-2322.2004.00183.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dekker MC, Koot HM. DSM-IV disorders in children with borderline to moderate intellectual disability. I: prevalence and impact. J Am Acad Child Adolesc Psychiatry 2003; 42:915-22. [PMID: 12874493 DOI: 10.1097/01.chi.0000046892.27264.1a] [Citation(s) in RCA: 189] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the prevalence, comorbidity, and impact of DSM-IV disorders in 7- to 20-year-olds with intellectual disability. METHOD A total of 474 children (response 86.8%) were randomly selected from a sample of students from Dutch schools for the intellectually disabled. Parents completed the anxiety, mood, and disruptive disorder modules of the Diagnostic Interview Schedule for Children. RESULTS A total of 21.9% of the children met the DSM-IV symptom criteria for anxiety disorder, 4.4% for mood disorder, and 25.1% for disruptive disorder. Similar prevalence rates were found for children who screened positive or negative for pervasive developmental disorder. More than half of the children meeting the criteria for a DSM-IV disorder were severely impaired in everyday functioning, and about 37% had a comorbid disorder. Children with multiple disorders were more likely to be impaired across various areas of everyday functioning. Almost 27% of the diagnosed children received mental health care in the last year. Comorbidity and impairment in everyday functioning increased the likelihood of referral. CONCLUSIONS Most disorders can be observed in intellectually disabled children. Impairment and comorbidity are high. The finding that less than one third of the children with a psychiatric disorder receive mental health care deserves attention.
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Affiliation(s)
- Marielle C Dekker
- Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, The Netherlands.
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Dekker MC, Koot HM. DSM-IV disorders in children with borderline to moderate intellectual disability. II: child and family predictors. J Am Acad Child Adolesc Psychiatry 2003; 42:923-31. [PMID: 12874494 DOI: 10.1097/01.chi.0000046891.27264.c1] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify child and family factors that predict DSM-IV disorders in children with intellectual disability. METHOD In 1997, a total of 968 6- to 18-year-olds were randomly selected from Dutch schools for intellectual disability (response 69.3%). Parents completed the Child Behavior Checklist, Developmental Behavior Checklist, Vineland Screener, and instruments addressing their child's physical health, family functioning, and parental mental health. One year later, parents of 474 children, randomly selected from the 1997 participants (response 86.8%), completed the anxiety, mood, and disruptive disorder modules of the Diagnostic Interview Schedule for Children-IV. RESULTS Both child and family factors were significantly related to DSM-IV outcome 1 year later. Social incompetence, inadequate daily living skills, child health problems, negative life events, emotional and behavioral problems, and parental mental health problems were the strongest predictors of DSM-IV disorders 1 year later. After correcting for the level of behavioral problems in the previous year, the first four factors proved to be significant risk factors for DSM-IV outcome. CONCLUSIONS These factors can improve the identification of children at risk and point to topics that need attention in diagnostic and intervention procedures.
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Affiliation(s)
- Marielle C Dekker
- Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, The Netherlands.
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Psychopathology in Children and Adolescents with Intellectual Disability: Measurement, Prevalence, Course, and Risk. INTERNATIONAL REVIEW OF RESEARCH IN MENTAL RETARDATION 2003. [DOI: 10.1016/s0074-7750(03)01003-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Dekker MC, Nunn RJ, Einfeld SE, Tonge BJ, Koot HM. Assessing emotional and behavioral problems in children with intellectual disability: revisiting the factor structure of the developmental behavior checklist. J Autism Dev Disord 2002; 32:601-10. [PMID: 12553596 DOI: 10.1023/a:1021263216093] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The objective of the reported study was to reassess the factor structure of the Developmental Behaviour Checklist (DBC) in a large cross-cultural sample representing all levels of intellectual disability. Parent and teacher DBC ratings on a combined sample of 1536 Dutch and Australian children and adolescents (ages 3-22) with mild to profound intellectual disability were used. Principal components analyses produced five subscales: Disruptive/Antisocial, Self-Absorbed. Communication Disturbance, Anxiety, and Social Relating, explaining 43.7% of the total variance. Internal consistencies of these subscales ranged from .66 to .91. The revised factor structure of the DBC appears to be an improved and useful tool for assessing emotional and behavioral problems in children with intellectual disabilities.
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Affiliation(s)
- Marielle C Dekker
- Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
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