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Smeets G, Volkers K, Scherder E, Moonen X. An Individual Music Intervention for Adults With Intellectual Disabilities and Challenging Behavior: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e52497. [PMID: 38324357 PMCID: PMC10882479 DOI: 10.2196/52497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Individuals with intellectual disabilities (ID) are more likely to have problems with executive functioning (EF) and challenging behavior (CB), which are negatively linked to well-being. Among clinical populations, music interventions have been shown to improve various outcome measures, such as CB and EF. Until now, no randomized controlled trials (RCTs) have been conducted to examine the effectiveness of an individual music intervention for adults with ID and CB. OBJECTIVE The study aims to identify the effect and feasibility of an individual music intervention compared with care-as-usual for people with ID and CB. METHODS In this study, a 2-group RCT with a pretest, posttest, and follow-up assessment after 8 weeks is presented. Participants of the music intervention condition will receive 16 individual music sessions within 8 to 10 weeks. The music intervention will be guided by a manual for music workers, in which every session will have a different focus (introduction, emotions, different EF, and end performance). Participants receiving care as usual will function as a control group. After the research is finished, they will be offered a budget, which they can spend on musical activities or musical instruments as they wish. Assessments will include caregiver rating scales and self-report questionnaires and tests, which will assess outcome measures of CB, well-being, depression, anxiety, self-esteem, and 4 domains of EF. A process evaluation will be conducted after the completion of the study, which entails the analysis of data on multiple aspects of the intervention and the study overall. RESULTS Enrollment commenced in July 2021, and data collection ended in May 2023. A total of 97 participants were recruited, with 44 participants allocated to the intervention group and 53 allocated to the control group. Data will be analyzed after this protocol has been accepted for publication. CONCLUSIONS Because there are currently no published RCTs of an individual music intervention for adults with ID and CB, this study will provide insight into the effectiveness and experiences of an individual music intervention for this target group. TRIAL REGISTRATION International Clinical Trials Registry Platform NL8482; http://tinyurl.com/4565s5pd. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52497.
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Affiliation(s)
| | - Karin Volkers
- Philadelphia Care Foundation, Amersfoort, Netherlands
| | - Erik Scherder
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Xavier Moonen
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
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Crutcher J, Butler E, Burke JD, Naigles L, Fein DA, Inge-Marie E. Pragmatic language and associations with externalizing behaviors in autistic individuals and those who have lost the autism diagnosis. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 108:102252. [PMID: 38045761 PMCID: PMC10688299 DOI: 10.1016/j.rasd.2023.102252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Pragmatic language weaknesses, a core feature of autism spectrum disorder (ASD), are implicated in externalizing behavior disorders (Gremillion & Martel, 2014). Particularly in a clinical setting, these co-occurring externalizing disorders are very common in autism; rates of Attentional Deficit-Hyperactive Disorder (ADHD) and Oppositional Defiant Disorder (ODD) are as high as 83% (ADHD) and 73% (ODD; Joshi et al., 2010). It is possible that pragmatic language weaknesses impact the ability to effectively communicate one's needs, which may lead autistic children to utilize externalizing behaviors in order to achieve a desired outcome (Ketelaars et al., 2010; Rodas et al., 2017). Methods The aim of the current study is to investigate the relationship between pragmatic language, assessed via multiple modalities, and externalizing behaviors, assessed by parent interview, in youth with autistic (n=33) or neurotypical (NT; n=34) developmental histories, along with youth diagnosed with autism, who lost the diagnosis (LAD) by adolescence (n=31). Results The autism group had significantly more pragmatic language difficulties, and more externalizing behaviors and disorders; ADHD symptoms were particularly more prevalent, while LAD and NT groups did not differ. Challenges in pragmatic language abilities were associated with more externalizing symptoms when controlling for other facts that typically influence such symptoms, including nonverbal cognition, structural language, executive functioning, and autistic characteristics, but did not remain when age was included in the model. Conclusions We discuss the mechanisms underlying difficult-to-manage externalizing behaviors and implications for interventions and long-term outcomes for youth with and without a history of autism.
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Affiliation(s)
- Jason Crutcher
- Department of Psychological Sciences, Institute for the Brain and Cognitive Sciences, University of Connecticut, 406 Babbidge Road, U-1020; Storrs, CT 06269; USA
| | - Emilie Butler
- Department of Psychological Sciences, Institute for the Brain and Cognitive Sciences, University of Connecticut, 406 Babbidge Road, U-1020; Storrs, CT 06269; USA
| | - Jeffrey D Burke
- Department of Psychological Sciences, Institute for the Brain and Cognitive Sciences, University of Connecticut, 406 Babbidge Road, U-1020; Storrs, CT 06269; USA
| | - Letitia Naigles
- Department of Psychological Sciences, Institute for the Brain and Cognitive Sciences, University of Connecticut, 406 Babbidge Road, U-1020; Storrs, CT 06269; USA
| | - Deborah A Fein
- Department of Psychological Sciences, Institute for the Brain and Cognitive Sciences, University of Connecticut, 406 Babbidge Road, U-1020; Storrs, CT 06269; USA
| | - Eigsti Inge-Marie
- Department of Psychological Sciences, Institute for the Brain and Cognitive Sciences, University of Connecticut, 406 Babbidge Road, U-1020; Storrs, CT 06269; USA
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Paphiti M, Jansson-Verkasalo E, Eggers K. Complex response inhibition and cognitive flexibility in school-aged Cypriot-Greek-speaking children who stutter. Front Psychol 2022; 13:991138. [PMID: 36467248 PMCID: PMC9716181 DOI: 10.3389/fpsyg.2022.991138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/20/2022] [Indexed: 10/10/2023] Open
Abstract
PURPOSE Over the last few years, research findings have suggested limitations in executive function (EF) of children who stutter (CWS) with the evidence being more consistent in studies with preschoolers (3-6 years old) than in studies with school-aged children (6-12 years old). The purpose of the current study was to assess complex response inhibition and cognitive flexibility in school-aged CWS and their non-stuttering peers. METHODS Participants, 19 CWS (mean age = 7.58 years, range 6.08-9.17) and 19 age-and gender-matched children who do not stutter (CWNS; mean age = 7.58 years, range 6.08-9.33), completed a visual task consisting of three task blocks. Analyses were based on response times and error percentages during the different task blocks. RESULTS All participants showed expected performance-costs in task block comparisons targeting complex response inhibition and cognitive flexibility. Significant group differences were found in measures of cognitive flexibility with CWS performing slower compared to CWNS (p = 0.02). Additionally, significant block × group interactions demonstrated that CWS, compared to CWNS, slowed down more (i.e., higher performance-cost) under both complex response inhibition (p = 0.049) and cognitive flexibility task conditions (p = 0.04 for no-set-shifting and p = 0.02 for set-shifting). CONCLUSION These results are in line with some of the previous findings in school-aged CWS and suggest that CWS present lower performance in complex response inhibition and cognitive flexibility task conditions when compared to their non-stuttering peers.
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Affiliation(s)
- Maria Paphiti
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Eira Jansson-Verkasalo
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Kurt Eggers
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- Department of Rehabilitation Sciences, Speech-Language Pathology/Audiology Research Group, Ghent University, Ghent, Belgium
- Department of Speech-Language Therapy and Audiology, Thomas More University College, Antwerp, Belgium
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Paphiti M, Eggers K. Cognitive flexibility in younger and older children who stutter. Front Psychol 2022; 13:1017319. [PMID: 36467213 PMCID: PMC9715977 DOI: 10.3389/fpsyg.2022.1017319] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/02/2022] [Indexed: 10/10/2023] Open
Abstract
Purpose Recent research findings suggest possible weaknesses in cognitive flexibility (CF) in children who stutter (CWS) when compared to children who do not stutter (CWNS). Studies so far, have been conducted with either younger (3-6 years old) or older children (6-12 years old) with a variety of measures. The purpose of the present study was to investigate CF with the use of a single behavioral measure across a broader age range (4-10 years old). Methods Participants were 37 CWS (mean age = 6.90 years) and 37 age-and gender-matched CWNS (mean age = 6.88 years), divided in a younger (below 7 years) and older (above 7 years) age group. All participants undertook a computerized visual set-shifting task consisting of three blocks. CF was evaluated through across-and within-block comparisons of the actual response speed and accuracy values. In addition, mixing-and set-shifting-costs were evaluated based on the mean response speed and accuracy. Results All participants showed expected mixing-and set-shifting-costs. Only the within-block analyses yielded significant between (sub)group differences. Investigation of the block × classification group × age group interactions showed that older CWS had larger set-shifting-costs (slowed down more and made more errors) compared to older CWNS. Conclusion While all participants required more time during set-shifting trials, only the older CWS (7-10 years old), and not younger CWS, were slower and made more errors. This finding corroborates previous findings in CWS of a similar age and could possibly point to a role of CF in stuttering persistence.
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Affiliation(s)
- Maria Paphiti
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Kurt Eggers
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- Department of Rehabilitation Sciences, Speech-language Pathology/Audiology Research Group, Ghent University, Ghent, Belgium
- Department of Speech-Language Therapy and Audiology, Thomas More University College, Antwerp, Belgium
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Yamamoto N, Imai-Matsumura K. Executive function training for kindergarteners after the Great East Japan Earthquake: intervention effects. EUROPEAN JOURNAL OF PSYCHOLOGY OF EDUCATION 2022. [DOI: 10.1007/s10212-022-00615-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractJapan’s Social Thinking and Academic Readiness Training (START) program Academic Readiness (AR) lesson aims to improve self-regulation, executive function, and behavior problems in kindergarten children, but the effects of the START program AR lessons in unfavorable circumstances are unclear. Therefore, this study investigated the effects of the START program AR lesson in affected areas after the Great East Japan Earthquake. A cluster randomized trial was conducted with 111 5-year-old children in two kindergartens in Miyagi Prefecture to evaluate the effectiveness of the six-week AR lesson. One kindergarten was randomly chosen to implement the AR lesson, and the other maintained standard education. In the intervention group, trained classroom teachers provided the children with a 20-min AR lesson once a week. Executive function, behavioral self-regulation, and internalizing and externalizing problem behaviors were measured before and after the six-week intervention. The intervention group showed improved inhibitory control and enhanced behavioral self-regulation compared with the standard practice group. In addition, teachers’ evaluations showed that children’s internalizing and externalizing problem behaviors improved significantly. The results indicate that the START program AR lesson was effective in enabling teachers to help students improve executive function, self-regulation, and problematic behaviors. Therefore, educators and policy-makers should consider implementing the START program AR lesson in kindergartens after a disaster.
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Investigating the Relation of Intelligence and Executive Functions in Children and Adolescents with and without Intellectual Disabilities. CHILDREN 2022; 9:children9060818. [PMID: 35740755 PMCID: PMC9221765 DOI: 10.3390/children9060818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
Despite their separate research traditions, intelligence and executive functioning (EF) are both theoretically and empirically closely related to each other. Based on a subsample of 8- to 20-year-olds of the standardization and validation sample (N = 1540) of an internationally available instrument assessing both cognitive abilities, this study aimed at investigating a comprehensive structural model of intelligence and EF tasks and at gaining insight into whether this comprehensive model is applicable across sexes and age groups as well as to a subsample of participants with (borderline) intellectual disabilities (IQ ≤ 85, n = 255). The results of our exploratory factor analysis indicated one common EF factor that could be sufficiently integrated into the intelligence model within our confirmatory factor analyses. The results suggest that the EF factor can be added into the model as a sixth broad ability. The comprehensive model largely showed measurement invariance across sexes and age groups but did not converge within the subsample of participants with (borderline) intellectual disabilities. The results and implications are discussed in light of the current literature.
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Petoft A, Abbasi M, Zali A. Toward children's cognitive development from the perspective of neurolaw: implications of Roper v Simmons. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2022; 30:144-160. [PMID: 36950188 PMCID: PMC10026748 DOI: 10.1080/13218719.2021.2003267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
After reaching the age of criminal responsibility, children are deemed capable of having committed criminal offenses. In this regard, the level of criminal responsibility depends on cognitive development and the type of offense committed. Cognitive development is a process of the growth of perception, thinking and reasoning in children. This concept is frequently referred to in cognitive neuroscience literature. Recently, the U.S. Supreme Court's decision in Roper v Simmons has substantially changed attitudes toward juvenile delinquency, considering the fact that cognitive development continues until early adulthood. The present study attempts to scrutinize this case and explain cognitive development by its factors from an interdisciplinary perspective, combining methods and theories from neuroscience and criminal law.
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Affiliation(s)
- Arian Petoft
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoud Abbasi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Prokhorenko E, Makarov I. Behavioral disorders in children and adolescents with intellectual disability. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:36-43. [DOI: 10.17116/jnevro202212204136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Santegoeds E, van der Schoot E, Roording‐Ragetlie S, Klip H, Rommelse N. Neurocognitive functioning of children with mild to borderline intellectual disabilities and psychiatric disorders: profile characteristics and predictors of behavioural problems. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:162-177. [PMID: 34378826 PMCID: PMC9290047 DOI: 10.1111/jir.12874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND The aim of the current study was twofold: first, to uncover a neurocognitive profile of normative and relative strengths and weaknesses that characterises an extremely vulnerable group of children with mild to borderline intellectual disabilities (MBID) and co-morbid psychiatric disorders, and second, to investigate the relevance of these neurocognitive functions explaining internalising and externalising symptoms. METHOD We recruited 45 children (Mage = 9.5, SDage = 1.7; range 6-13 years) with MBID (Full-Scale IQ 50-85) and at least one psychiatric disorder. Neurocognitive functioning was examined utilising the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V) indices and the Cognitive Task Application (COTAPP), a comprehensive computerised self-paced task designed in such a manner that 'g' (an overall tendency of children with MBID to execute tasks with a slower reaction time and a higher error rate) has been corrected for in the administration of the task (i.e. completely self-paced) and in the operationalisation of outcome measures. Behavioural problems were measured using the CBCL and TRF. One-sample t-tests and binomial tests were carried out to compare performance with normative data. Regression analyses were used to examine the relationship between neurocognitive parameters and mental health. RESULTS Compared with normative data, very small to very large effect sizes were found, indicating clear heterogeneity amongst neurocognitive domains relevant for children with MBID. Two prominent neurocognitive weaknesses emerged: processing speed - characterised by slowness and unstableness combined with a high drift rate and delayed processing of the previous trial, particularly under higher cognitive demands - and working memory - in terms of a weaker central executive and 'slave' systems to temporarily store information. Both domains were not clearly predictive of internalising or externalising problems. CONCLUSION Children with MBID and psychiatric disorders are hampered by a strongly diminished processing speed and working memory capacity, together resulting in an overall limited processing capacity that may underlie the general developmental delays on domains that depend on fast and parallel processing of information (i.e. language, reading, mathematics and more complex forms of social cognition). Neurocognitive vulnerabilities are neither necessary nor sufficient to explain internalising and externalising problems; rather, a mismatch between the support needs and adaptations these children need, arising from their diminished processing capacity, and the inadequacy of the environment to compensate for this vulnerability may be of relevance.
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Affiliation(s)
- E. Santegoeds
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryEdeThe Netherlands
| | - E. van der Schoot
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryEdeThe Netherlands
| | - S. Roording‐Ragetlie
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryEdeThe Netherlands
| | - H. Klip
- Karakter Child and Adolescent PsychiatryNijmegenThe Netherlands
| | - N. Rommelse
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryEdeThe Netherlands
- Karakter Child and Adolescent PsychiatryNijmegenThe Netherlands
- Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
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Erostarbe-Pérez M, Reparaz-Abaitua C, Martínez-Pérez L, Magallón-Recalde S. Executive functions and their relationship with intellectual capacity and age in schoolchildren with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:50-67. [PMID: 34542219 DOI: 10.1111/jir.12885] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 08/19/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND There is certain empirical evidence of, on the one hand, a positive correlation between executive functions (EFs) and intelligence in people with intellectual disability (ID) and, on the other hand, a slower rate of development of EFs in these people relative to people without ID. This evidence is not, however, unequivocal, and further studies are required. METHODS We analysed the relationship between development of EFs and both age and intellectual capacity, in a sample of 106 students with either ID or borderline intellectual functioning (BIF) at a special education centre [63 boys and 43 girls, 11-18 years old, mean total intelligence quotient (TIQ) of 59.6]. We applied nine instruments to evaluate both neuropsychological development (working memory, inhibitory control, cognitive flexibility, planning, processing speed and verbal fluency) and behavioural development [teachers' perceptions of the EFs of their students by Behavior Rating Inventory of Executive Function - Second Edition (BRIEF-2) School]. ID and BIF groups were statistically compared in terms of mean performance measures in EF tests. We looked at the correlation between EFs and age, and correlations between EFs and intelligence: TIQ, fluid intelligence [measured by the perceptual reasoning (PR) sub-index of Wechsler Intelligence Scale for Children-IV (WISC-IV)] and crystallised intelligence (measured by the verbal comprehension (VC) sub-index of WISC-IV). Regression models were built for variables with strong correlation. RESULTS In most of the tests used to evaluate EFs, the ID subgroup performed significantly worse than the subgroup with BIF. In general, teachers' thought that participants had 'medium-low' levels of EFs. TIQ, by WISC-IV scale, correlated significantly with scores in all tests for all EFs. The PR sub-index correlated significantly with 14 of the tests for EFs; 35% of the variation in PR can be explained by variation in performance in Picture Span (working memory) and Mazes (planning). The VC sub-index correlated weakly with seven of the EF tests. We found significant correlations in the ID group between age and scores in all tests of working memory and inhibitory control. Age - considering all participants - did not correlate with any of the variables of teachers' perception except for working memory, and this correlation was not strong. CONCLUSIONS The results of our study are consistent with descriptions of the typical population: (1) fluid intelligence is more related to EFs than crystallised intelligence is; and (2) working memory capacity is the EF most strongly related with general, fluid and crystallised forms of intelligence. The results suggest that as children and adolescents with ID/BIF get older, their capacities for working memory and inhibitory control increase; development of the other EFs studied was less evident. Teachers' perceptions of the EFs of children with ID or BIF were independent of intellectual capacity and age. More research is needed to delve further into the development of EFs in people with ID/BIF.
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Affiliation(s)
- M Erostarbe-Pérez
- Department of Neuropediatry, Clínica Universidad de Navarra, Madrid, Spain
| | - C Reparaz-Abaitua
- School of Education and Psychology, Universidad de Navarra, Pamplona, Spain
| | - L Martínez-Pérez
- School of Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - S Magallón-Recalde
- School of Education and Psychology, Universidad de Navarra, Pamplona, Spain
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Tajik-Parvinchi D, Farmus L, Tablon Modica P, Cribbie RA, Weiss JA. The role of cognitive control and emotion regulation in predicting mental health problems in children with neurodevelopmental disorders. Child Care Health Dev 2021; 47:608-617. [PMID: 33772823 DOI: 10.1111/cch.12868] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/12/2021] [Accepted: 03/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many youth with neurodevelopmental disorders (NDDs) experience mental health problems such as anxiety, depression or anger, and these are often associated with impairments of cognition and emotion regulation. The mechanisms that may be linking cognitive difficulties, emotion regulation and mental health are not known. AIMS The current study examined whether adaptive and maladaptive (dysregulated) emotion regulation mediated the link between different cognitive control processes (working memory, inhibition and shifting) and internalizing/externalizing symptoms in children with NDDs. METHODS Participants included 48 children (8-13 years of age) with one or more diagnoses of autism, attention deficit hyperactivity disorder, cerebral palsy and learning disability, who were enrolled in a larger study of cognitive behaviour therapy targeting emotion regulation. Multiple mediation analyses were implemented using the PROCESS macro. The mediation effects of adaptive and maladaptive emotion regulation were examined on the relationships between (1) working memory and internalizing/externalizing symptoms, (2) inhibition and internalizing/externalizing symptoms and (3) shifting and internalizing/externalizing symptoms. All data were collected prior to intervention, at baseline. RESULTS Shifting, inhibitory control and working memory predicted increased emotion dysregulation, which functioned as a full mediator to both internalizing and externalizing problems in children with NDDs. CONCLUSIONS In the presence of emotionally triggering situations, children with greater cognitive challenges experience greater maladaptive emotion regulation, which results in both internalizing and externalizing problems. For youth with NDDs, therapeutic plans that include strengthening of working memory, inhibition and shifting abilities in addition to emotion regulation skills training may be helpful in alleviating externalizing and internalizing behaviour.
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Affiliation(s)
- Diana Tajik-Parvinchi
- Department of Psychology, York University, Toronto, Ontario, Canada.,Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Linda Farmus
- Quantitative Methods, Department of Psychology, York University, Toronto, Ontario, Canada
| | | | - Robert A Cribbie
- Quantitative Methods, Department of Psychology, York University, Toronto, Ontario, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, Toronto, Ontario, Canada
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Torra Moreno M, Canals Sans J, Colomina Fosch MT. Behavioral and Cognitive Interventions With Digital Devices in Subjects With Intellectual Disability: A Systematic Review. Front Psychiatry 2021; 12:647399. [PMID: 33927655 PMCID: PMC8076520 DOI: 10.3389/fpsyt.2021.647399] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/17/2021] [Indexed: 01/01/2023] Open
Abstract
In recent years, digital devices have been progressively introduced in rehabilitation programs and have affected skills training methods used with children and adolescents with intellectual disabilities (ID). The objective of this review is to assess the effects of the use of digital devices on the cognitive functions and behavioral skills in this population, and to acknowledge their potential as a therapeutic tool. Electronic databases were analyzed until February 2020 using search formulas with free terms related to ID and the use of digital systems with children or adolescents. The risk of bias in randomized controlled trials was assessed by means of the modified Cochrane Collaboration tool and the quality level of the non-randomized studies was assessed using the Newcastle-Ottawa Scale. Forty-four studies were analyzed, most of which were categorized as low quality. Of the executive function studies analyzed, 60% reported significant improvements, most commonly related to working memory. Within the cognitive skills, 47% of the studies analyzed reported significant improvements, 30% of them in language. Significant improvements in the social (50%) and behavioral domains (30%) were also reported. These results suggest that digital interventions are effective in improving working memory and academic skills, and positively affect both the social and behavioral domains. Little information has been published regarding the duration of the effects, which could be limited in time. Further research is necessary to assess long-term effectiveness, the influence of comorbidities, and the effects on subjects with severe ID. The inclusion of smartphones and special education centers is also necessary.
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Affiliation(s)
- Marta Torra Moreno
- Jeroni de Moragas Private Fundation, Tarragona, Spain
- Jeroni de Moragas Association, Tarragona, Spain
| | - Josefa Canals Sans
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain
| | - Maria Teresa Colomina Fosch
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain
- Research Group in Neurobehavior and Health (NEUROLAB), Tarragona, Spain
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13
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Te Brinke LW, Schuiringa HD, Matthys W. Emotion regulation and angry mood among adolescents with externalizing problems and intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 109:103833. [PMID: 33421677 DOI: 10.1016/j.ridd.2020.103833] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND AIMS Cognitive behavior therapy targeting emotion regulation is found to be effective in decreasing externalizing problems, but little is known about the emotion regulation capacities of adolescents with externalizing problems and Mild Intellectual Disabilities or Borderline Intellectual Functioning (MID-BIF). Therefore, the aim of this study was to compare emotion (i.e., anger) regulation capacities, angry mood level and angry mood variability between two groups: adolescents with externalizing problems and MID-BIF and adolescents with externalizing problems and average intelligence (AIQ). METHODS AND PROCEDURES Participants in the MID-BIF (n = 42, Mage = 15.52, SD = 1.43) and AIQ (n = 39, Mage = 13.67, SD = 1.06) group completed questionnaires about emotion regulation difficulties, emotion regulation strategies, and angry mood. OUTCOMES AND RESULTS Adolescents in the MID-BIF group reported fewer emotion regulation difficulties, fewer maladaptive regulation strategies, and lower levels of angry mood than adolescents in the AIQ group. No between-group differences in angry mood variability were found. Lastly, adolescents in the MID-BIF group reported to use more behavioral than cognitive regulation strategies. CONCLUSIONS AND IMPLICATIONS These findings provide a starting point in understanding emotion regulation and angry mood of adolescents with externalizing problems and MID-BIF and show that it is important to consider differences between cognitive and behavioral regulation processes.
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Affiliation(s)
- Lysanne W Te Brinke
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3508 TC, Utrecht, the Netherlands.
| | - Hilde D Schuiringa
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3508 TC, Utrecht, the Netherlands.
| | - Walter Matthys
- Department of Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, 3508 TC, Utrecht, the Netherlands; Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands.
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14
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DiStefano C, Sadhwani A, Wheeler AC. Comprehensive Assessment of Individuals With Significant Levels of Intellectual Disability: Challenges, Strategies, and Future Directions. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:434-448. [PMID: 33211812 DOI: 10.1352/1944-7558-125.6.434] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
The variety and extent of impairments in individuals with severe-profound levels of intellectual disability (ID) impact their ability to complete valid behavioral assessments. Although standardized assessment is crucial for objectively evaluating patients, many individuals with severe-profound levels of ID perform at the floor of most assessments designed for their chronological age. Additionally, the presence of language and motor impairments may influence the individual's ability to perform a task, even when that task is meant to measure an unrelated construct leading to an underestimation of their true ability. This article provides an overview of the assessment protocols used by multiple groups working with individuals with severe-profound levels of ID, discusses considerations for obtaining high-quality assessment results, and suggests guidelines for standardizing these protocols across the field.
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Affiliation(s)
| | - Anjali Sadhwani
- Anjali Sadhwani, Boston Children's Hospital, Harvard Medical School
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15
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Witt A, Comblain A, Thibaut JP. Do typically and atypically developing children learn and generalize novel names similarly: The role of conceptual distance during learning and at test. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 104:103720. [PMID: 32622309 DOI: 10.1016/j.ridd.2020.103720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 06/04/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
There is a large body of evidence showing that comparison of multiple stimuli leads to better conceptualization and generalization of novel names than no-comparison settings in typically developing (TD) children. By contrast, the evidence regarding this issue remains scarce in children with intellectual disabilities (ID). Children with intellectual disabilities (ID) and TD children matched on mental age with the Raven's coloured progressive matrices were tested in several novel name learning comparison conditions, with familiar objects. We manipulated the conceptual distance between the learning stimuli in the learning phase and between the learning and generalization phase stimuli for object and relational nouns. Results showed that both populations had rather similar performance profile when matched on their cognitive skills (low- vs. high-functioning). Unexpectedly, ID children's performance was equivalent for relations and better for objects compared to their TD peers' performance. However, when controlling for chronological age, the difference between ID and TD children disappeared in the case of object categories and was better understood by TD children in the case of relations. We discuss the role of conceptual distance on participants' conceptual generalization as a function of their intellectual abilities and cognitive functioning.
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Affiliation(s)
- Arnaud Witt
- LEAD-CNRS, UMR 5022, Université de Bourgogne Franche-Comté, Pôle AAFE - Esplanade Erasme, 21065 Dijon, France.
| | | | - Jean-Pierre Thibaut
- LEAD-CNRS, UMR 5022, Université de Bourgogne Franche-Comté, Pôle AAFE - Esplanade Erasme, 21065 Dijon, France
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16
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Wagemaker E, Huizenga HM, Dekkers TJ, Collot d'Escury-Koenigs AL, Salemink E, Bexkens A. When Do those "Risk-Taking Adolescents" Take Risks? The Combined Effects of Risk Encouragement by Peers, Mild-to-Borderline Intellectual Disability and Sex. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:573-587. [PMID: 31953583 PMCID: PMC7078137 DOI: 10.1007/s10802-020-00617-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Adolescents with mild to borderline intellectual disability (MBID) show more daily life risk taking than typically developing adolescents. To obtain insight in when these "risk-taking adolescents" especially take risks, we investigated main and interaction effects of (a) MBID, (b) sex, and (c) type of peer influence on risk taking. The Balloon Analogue Risk Task (BART) was used as a proxy of real-life risk taking. 356 adolescents (12-19 years, 51.7% MBID, 63.4% boys) were randomly assigned to one of three BART peer-influence conditions: solo (no peers), positive risk encouragement (e.g., 'You are cool if you continue') or negative risk encouragement (e.g., 'You are a softy if you do not continue'). The main finding was that boys with MBID took more risks than typically developing boys in the negative risk encouragement condition. Boys with MBID also took more risks in the negative risk encouragement condition compared to the solo condition, whereas typically developing boys did not. There were no such effects for girls. Surprisingly, boys with MBID took less risks in the solo condition than typically developing boys. We conclude that boys with MBID especially show high risk taking when peers belittle or threat with exclusion from the peer group. Prevention and intervention programs should specifically target boys with MBID to teach them to resist negative risk encouragement by peers.
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Affiliation(s)
- Eline Wagemaker
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129b, 1018, WS, Amsterdam, The Netherlands.
- Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands.
| | - Hilde M Huizenga
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129b, 1018, WS, Amsterdam, The Netherlands
- Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Tycho J Dekkers
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129b, 1018, WS, Amsterdam, The Netherlands
- Department of Forensic Youth Psychiatry and Behavioral Disorders, De Bascule, Academic Center of Child- and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Annematt L Collot d'Escury-Koenigs
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129b, 1018, WS, Amsterdam, The Netherlands
- Mind at Work, Almere, The Netherlands
| | - Elske Salemink
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129b, 1018, WS, Amsterdam, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Anika Bexkens
- Department of Psychology, Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands
- GGZ Delfland, Delft, The Netherlands
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17
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Van Rest MM, Matthys W, Van Nieuwenhuijzen M, De Moor MHM, Vriens A, Schuengel C. Social information processing skills link executive functions to aggression in adolescents with mild to borderline intellectual disability. Child Neuropsychol 2018; 25:573-598. [PMID: 30010484 DOI: 10.1080/09297049.2018.1495186] [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] [Indexed: 10/28/2022]
Abstract
Executive Functions (EFs) have been associated with aggression in children and adolescents. EFs as higher-order cognitive abilities are assumed to affect cognitive functions such as Social Information Processing (SIP). We explored SIP skills as a mediating mechanism linking EFs to aggression in adolescents with mild to borderline intellectual disability (MBID with IQ from 50-84), a high risk group for aggressive behaviors and EF impairments. A total of 153 adolescents (Mage = 15.24, SD = 1.35; 54% male) with MBID participated. Focused attention, behavioral inhibition, and working memory were tested with multiple neurocognitive tasks to define latent EF constructs. Participants responded to a video-based SIP task. A latent construct for aggression was defined by caretaker, teacher, and adolescent self-reports of aggression (Child Behavior Check List, Teacher Report Form, and Youth Self Report). Structural equation modeling was performed to test mediation. Results were consistent with mediation of the relation between focused attention and aggression by SIP, namely via hostile interpretations and self-efficacy for aggression. Behavioral inhibition was linked to aggression, but this relation was not mediated by SIP. The relation between working memory and aggression was mediated by SIP, namely via hostile interpretations, aggressive response generation and via self-efficacy for aggressive responses. Bearing the cross-sectional design in mind, support was found for SIP skills as a mechanism linking EFs, in particular focused attention and working memory, to aggression, providing a viable explanation for the high vulnerability of adolescents with MBID for aggression.
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Affiliation(s)
- Maaike M Van Rest
- a Department of Clinical Child and Family Studies, and Amsterdam Public Health , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - Walter Matthys
- b Department of Child and Adolescent Studies, Utrecht University, and Department of Psychiatry , University Medical Center Utrecht , Utrecht , The Netherlands
| | | | - Marleen H M De Moor
- a Department of Clinical Child and Family Studies, and Amsterdam Public Health , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - Aart Vriens
- d Department for Psychology and Adult Care , RIBW , Purmerend , The Netherlands
| | - Carlo Schuengel
- a Department of Clinical Child and Family Studies, and Amsterdam Public Health , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
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