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Anacker L, Edwards M, Nonnemacher S, Pinals DA. Attending to Persons with Intellectual and/or Other Developmental Disorders in Crisis Settings. Psychiatr Clin North Am 2024; 47:563-576. [PMID: 39122346 DOI: 10.1016/j.psc.2024.04.024] [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] [Indexed: 08/12/2024]
Abstract
Crisis response is growing across the United States with increasingly broad phone, text, and chat response systems that lead to triaging callers who may be in need of further outreach. This might include deploying a mobile crisis response team and/or referring a caller to a crisis stabilization unit. The information set forth earlier aims to help advance the field and individual practices to ensure that persons with intellectual and/or other developmental disorders receive equivalent care and treatment with information that helps focus on this population's unique features and needs.
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Affiliation(s)
- Lisa Anacker
- Center for Forensic Psychiatry, 8303 Platt Road, Saline, MI 48176, USA
| | - Matthew Edwards
- Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Suite 2204, MC 5723, Stanford, CA 94305, USA
| | - Stacy Nonnemacher
- NASDDDS (National Association of State Directors of Developmental Disabilities Services), P.O. Box 26128, Alexandria, VA 22313, USA
| | - Debra A Pinals
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
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2
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Kildahl AN. Bias in assessment of co-occurring mental disorder in individuals with intellectual disabilities: Theoretical perspectives and implications for clinical practice. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:393-414. [PMID: 36708367 PMCID: PMC11059834 DOI: 10.1177/17446295231154119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Influence from bias is unavoidable in clinical decision-making, and mental health assessment seems particularly vulnerable. Individuals with intellectual disabilities have increased risk of developing co-occurring mental disorder. Due to the inherent difficulties associated with intellectual disabilities, assessment of mental health in this population often relies on a different set of strategies, and it is unclear how these may affect risk of bias. In this theoretical paper, we apply recent conceptualisations of bias in clinical decision-making to the specific challenges and strategies in mental health assessment in intellectual disabilities. We suggest that clinical decision-making in these assessments is particularly vulnerable to bias, including sources of bias present in mental health assessment in the general population, as well as potential sources of bias which may be specific to assessments in this population. It follows that to manage potential bias, triangulating information from multi-informant, multi-method, interdisciplinary assessment strategies is likely to be necessary.
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Affiliation(s)
- Arvid Nikolai Kildahl
- Arvid Nikolai Kildahl, Regional Section Mental Health, Intellectual Disabilities/Autism, Oslo University Hospital, Verkensveien 19, Oslo, Asker 1385, Norway.
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Jouira G, Alexe DI, Moraru CE, Rekik G, Alexe CI, Marinău MA, Sahli S. The influence of cognitive load and vision variability on postural balance in adolescents with intellectual disabilities. Front Neurol 2024; 15:1385286. [PMID: 38882695 PMCID: PMC11176554 DOI: 10.3389/fneur.2024.1385286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/10/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction This study aimed to investigate the impact of cognitive load, particularly its escalation during the execution of the same test, under varying vision conditions, on postural balance among adolescents with intellectual disability (ID). Methods Twenty adolescents underwent balance assessments under different visual conditions (Open Eyes (OE), Closed Eyes (CE), Flash, Goggles, Visual Stimulation (VS)) and task settings (Single Task (ST), Dual Task (DT) without challenges, and DT with challenges). The cognitive test was assessed using Verbal Fluency (VF). Results and discussion Significant effects were found for Task (p < 0.001, ηp2 = 0.85), indicating that CoP values significantly increased (p < 0.05) with the introduction of the DT. Dual Task Cost (DTC) demonstrated significant effects for Vision (p = 0.008, ηp2 = 0.62), with values varying significantly (p < 0.05) among different vision conditions, especially in CE and Flash conditions. Visual Dependency Quotient (VDQ) analyses revealed significant effects of condition (p < 0.001, ηp2 = 0.84), with significant changes observed in CE/OE and Flash/OE conditions (p < 0.05). Significant effects were observed for Cognitive performance in the Challenge condition (p < 0.001, ηp2 = 0.86), with decreased performance with cognitive task challenges, particularly in Flash and Goggles conditions (p < 0.05). In conclusion, cognitive tasks, especially challenging ones, and visual variations significantly impact postural balance in adolescents with ID.
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Affiliation(s)
- Ghada Jouira
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Dan Iulian Alexe
- Department of Physical and Occupational Therapy, "Vasile Alecsandri" University of Bacău, Bacău, Romania
| | - Cristina Elena Moraru
- Department of Physical Education and Sport, "Alexandru Ioan Cuza" University of Iaşi, Iaşi, Romania
| | - Ghazi Rekik
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Tanyu Research Laboratory, Taipei, Taiwan
| | - Cristina Ioana Alexe
- Department of Physical Education and Sports Performance, "Vasile Alecsandri" University of Bacău, Bacău, Romania
| | - Marius Alin Marinău
- Department of Physical Education, Sport and Kinetotherapy, University of Oradea, Oradea, Romania
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
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Kanthasamy S, Miskon N, Barlas J, Marsh NV. Family Caregiver Adaptation during the Transition to Adulthood of Individuals with Intellectual Disabilities: A Scoping Review. Healthcare (Basel) 2024; 12:116. [PMID: 38201021 PMCID: PMC10779180 DOI: 10.3390/healthcare12010116] [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: 09/22/2023] [Revised: 12/08/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
During the transition to adulthood, individuals diagnosed with intellectual disability (ID) and their family caregivers have unique experiences. This scoping review studies the sources of the family caregiver's objective burden, support, coping mechanisms, positive caregiving, and quality of life to understand the caregiver's adaptation process when the individual with ID transits to adulthood, according to Joanna Briggs Institute (JBI) Scoping Review methodology guidelines. The inclusion criteria included studies of family caregivers of any age who provide unpaid care and live with individuals diagnosed with ID who are transitioning to adulthood. Of 2875 articles identified, 12 published studies were included. The main themes included caregivers reporting dissatisfaction with the available adult services and exhaustion from being a caregiver. Overall, a vicious cycle of likely increased demands during the transition, with caregivers not being prepared to cope with these demands while concurrently being dissatisfied with the adult services system, leads the caregivers to develop a pervasive sense of helplessness. Future studies would benefit from recruiting caregivers from sources other than adult-only service centres and using qualitative (to identify the broad aspects of the key factors) and quantitative (to identify the significant differences between the key factors) methodologies.
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Affiliation(s)
- Shivasangarey Kanthasamy
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore; (S.K.); (J.B.)
- Department of Psychology, Institute of Mental Health, Singapore 539747, Singapore;
| | - Nazleen Miskon
- Department of Psychology, Institute of Mental Health, Singapore 539747, Singapore;
| | - Joanna Barlas
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore; (S.K.); (J.B.)
| | - Nigel V. Marsh
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore; (S.K.); (J.B.)
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Santambrogio J, Bertelli MO, Terrevazzi S, De Carolis L, Francia E, Boldoni C, Calascibetta M, Cudazzo E, Lucca C, Viganò V, Danese M, Minazzi GA, Santarone A, Bianco A, Hassiotis A, Clerici M. Cognitive dysfunction and psychopathology: a cohort study of adults with intellectual developmental disorder. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1029-1045. [PMID: 37690814 DOI: 10.1111/jir.13077] [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: 05/03/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Cognitive impairment of intellectual developmental disorders (IDD) is determined by several different combinations of specific cognitive alterations. People with IDD present a rate of mental health problems that is up to 4 times higher than that of the general population. Despite this, the relationship between specific cognitive dysfunctions and co-occurring mental disorders has not been adequately studied. The aim of the present paper is to investigate the association between specific cognitive dysfunctions and specific psychiatric symptoms and syndromes in people with IDD. METHODS One hundred and twenty adults with mild to moderate IDD living in residential facilities underwent a clinical and instrumental assessment for specific cognitive and psychopathological features. RESULTS Participants with IDD and ASD have significantly lower scores compared to those without respect to who has not the diagnosis on the Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI) on the WAIS-IV and higher time scores on the TMT A. Moreover, there is a significant association between years of hospitalisation and TMT B and TMT B A time scores; the longer a participant with IDD was hospitalised, the worse their performance on the TMT. Although not statistically significant, many psychopathological clusters showed substantial cognitive profiles. CONCLUSIONS Although further research is needed, neuropsychological and IQ tests scores seem to be differently associated to various psychopathological conditions co-occurring with IDD, and with ASD especially. Cognitive assessment seems to support diagnosis and treatment of psychopathological co-occurrences in persons with IDD, also in consideration of indirect implications including a better knowledge of the patient's characteristics beyond IQ deficit.
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Affiliation(s)
- J Santambrogio
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
- Presidio Corberi, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - M O Bertelli
- Research and Clinical Center (CREA), San Sebastiano Foundation, Misericordia di Firenze, Firenze, Italy
| | - S Terrevazzi
- Presidio Corberi, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - L De Carolis
- Department of Economics, Management and Statistics, University of Milano-Bicocca, Milan, Italy
| | - E Francia
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
| | - C Boldoni
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - M Calascibetta
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - E Cudazzo
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - C Lucca
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - V Viganò
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - M Danese
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - G A Minazzi
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - A Santarone
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
| | - A Bianco
- Research and Clinical Center (CREA), San Sebastiano Foundation, Misericordia di Firenze, Firenze, Italy
| | - A Hassiotis
- Division of Psychiatry, University College of London, London, UK
| | - M Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Mental Health and Addiction Department, IRCCS Ospedale San Gerardo dei Tintori, Monza, Italy
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Gravråkmo S. Associations between executive functions, intelligence and adaptive behaviour in children and adolescents with mild intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:715-727. [PMID: 35543122 PMCID: PMC10467003 DOI: 10.1177/17446295221095951] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: The purpose of this study was to explore the role of everyday executive functions in relation to intelligence and adaptive behaviour in children and adolescents with mild intellectual disability. Method: A group of children and adolescents, previously diagnosed with mild intellectual disability were assessed according to intelligence, everyday executive functions and adaptive behaviour. The association between everyday executive functions and intelligence was examined, and it was explored whether intelligence or everyday executive functions would best predict adaptive behaviour. Results: Adaptive behaviour was significantly predicted by executive functions, but not by intelligence. Nor was intelligence significantly related to everyday executive functions in this group. Conclusions: Although fundamental in diagnosing intellectual disability, intelligence cannot predict adaptive behaviour. Assessing everyday executive functions and adaptive behaviour, as well as acknowledging the strong association between them, provides valuable information in the process of optimizing developmental support for children and adolescents with mild intellectual disability.
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Affiliation(s)
- Sissel Gravråkmo
- Regional Centre for Habilitation at the Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway; Department of Habilitation Services at the Children´s Clinic, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway
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Asensio D, Duñabeitia JA. The necessary, albeit belated, transition to computerized cognitive assessment. Front Psychol 2023; 14:1160554. [PMID: 37168430 PMCID: PMC10165007 DOI: 10.3389/fpsyg.2023.1160554] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/06/2023] [Indexed: 05/13/2023] Open
Abstract
Cognitive assessment is a common and daily process in educational, clinical, or research settings, among others. Currently, most professionals use classic pencil-and-paper screenings, tests, and assessment batteries. However, as the SARS-CoV-2 health crisis has shown, the pencil-and-paper format is becoming increasingly outdated and it is necessary to transition to new technologies, using computerized cognitive assessments (CCA). This article discusses the advantages, disadvantages, and implications of this necessary transition that professionals should face in the immediate future, and encourages careful adoption of this change to ensure a smooth transition.
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Affiliation(s)
- David Asensio
- Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Jon Andoni Duñabeitia
- Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
- AcqVA Aurora Center, UiT The Arctic University of Norway, Tromsø, Norway
- *Correspondence: Jon Andoni Duñabeitia,
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Porthukaran A, Zak M, Moharir M, Mamak E, Sinopoli KJ. Neuropsychological Outcome of Glucose Transporter-1 Deficiency Syndrome: a Case Study of Identical Twin Boys Without Intellectual Disability. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2022. [DOI: 10.1007/s40817-022-00130-4] [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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9
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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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Frequência de comorbidades em crianças com paralisia cerebral de diferentes níveis de função motora grossa. CONSCIENTIAE SAÚDE 2022. [DOI: 10.5585/21.2022.21189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ResumoIntrodução: A paralisia cerebral (PC) é uma desordem predominantemente motora, no entanto, pode estar associada a outras disfunções, que também impactam a funcionalidade das crianças. Objetivo: Documentar a frequência das comorbidades em crianças com PC nos diferentes níveis do Sistema de Classificação da Função Motora Grossa (GMFCS). Métodos: Estudo observacional, descritivo, de corte transversal. Foram coletados dados de 70 crianças com diagnóstico de PC, que recebiam tratamento fisioterapêutico em Belo Horizonte e na região metropolitana, por meio de entrevistas, e realizada análise descritiva e quantitativa. Resultados: As comorbidades mais frequentes foram as limitações do uso das mãos e dos braços, deficiências de continência urinária e fecal, deficiências da voz e da fala, deficiências de comportamento limitação para andar e epilepsia. Um número maior de comorbidades foi encontrado em crianças com maior comprometimento da função motora grossa. Conclusão: Profissionais da saúde devem observar com atenção a ocorrência das comorbidades na PC, proporcionando intervenções para preveni-las ou tratá-las, melhorando a funcionalidade desses indivíduos.
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Hom CL, Walsh D, Fernandez G, Tournay A, Touchette P, Lott IT. Cognitive assessment using the Rapid Assessment for Developmental Disabilities, Second Edition (RADD-2). JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:831-848. [PMID: 34196436 DOI: 10.1111/jir.12863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 04/12/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Individuals with developmental disabilities (DD) often have severe impairments and maladaptive behaviours that make it difficult to reliably assess their cognitive abilities. Given these challenges, the Rapid Assessment of Developmental Disabilities, Second Edition (RADD-2), was designed to measure general cognitive ability in this population. The purpose of this study is to demonstrate the battery's psychometric properties when used with individuals with DD who have challenging behavioural and psychiatric conditions and for those who have limited verbal skills. METHOD The cognitive and adaptive behaviour skills of 193 children and adults with DD and considerable medical, behavioural and/or psychiatric problems were evaluated using the first and second editions of the RADD, Kaufmann Brief Intelligence Test - 2nd Edition, and Scales of Independent Behaviour - Revised Edition. Medication side effects and challenging behaviours were assessed using the Aberrant Behaviour Checklist. RESULTS There were no floor or ceiling effects on the RADD-2. Both the nonverbal index and total scores had strong concurrent validity with other abbreviated tests of intellectual ability and good discriminant validity from measures of adaptive behaviour and medication side effects. RADD-2 scores also had strong criterion validity as they successfully differentiated between all levels of intellectual functioning. Age and sex did not differentially affect RADD-2 performance, and the co-occurrence of psychiatric conditions did not negatively affect performance. The only medical condition associated with lower RADD-2 performance was epilepsy. CONCLUSIONS The RADD-2 can quantify the differential cognitive abilities of individuals with DD, even for those with minimal communication skills, challenging behaviours or severe medication side effects that can typically complicate assessment. This brief cognitive battery can be used to measure changes due to interventions, on the one hand, and progression of neurological disease, on the other.
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Affiliation(s)
- C L Hom
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D Walsh
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - G Fernandez
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - A Tournay
- Department of Pediatrics, Division of Child Neurology, University of California, Irvine, CA, USA
| | - P Touchette
- Department of Pediatrics, Division of Child Neurology, University of California, Irvine, CA, USA
| | - I T Lott
- Department of Pediatrics, Division of Child Neurology, University of California, Irvine, CA, USA
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Lemmey S, Burns J, Jones F. Developing additional competition classes for athletes with intellectual impairments: Conceptual approach and efficacy of an ICF derived measure. J Sports Sci 2021; 39:99-108. [PMID: 33586628 DOI: 10.1080/02640414.2021.1881302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of para sport classification systems is to minimize the impact of impairment on competition outcome. Currently, athletes with intellectual impairment (II) compete in one class, regardless of the extent of activity limitation resulting from their impairment. Consequently, athletes with II that cause relatively minor difficulty in sport have a competitive advantage over athletes who have intellectual impairments that cause more significant advantage. This research investigated the efficacy of a measure of health-related functional impairment, derived from the World Health Organization International Classification of Functioning, Disability, and Health (ICF), as a tool to classify athletes with intellectual impairments (II) into groups with impairments that cause similar activity limitation. The first study used a Delphi technique to identify the most relevant codes within the ICF from which a measure of impairment presence and severity was derived. The second study investigated whether the measure could discriminate between groups of II athletes organized into three competition groups, and whether these groups could be predicted by ICF score. The ICF-based questionnaire shows promise as a conceptual approach and as a tool in this context, but this is a preliminary step before establishing a sport-specific approach to classification.
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Affiliation(s)
- Suzie Lemmey
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Canterbury, UK
| | - Jan Burns
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Canterbury, UK
| | - Fergal Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Canterbury, UK
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13
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Burack JA, Evans DW, Russo N, Napoleon JS, Goldman KJ, Iarocci G. Developmental Perspectives on the Study of Persons with Intellectual Disability. Annu Rev Clin Psychol 2021; 17:339-363. [PMID: 33561363 DOI: 10.1146/annurev-clinpsy-081219-090532] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Developmental approaches provide inclusive, universal, and methodologically rigorous frameworks for studying persons with intellectual disability (ID). This is an exceptionally heterogeneous group with regard to etiology, genotype, and phenotype that simply shares the traditional diagnostic criteria, typically a score of two standard deviations below the population mean of 100 on standardized IQ tests and deficits in adaptive behavior. We trace the foundational, conceptual, and methodological roots of developmental approaches and highlight ways that these and more recent iterations continue to be central to advances in the increasingly nuanced study of persons with ID. This work is premised on the consideration of specific etiological groupings and subgroupings across and between different domains of functioning within the context of familial and complex environments throughout the life span. We highlight the potential contributions of advances in behavioral methodologies, genomics, and neuroscience when considered within universal and hierarchic frameworks based on development.
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Affiliation(s)
- Jacob A Burack
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec H3A 1Y2, Canada; ,
| | - David W Evans
- Department of Psychology, Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania 17837, USA;
| | - Natalie Russo
- Department of Psychology, Syracuse University, Syracuse, New York 13078, USA;
| | - Jenilee-Sarah Napoleon
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec H3A 1Y2, Canada; ,
| | | | - Grace Iarocci
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada;
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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: 7] [Impact Index Per Article: 1.8] [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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Di Pietro ML, Zaçe D. Three scenarios illustrating ethical concerns when considering bariatric surgery in obese adolescents with Prader-Willi syndrome. JOURNAL OF MEDICAL ETHICS 2020; 46:738-742. [PMID: 32341185 DOI: 10.1136/medethics-2019-106038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
Prader-Willi syndrome (PWS) is one of the 25 syndromic forms of obesity, in which patients present-in addition to different degrees of obesity-intellectual disability, endocrine disturbs, hyperphagia and/or other signs of hypothalamic dysfunction. In front of a severe/extreme obesity and the failure of non-invasive treatments, bariatric surgery is proposed as a therapeutic option. The complexity of the clinical condition, which could affect the long-term effects of bariatric surgery, and the frequent association with a mild to severe intellectual disability raise some ethical concerns in the treatment of obese PWS adolescents. This article analyses these issues referring to the principles of healthcare ethics: beneficence/non-maleficence (proportionality of treatments; minimisation of risks); respect of autonomy; justice. Based on these principles, three hypothetical scenarios are defined: (1) obese PWS adolescent, capable of making an autonomous decision; (2) obese PWS adolescent with a severe intellectual disability, whose parents agree with bariatric surgery; (3) obese PWS adolescent with a life-threatening condition and a severe intellectual disability, whose parents do not agree with bariatric surgery. The currently available evidence on efficacy and safety of bariatric surgery in PWS adolescents with extreme or severe obesity and the lack of adequate long-term follow-up suggests great caution even in a very life-threatening condition. Clinicians must always obtain a full IQ assessment of patients by psychologists. A multidisciplinary team is needed to analyse the clinical, psychological, social and ethical aspects and organise support for patient and parents, involving also the hospital ethical committee or, if necessary, legal authorities.
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Affiliation(s)
- Maria Luisa Di Pietro
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Drieda Zaçe
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Controversies and clarifications in the classification of disorders of intellectual development, new genetic findings, epilepsy, bullying, and innovative developmental neuropsychiatric treatments (deep-brain stimulation, electroconvulsive therapy, and oxytocin). Curr Opin Psychiatry 2018; 31:75-78. [PMID: 29278530 DOI: 10.1097/yco.0000000000000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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