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Parikh N, Faulkner A, Hadji-Michael M, Heyman I, Murphy T, McAllister E. Group-based parent training programme for children with neurological conditions: a feasibility study. Arch Dis Child 2024; 109:138-143. [PMID: 37898503 DOI: 10.1136/archdischild-2023-326174] [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: 08/03/2023] [Accepted: 09/30/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE AND DESIGN This study aimed to determine the feasibility and effectiveness of a parent training programme for parents of children with neurological conditions and behaviours that challenge. SETTING Child and adolescent mental health service within a specialist children's hospital. PARTICIPANTS Parents of 31 children with neurological conditions and behaviours that challenge. INTERVENTIONS Parents attended a 6-week evidence-based behavioural parenting programme delivered in a group format, either face-to-face or remote. MAIN OUTCOME MEASURES Feasibility was determined by attendance rates. Effectiveness was analysed primarily using parent-reported measures of child behaviour (Strengths and Difficulties Questionnaire, Paediatric Quality of Life and Goal-Based Outcomes). Secondary measures of parental well-being were also reported (Brief Parental Self-Efficacy Scale, Depression Anxiety Stress Scale Short Form and Parental Sense of Competence). Paired t-tests or Wilcoxon rank-sum tests were conducted to analyse differences preintervention and postintervention. RESULTS The attendance rates for the face-to-face and remote groups were 80% and 79%, respectively. Medium to large effect sizes were reported for most measures of child behaviour and parental well-being. There were statistically significant improvements found postintervention in children's behaviour (p=0.014), quality of life (p<0.001), goal-based outcomes (p<0.001), parental self-efficacy (p<0.001) and parental anxiety (p=0.030). Anecdotal feedback showed that parents indicated the group format was acceptable. CONCLUSIONS The group parenting intervention for parents of children with heterogeneous neurological conditions and behaviours that challenge appears feasible and effective in improving child behaviour and parental well-being.
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Affiliation(s)
- Nimmi Parikh
- Great Ormond Street Hospital for Children, London, UK
| | | | | | - Isobel Heyman
- Great Ormond Street Hospital for Children, London, UK
| | - Tara Murphy
- Great Ormond Street Hospital for Children, London, UK
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Höglund B, Janeslätt G, Arvidsson P, Randell E. Efficacy of a school-based intervention to influence attitudes about future parenting among Swedish youth with intellectual disability: An RCT study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1000-1012. [PMID: 37082781 DOI: 10.1111/jar.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND The study aim was to investigate the efficacy of an intervention designed to provide a basis for informed choices about future parenthood to special upper secondary school students with intellectual disabilities. METHODS A randomised trial with a waiting list control group was used. In total, 108 special upper secondary school students with mild or moderate intellectual disabilities, age 16-21 years, provided informed consent and participated. The intervention included education using the Parenting Toolkit and a Real Care Baby simulator. The analyses included 91 students (intervention group n = 46, 24F/22M; control group n = 45, 26F/19M). RESULTS The result showed that intervention group changed their attitudes to future parenting, from 'do not know' to 'know', significantly more than control group. The intervention increased knowledge levels in the intervention group. CONCLUSIONS The intervention group showed increased ability to make informed choices and decisions about parenthood.
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Affiliation(s)
- Berit Höglund
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Gunnel Janeslätt
- Department of Public Health and Caring Sciences, SUF Resource Centre, Region Uppsala, Centre for Clinical Research in Dalarna, Uppsala University, Falun, Sweden
| | - Patrik Arvidsson
- Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden
- School of Health and Welfare, Disability Research, Jonkoping University, Jonkoping, Sweden
| | - Eva Randell
- Department of Social Work, Uppsala University, Uppsala, Sweden
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Groves L, Jones C, Welham A, Hamilton A, Liew A, Richards C. Non-pharmacological and pharmacological interventions for the reduction or prevention of topographies of behaviours that challenge in people with intellectual disabilities: a systematic review and meta-analysis of randomised controlled trials. Lancet Psychiatry 2023; 10:682-692. [PMID: 37595996 DOI: 10.1016/s2215-0366(23)00197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/22/2023] [Accepted: 06/01/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND People with intellectual disability show a high prevalence of behaviours that challenge. Clinical guidelines recommend that such behaviour should first be treated with non-pharmacological interventions, but research suggests off-label pharmaceuticals are commonly used. We aimed to evaluate the efficacy of non-pharmacological and pharmacological interventions for topographies of behaviours that challenge drawn from randomised controlled trials (RCTs). METHODS In this systematic review and meta-analysis, we searched PsycINFO, MEDLINE, Embase, CINAHL, and CENTRAL databases for RCT studies assessing an intervention (pharmacological or non-pharmacological) for behaviours that challenge (self-injury behaviour, aggression, destruction of property, irritability, and a composite overall measure) in participants with intellectual disability. The primary aim was to assess the efficacy of non-pharmacological and pharmacological interventions on behaviours that challenge. Secondary aims were to evaluate how effects varied over time and whether intervention, methodological, and participant characteristics moderate efficacy. We extracted standard mean difference (SMD) effect sizes (Cohen's d) from eligible studies and meta-analysed the data using a series of random effects models and subgroup analyses. This study was registered with PROSPERO 2021, CRD4202124997. FINDINGS Of 11 912 reports identified, 82 studies were included. 42 (51%) studies assessed non-pharmacological interventions and 40 (49%) assessed pharmacological interventions. Across all studies, 4637 people with intellectual disability aged 1-84 years (mean age 17·2 years) were included. 2873 (68·2%) were male, 1339 (28·9%) were female, and for 425 (9·2%) individuals, data on gender were not available. Data on ethnicity were unavailable. Small intervention effects were found for overall behaviours that challenge at post-intervention (SMD -0·422, 95% CI -0·565 to -0·279), overall behaviours that challenge at follow-up (-0·324, -0·551 to -0·097), self-injury behaviour at post-intervention (-0·238, -0·453 to -0·023), aggression at post-intervention (-0·438, -0·566 to -0·309), and irritability at post-intervention (-0·255, -0·484 to -0·026). No significant differences between non-pharmacological and pharmacological interventions were found for any topography of behaviours that challenge (all p>0·05). INTERPRETATION A broad range of interventions for behaviours that challenge are efficacious with small effect sizes for people with intellectual disability. These findings highlight the importance of precision in the measurement of behaviours that challenge, and when operationalising intervention components and dosages. FUNDING Cerebra.
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Affiliation(s)
- Laura Groves
- School of Psychology, University of Birmingham, Birmingham, UK; Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.
| | - Chris Jones
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Alice Welham
- School of Psychology, University of Birmingham, Birmingham, UK; Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Anna Hamilton
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Ashley Liew
- School of Psychology, University of Birmingham, Birmingham, UK; Paediatric Neurosciences, Evelina London Children's Hospital, London, UK; Institute for Mental Health, University of Birmingham, Birmingham, UK; CEDAR, University of Warwick, Warwick, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Birmingham, UK; Cerebra Network, University of Birmingham, Birmingham, UK
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van Herwaarden A, Schuiringa H, van Nieuwenhuijzen M, Orobio de Castro B, Lochman JE, Matthys W. Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 128:104296. [PMID: 35810544 DOI: 10.1016/j.ridd.2022.104296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects. AIMS The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF. METHODS AND PROCEDURES Seventy-two children (aged 9-18; Mage = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions. OUTCOMES AND RESULTS The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002). CONCLUSIONS AND IMPLICATIONS The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF.
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Affiliation(s)
- Aniek van Herwaarden
- Radboud University, Programme of Learning and Plasticity, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Hilde Schuiringa
- Utrecht University, Department of Developmental Psychology, Utrecht, the Netherlands
| | - Maroesjka van Nieuwenhuijzen
- Expertise Center William Schrikker, Amsterdam, the Netherlands; University of Amsterdam, Research Institute Child Development and Education, Amsterdam, the Netherlands
| | - Bram Orobio de Castro
- University of Amsterdam, Research Institute Child Development and Education, Amsterdam, the Netherlands
| | - John E Lochman
- University of Alabama, Department of Psychology, Tuscaloosa, AL, USA
| | - Walter Matthys
- Utrecht University, Department of Clinical Child and Family Studies, Utrecht, the Netherlands
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Ayer C, Eapen V, Overs B, Descallar J, Jalaludin B, Eastwood JG, Dissanayake C, Williams K, Murphy E, Woolfenden S. Risk factors for non-participation in a universal developmental surveillance program in a population in Australia. AUST HEALTH REV 2020; 44:512-520. [PMID: 32731919 DOI: 10.1071/ah18236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/09/2019] [Indexed: 11/23/2022]
Abstract
Objectives This study examined the risk factors for non-participation in a developmental surveillance program in a population in south-west Sydney with a high proportion of culturally diverse and socioeconomically disadvantaged people. Methods Data from 850 and 625 12- and 18-month-old children respectively from the Watch Me Grow (WMG) birth cohort were used for this study. Logistic regression models were used to assess risk factors for 12- and 18-month non-attendance at Well Child Visits, as well as non-completion of the developmental surveillance questionnaire Parents' Evaluation of Developmental Status (PEDS) in the child's personal health record (PHR). Results Independent risk factors for non-attendance at Well Child Visits were female sex of the child (odds ratio (OR) 12 months 1.5; 95% confidence interval (CI) 1.0-2.3), mother's country of birth Australia (OR 18 months 1.8; 95% CI 1.2-2.7), annual household income less than A$25001 (OR 12 months 1.8; 95% CI 1.0-3.2) and residing in a socioeconomically disadvantaged neighbourhood (OR 12 months 1.7; 95% CI 1.1-2.5). Independent risk factors for non-completion of PEDS in those who did not attend the Well Child Visit compared with those who did attend and did complete PEDS were household annual income at birth less than A$25001 (OR 12 months 3.9; 95% CI 1.9-8.1) and residing in a socioeconomically disadvantaged neighbourhood (OR 12 months 2.1 (95% CI 1.2-3.7) and OR 18 months 2.0 (95% CI 1.2-3.6)). Conclusions In this population, children exposed to socioeconomic disadvantage are less likely to have attended a Well Child Visit and to have a completed PEDS in their PHR at 12 and/or 18 months of age. What is known about the topic? Developmental problems are common in early childhood, and children from socioeconomically disadvantaged households are at higher risk. Universal developmental surveillance programs may be effective at early identification of children at risk of developmental problems. Early childhood interventions, when accessed, can lessen the effects of developmental problems in later years. What does this paper add? This paper highlights that children exposed to socioeconomic disadvantage in early childhood who are at higher risk of having developmental problems are also at higher risk of missing out on early identification by non-participation in universal developmental surveillance. What are the implications for practitioners? A more equitable model of developmental surveillance should include a framework of proportionate universalism to ensure optimal engagement of high-risk population groups.
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Affiliation(s)
- Chandra Ayer
- Royal Far West, PO Box 52, Manly, NSW 1655, Australia; and Kogarah Diagnostic Assessment Service, St George Hospital, 90 Railway Parade, Kogarah, NSW 2217, Australia; and Corresponding author.
| | - Valsamma Eapen
- Psychiatry Research and Teaching Unit, School of Psychiatry, UNSW, Level 1, Mental Health Centre, Liverpool Hospital, corner Forbes and Campbell Streets, Liverpool, NSW 2170, Australia. ; and Academic Unit of Child Psychiatry, Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia; and South Western Sydney Clinical School, Faculty of Medicine, UNSW, Liverpool Hospital, Liverpool, NSW 2170, Australia
| | | | - Joseph Descallar
- South Western Sydney Clinical School, Faculty of Medicine, UNSW, Liverpool Hospital, Liverpool, NSW 2170, Australia; and Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ;
| | - Bin Jalaludin
- Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ; ; and School of Public Health and Community Medicine, UNSW, Sydney, NSW 2052, Australia
| | - John Graeme Eastwood
- Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ; ; and Community Paediatrics, Sydney Local Health District, Level 11 KGV Building, Missenden Road, Camperdown, NSW 2050, Australia. ; and School of Public Health, Menzies Centre for Health Policy, University of Sydney, Edward Ford Building, A27 Fisher Road, Sydney, NSW 2006, Australia; and School of Medicine, Griffith University, Parklands Drive, Southport, Gold Coast, Qld 4222, Australia; and School of Women's and Children's Health, UNSW, Sydney, NSW 2052, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3083, Australia.
| | - Katrina Williams
- Department of Paediatrics, Melbourne Medical School, The University of Melbourne, Melbourne, Vic. 3010, Australia; and Present address: Department of Paediatrics, Monash University, School of Clinical Sciences, Level 5, Monash Children's Hospital, 246 Clayton Road, Clayton, Vic. 3168, Australia.
| | - Elisabeth Murphy
- NSW Ministry of Health, Child, Youth and Family Health Services, PO Box 4007, Royal North Shore LPO, St Leonards, NSW 2065, Australia.
| | - Susan Woolfenden
- School of Women's and Children's Health, UNSW, Sydney, NSW 2052, Australia; and Department of Community Paediatrics, Sydney Children's Hospital Network, High Street, Randwick, NSW 2031, Australia.
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Oner O, Kahilogullari AK, Acarlar B, Malaj A, Alatas E. Psychosocial and cultural needs of children with intellectual disability and their families among the Syrian refugee population in Turkey. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:644-656. [PMID: 32627246 DOI: 10.1111/jir.12760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Turkey is the country hosting the largest number of refugees from Syria, with currently 3 571 175 million persons. The general health needs of the refugees are being addressed; however, people with intellectual disabilities (IDs), particularly children, are relatively missed. The aim of this study was to identify medical, psychological and social needs of children with ID and their families, among the Syrian refugee population in Turkey, and to define psychosocial and cultural needs for planning of future services. METHODS One hundred forty-two children (67.6% men; mean age 90.5 months) diagnosed with intellectual disorders were included in the study. Family Needs Survey, with additional open-ended and close-ended questions, was used to evaluate family needs. Items from Developmental Disabilities Profile-2 were used to evaluate and screen cognitive, motor and language development as well as medical concerns and behavioural problems. Data on sociodemographic characteristics were also collected. RESULTS The highest needs were identified in information and financial needs domains. Other indicated needs were on child care and community services domains. The least indicated items were on family and social support and explaining to others domains. An average of 63.5% of the respondents definitely agreed with the Family Needs Survey items. The overall level of identification of need items was higher than that in some previous studies, indicating the level of unmet needs of the studied population. Family income, parents' employment and parents' education were not significantly associated with unmet family needs. Special education services were unreachable for most of the families in the study. CONCLUSIONS Families reported the highest needs in information and financial needs domains. The overall level of identification of needs was higher than that in some previous studies, indicating the level of unmet needs of the studied population. The majority of the parents reported that they had sufficient family and social support, which might be a protective factor for parental mental health. Parents' Turkish fluency was very significantly associated with every domain of unmet needs. Language barriers and translation problems had significant negative effects on families, as confirmed by the answers to open-ended questions. Another important factor identified was access to service professionals. Special education services, sorely needed for most of the families, could not always be reached. Although the progress of children who had received special education was not very encouraging, it was better than those who did not receive it. The first implication of the study is that increasing Turkish proficiency or providing high-quality and consistent translation services is vital for this category of children with ID. The second implication is that information and financial needs must be met with priority. Information must be tailored for each child's needs and developmental level. Special education and physical therapy must be more accessible and at higher quality.
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Affiliation(s)
- O Oner
- Child and Adolescent Psychiatry Department, Bahçeşehir University School of Medicine, Istanbul, Turkey
| | | | - B Acarlar
- Advanced Research Design and Analysis, Noema Scientific Consultancy, Istanbul, Turkey
| | - A Malaj
- WHO Country Office, Ankara, Turkey
| | - E Alatas
- Department of Mental Health, Ministry of Health, Ankara, Turkey
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Baker J, Kohlhoff J, Onobrakpor SI, Woolfenden S, Smith R, Knebel C, Eapen V. The Acceptability and Effectiveness of Web-Based Developmental Surveillance Programs: Rapid Review. JMIR Mhealth Uhealth 2020; 8:e16085. [PMID: 32324149 PMCID: PMC7206511 DOI: 10.2196/16085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/05/2020] [Accepted: 02/10/2020] [Indexed: 12/05/2022] Open
Abstract
Background Web-based developmental surveillance programs may be an innovative solution to improving the early detection of childhood developmental difficulties, especially within disadvantaged populations. Objective This review aimed to identify the acceptability and effectiveness of web-based developmental surveillance programs for children aged 0 to 6 years. Methods A total of 6 databases and gray literature were searched using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses–informed protocol. Data extraction included variables related to health equity. Results In total, 20 studies were identified. Most papers implemented web-based versions of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up screener for autism spectrum disorder or Parent Evaluation of Developmental Status screeners for broad developmental delay. Caregivers and practitioners indicated a preference for web-based screeners, primarily for user-friendliness, improved follow-up accuracy, time, and training efficiencies. Conclusions Although evidence is limited as to the necessity of web- versus face-to-face–based developmental screening, there are clear efficiencies in its use. Trial Registration PROSPERO CRD42019127894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=127894
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Affiliation(s)
- Jess Baker
- The University of New South Wales, Liverpool, Australia
| | - Jane Kohlhoff
- The University of New South Wales, Carramarr, Australia
| | | | | | - Rebecca Smith
- South Eastern Sydney Local Health District, Sydney, Australia
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Cook JL, Green CR, Lilley C, Psych R, Anderson S, Baldwin ME, Chudley AE, Conry J, LeBlanc N, Loock CA, Mallon B, McFarlane A, Temple V, Psych C. Response to "A critique for the new Canadian FASD diagnostic Guidelines". JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2018; 27:83-87. [PMID: 29662519 PMCID: PMC5896521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada (SOGC), University of Ottawa, Ottawa, Ontario
- Canada FASD Research Network, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
| | - Courtney R Green
- The Society of Obstetricians and Gynaecologists of Canada (SOGC), University of Ottawa, Ottawa, Ontario
- Canada FASD Research Network, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
| | - Christine Lilley
- The Society of Obstetricians and Gynaecologists of Canada (SOGC), University of Ottawa, Ottawa, Ontario
- Canada FASD Research Network, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
- Compass Clinic, Vancouver, British Columbia
- National Institutes of Health, Bethesda, Maryland, USA
- Fetal Alcohol Spectrum Disorders Clinic, Child Development Services, Alberta Children's Hospital, Calgary, Alberta
- Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba
- Emerita University of British Columbia, Vancouver, British Columbia
- Dr. Georges-L.-Dumont University Hospital Centre, Moncton, New Brunswick
- FASD Centre of Excellence, Université de Moncton and Université de Sherbrooke, Moncton, New Brunswick
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta
- Lakeland Centre for FASD, Cold Lake, Alberta
- Surrey Place Centre, Toronto, Ontario
| | - R Psych
- Compass Clinic, Vancouver, British Columbia
| | | | - Mary Ellen Baldwin
- Fetal Alcohol Spectrum Disorders Clinic, Child Development Services, Alberta Children's Hospital, Calgary, Alberta
| | - Albert E Chudley
- Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba
| | - Julianne Conry
- Emerita University of British Columbia, Vancouver, British Columbia
| | - Nicole LeBlanc
- Dr. Georges-L.-Dumont University Hospital Centre, Moncton, New Brunswick
- FASD Centre of Excellence, Université de Moncton and Université de Sherbrooke, Moncton, New Brunswick
| | - Christine A Loock
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
| | - Bernadene Mallon
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta
| | | | - Valerie Temple
- The Society of Obstetricians and Gynaecologists of Canada (SOGC), University of Ottawa, Ottawa, Ontario
- Canada FASD Research Network, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
- Compass Clinic, Vancouver, British Columbia
- National Institutes of Health, Bethesda, Maryland, USA
- Fetal Alcohol Spectrum Disorders Clinic, Child Development Services, Alberta Children's Hospital, Calgary, Alberta
- Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba
- Emerita University of British Columbia, Vancouver, British Columbia
- Dr. Georges-L.-Dumont University Hospital Centre, Moncton, New Brunswick
- FASD Centre of Excellence, Université de Moncton and Université de Sherbrooke, Moncton, New Brunswick
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta
- Lakeland Centre for FASD, Cold Lake, Alberta
- Surrey Place Centre, Toronto, Ontario
| | - C Psych
- Surrey Place Centre, Toronto, Ontario
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Bezzina LA, Rice LJ, Howlin P, Tonge BJ, Einfeld SL. Syndrome specific modules to enhance the Stepping Stones Triple P public health intervention. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:836-842. [PMID: 28833838 DOI: 10.1111/jir.12405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 07/11/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Service responses to behaviour phenotypes include care by expert clinicians, syndrome-specific clinics, disability-specific mental health services and generic mental health services. While these services contribute to care, they are often of limited accessibility. METHODS We describe a population-wide public health intervention aimed at increasing the accessibility of services to the target population. Stepping Stones Triple P (SSTP) is a public health intervention of known efficacy in reducing behaviour problems when delivered to parents of children aged 0-12 with mixed developmental disabilities. RESULTS The strategy we discuss involves enhancing SSTP with modules for specific causes of developmental disabilities including Down, Fetal Alcohol, Fragile X, Prader-Willi and Williams syndromes. CONCLUSIONS We propose that enhancing SSTP with syndrome specific modules will increase the accessibility of support to families who have a child with a specific behaviour phenotype. We suggest that future research should confirm the public health impact of the modified SSTP programme using the RE-AIM framework.
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Affiliation(s)
- L A Bezzina
- Faculty of Health Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - L J Rice
- Faculty of Health Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - P Howlin
- Faculty of Health Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - B J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University
| | - S L Einfeld
- Faculty of Health Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
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Hinton S, Sheffield J, Sanders MR, Sofronoff K. A randomized controlled trial of a telehealth parenting intervention: A mixed-disability trial. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 65:74-85. [PMID: 28458049 DOI: 10.1016/j.ridd.2017.04.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 03/31/2017] [Accepted: 04/05/2017] [Indexed: 05/12/2023]
Abstract
BACKGROUND The quality of parenting a child receives has a major impact on development, wellbeing and future life opportunities. AIMS This study examined the efficacy of Triple P Online - Disability (TPOL-D) a telehealth intervention for parents of children with a disability. METHODS Ninety-eight parents and carers of children aged 2-12 years diagnosed with a range of developmental, intellectual and physical disabilities were randomly assigned to either the intervention (51) or treatment-as-usual (47) control group. RESULTS At post-intervention parents receiving the TPOL-D intervention demonstrated significant improvements in parenting practices and parenting self-efficacy, however a significant change in parent-reported child behavioral and emotional problems was not detected. At 3-month follow up intervention gains were maintained and/or enhanced. A significant decrease in parent-reported child behavioral and emotional problems was also detected at this time. CONCLUSIONS The results indicate that TPOL-D is a promising telehealth intervention for a mixed-disability group.
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Affiliation(s)
- Sharon Hinton
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Jeanie Sheffield
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Matthew R Sanders
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Kate Sofronoff
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
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11
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Stasolla F, Perilli V, Damiani R, Albano V. Assistive technology to promote occupation and reduce mouthing by three boys with fragile X syndrome. Dev Neurorehabil 2017; 20:185-193. [PMID: 27054947 DOI: 10.3109/17518423.2015.1133724] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To extend the use of assistive technology (AT) for promoting a new adaptive response and to reduce hand mouthing, by three boys with fragile X syndrome. To monitor the effects of the intervention program on the positive mood. To carry out a three month follow-up phases. To conduct a social validation assessment involving 30 parents of children who presented multiple disabilities as raters. METHODS The study was implemented according to an ABAB experimental design, where A represented baseline phases (technology available but inactive) and B represented intervention phases (the technology ensured 7 s of positive stimulation). RESULTS All participants improved and consolidated their performance. Parents involved in the social validation assessment rated positively the use of such technology. CONCLUSION AT-based program was useful, affordable, and effective for enhancing constructive engagement, self-determination, and for improving quality of life by children with fragile X syndrome and severe to profound developmental disabilities.
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Affiliation(s)
| | | | - Rita Damiani
- c Department of Educational Sciences, Psychology, Communication , University of Bari , Bari , Italy
| | - Vincenza Albano
- c Department of Educational Sciences, Psychology, Communication , University of Bari , Bari , Italy
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12
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Overs BJ, Woolfenden S, Williams K, Jalaludin B, Axelsson EL, Dissanayake C, Descallar J, Harvey S, Beasley D, Murphy E, Eapen V. Predictors of developmental surveillance completion at six months of age in south western Sydney. Child Care Health Dev 2017; 43:307-315. [PMID: 27910128 PMCID: PMC5396131 DOI: 10.1111/cch.12425] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 09/22/2016] [Accepted: 10/09/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND While developmental surveillance programs promote early identification of child developmental problems, evidence has indicated suboptimal uptake. This study aimed to identify predictors of developmental surveillance completion at 6 months postpartum. METHODS Questionnaires were administered to the parents of 510 infants who were born in south western Sydney, Australia over a 22-month period. Attendance for developmental screening and completion of the Parents' Evaluation of Developmental Status (PEDS) at 6 months postpartum were modelled separately using multivariable logistic regression. RESULTS Developmental surveillance attendance was predicted by higher levels of maternal education, annual income and being informed about checks. PEDS completion at 6 months of age was predicted by higher income and being informed, as well as being married, employed, speaking English at home, full-term birth and the professional status of the practitioner completing the check. CONCLUSIONS Barriers to developmental surveillance included low socioeconomic status, linguistic diversity and possible gaps in parental knowledge and professional education. Developmental surveillance rates may be increased by the addition of targeted parental and professional support within current universal frameworks.
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Affiliation(s)
- B. J. Overs
- University of New South WalesSydneyNSWAustralia
| | - S. Woolfenden
- University of New South WalesSydneyNSWAustralia,Sydney Children's Hospitals NetworkSydneyNSWAustralia
| | - K. Williams
- Royal Children's HospitalParkvilleVICAustralia,Murdoch Children's Research InstituteParkvilleVICAustralia,University of MelbourneMelbourneVICAustralia
| | - B. Jalaludin
- University of New South WalesSydneyNSWAustralia,South Western Sydney Local Health DistrictLiverpoolNSWAustralia,Ingham Institute for Applied Medical ResearchLiverpoolNSWAustralia
| | - E. L. Axelsson
- Australian National UniversityCanberraACTAustralia,Academic Unit of Child PsychiatrySouth Western Sydney Local Health District LiverpoolNSWAustralia
| | - C. Dissanayake
- Olga Tennison Autism Research CentreLa Trobe UniversityMelbourneVICAustralia
| | - J. Descallar
- Ingham Institute for Applied Medical ResearchLiverpoolNSWAustralia,South Western Sydney Clinical SchoolUniversity of New South WalesLiverpoolNSWAustralia
| | - S. Harvey
- University of New South WalesSydneyNSWAustralia
| | - D. Beasley
- Child and Family HealthNew South Wales Ministry of HealthSydneyNSWAustralia
| | - E. Murphy
- Child and Family HealthNew South Wales Ministry of HealthSydneyNSWAustralia
| | - V. Eapen
- University of New South WalesSydneyNSWAustralia,South Western Sydney Local Health DistrictLiverpoolNSWAustralia,Ingham Institute for Applied Medical ResearchLiverpoolNSWAustralia
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13
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Schuiringa H, van Nieuwenhuijzen M, Orobio de Castro B, Lochman JE, Matthys W. Effectiveness of an Intervention for Children with Externalizing Behavior and Mild to Borderline Intellectual Disabilities: A Randomized Trial. COGNITIVE THERAPY AND RESEARCH 2016; 41:237-251. [PMID: 28344370 PMCID: PMC5346153 DOI: 10.1007/s10608-016-9815-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study evaluated the effectiveness of Standing Strong Together (SST), a combined group based parent and child intervention for externalizing behavior in 9-16 year-old children with mild to borderline intellectual disabilities (MBID). Children with externalizing behavior and MBID (IQ from 55 to 85) (N = 169) were cluster randomly assigned to SST combined with care as usual or to care as usual only. SST led to a significant benefit on teacher reported but not on parent reported externalizing behavior. SST had significant effects on parent rated positive parenting and the parent-child relationship. The present study shows that a multicomponent group based intervention for children with MBID is feasible and has the potential to reduce children's externalizing behavior and improve both parenting behavior and the parent-child relationship.
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Affiliation(s)
- Hilde Schuiringa
- Department of Developmental Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
| | - Maroesjka van Nieuwenhuijzen
- Department of Clinical Child and Family Studies, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- Learn Research Institute for Learning and Education, VU University Amsterdam, Amsterdam, The Netherlands
- The EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
| | - Bram Orobio de Castro
- Department of Developmental Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
| | - John E. Lochman
- Department of Clinical Psychology, University of Alabama, Tuscaloosa, AL USA
- The Conduct Disorder Prevention Research Group, University of Alabama, Tuscaloosa, AL USA
| | - Walter Matthys
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry of University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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14
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15
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Johnson R. Towards an Evidence-Based Clinical Forensic Diagnostic Assessment Framework for Juvenile Fire Setting and Bomb Making: DSM-5 Quadrant. JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE 2015. [DOI: 10.1080/15228932.2015.1022479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Emerson E, Brigham P. Exposure of children with developmental delay to social determinants of poor health: cross-sectional case record review study. Child Care Health Dev 2015; 41:249-57. [PMID: 24797435 DOI: 10.1111/cch.12144] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research on child development in general has highlighted the importance that the family environment plays in mediating the pathway between exposure to low socio-economic position (SEP) and child well-being. While child developmental models in intellectual disability have highlighted the interplay between social context, family environment and child development, little empirical work has attempted to formally evaluate the evidence in support of specific mediating pathways between low SEP and child outcomes. METHODS Secondary analysis of cross-sectional confidentialized needs analysis data collected in three Primary Care Trusts in England covering a total population of 1.25 million people. Case record reviews were undertaken for 46 023 households, 2236 (4.9%) of which contained a child in the target age range with developmental delay. RESULTS Children with developmental delay, when compared with their non-disabled peers, were at significantly increased risk of poorer health outcomes and of being exposed to a wide range of social determinants of poor health. Controlling for between-group differences in exposure to social determinants of poor health reduced the risk of developmental delay being associated with poorer health outcomes by 45% for behaviour problems and 89% for risk of significant harm. For children with developmental delay, parenting difficulties appears to play a particularly significant role in partially mediating the effects of low SEP. CONCLUSIONS The findings of the present study point to the potential effectiveness of family-focused early intervention to prevent the emergence and escalation of behavioural difficulties and health problems in children with developmental delay.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, NSW, Australia
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Emerson E, Blacher J, Einfeld S, Hatton C, Robertson J, Stancliffe RJ. Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3508-3517. [PMID: 25238636 DOI: 10.1016/j.ridd.2014.08.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/28/2014] [Accepted: 08/28/2014] [Indexed: 06/03/2023]
Abstract
We investigated the association between exposure to environmental risks in early childhood and the prevalence and persistence of conduct difficulties (CD) in children with intellectual disability (ID) who did not have autistic spectrum disorder (ASD), children with ASD and typically developing (TD) children. Results indicated that: (1) exposure to risk was associated with elevated prevalence of CD at age three and, for TD children and children with ID, increased risk of CD persisting to ages five and seven; (2) at all levels of risk, children with ASD were more likely to show persistent CD than other children; (3) children with ID were no more likely to show persistent CD than TD children at low levels of exposure to environmental risk.
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Affiliation(s)
- Eric Emerson
- University of Sydney, Australia; Lancaster University, UK.
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18
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Schroeder SR, Rojahn J, An X, Mayo-Ortega L, Oyama-Ganiko R, LeBlanc J. The Parental Concerns Questionnaire: A Brief Screening Instrument for Potentially Severe Behavior Problems in Infants and Toddlers At-Risk for Developmental Delays. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2014; 26:237-247. [PMID: 24659900 PMCID: PMC3960007 DOI: 10.1007/s10882-013-9359-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The Parental Concerns Questionnaire (PCQ) was designed as a parent-interview screening instrument for young children with developmental concerns at risk for potentially severe behavior problems (SBDs). Parents of 262 young children (4 to 48 months) answered to the 15 dichotomous PCQ items interviewed by trained staff. Cluster analysis for items revealed three item clusters, which we labeled Developmental/Social (8 items), Biomedical (3 items), and Behavior Problems (3 items). This paper discussed primarily the Behavior Problems cluster, with items referring to self-injurious, aggressive, and destructive behaviors. Parents' concerns about behavior problems were high, with item-endorsements of the Behavior Problems cluster ranging from 41.8 % to 68.8 %. The Behavior Problems cluster was significantly correlated with all three subscales of the Behavior Problems Inventory (BPI-01), with select subscales of the Aberrant Behavior Checklist (ABC), and with the Repetitive Behavior Scale-Revised (RBS-R) providing some evidence for concurrent validity. Sensitivity and specificity data were computed for the three PCQ items as well as for the cluster score in comparison with the BPI-01, ABC, and RBS-R showing strong sensitivity. The PCQ Behavior Problems cluster is a useful screening checklist with high sensitivity for potential SBDs in young children at-risk for developmental delays.
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Affiliation(s)
| | | | - Xiaozhu An
- George Mason University, Fairfax, VA, USA
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Psychiatry looks towards the future in neurodegenerative and neurodevelopmental disorders. Curr Opin Psychiatry 2013; 26:237-8. [PMID: 23493132 DOI: 10.1097/yco.0b013e32835fd70e] [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: 11/25/2022]
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