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Weiss MD, Daniolos PT, Coughlin K, Mulvaney-Day N, Cook B, Rosenblum D. A Scoping Review of the Intersectionality of Autism and Intellectual and Developmental Disability with Social Inequity on Diagnosis and Treatment of Youth. J Child Adolesc Psychopharmacol 2024. [PMID: 38957953 DOI: 10.1089/cap.2023.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Objective: To describe how the intersectionality of race, ethnicity, and language with autism and intellectual and developmental disability (IDD) impacts mental health inequities in psychopharmacological management of youth. Method: This was a scoping review in which a series of searches were conducted in PubMed, Web of Science, Google Scholar, and manual review of the articles collected. Results: Although autism and/or IDD increases the risk for poor physical and mental health, social determinants of health such as race, ethnicity, and language account for approximately a third of poor outcomes. Minoritized children with autism/IDD experience significantly greater delays to diagnosis and misdiagnosis and are less likely to receive appropriate services. Access to psychological testing and psychosocial services is often limited by availability, skilled practitioners, a shortage of non-English-language providers or interpreters, and poor reimbursement. Conclusion: The intersectionality of autism and/or IDD with race, ethnicity, and language compounds the health inequities associated with either of these challenges independently.
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Affiliation(s)
- Margaret Danielle Weiss
- Cambridge Health Alliance, Department of Psychiatry, Cambridge, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Peter T Daniolos
- Cambridge Health Alliance, Department of Psychiatry, Cambridge, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Kevin Coughlin
- Cambridge Health Alliance, Department of Psychiatry, Cambridge, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Norah Mulvaney-Day
- Cambridge Health Alliance, Department of Psychiatry, Cambridge, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Benjamin Cook
- Cambridge Health Alliance, Department of Psychiatry, Cambridge, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Debra Rosenblum
- Cambridge Health Alliance, Department of Psychiatry, Cambridge, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
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Belza C, Szentkúti P, Horváth-Puhó E, Ray JG, Nelson KE, Grandi SM, Brown HK, Sørensen HT, Cohen E. Use of Latent Class Analysis to Predict Intensive Care Unit Admission and Mortality in Children with a Major Congenital Anomaly. J Pediatr 2024; 270:114013. [PMID: 38494089 DOI: 10.1016/j.jpeds.2024.114013] [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: 12/04/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE To define major congenital anomaly (CA) subgroups and assess outcome variability based on defined subgroups. STUDY DESIGN This population-based cohort study used registries in Denmark for children born with a major CA between January 1997 and December 2016, with follow-up until December 2018. We performed a latent class analysis (LCA) using child and family clinical and sociodemographic characteristics present at birth, incorporating additional variables occurring until age of 24 months. Cox proportional hazards regression models estimated hazard ratios (HRs) of pediatric mortality and intensive care unit (ICU) admissions for identified LCA classes. RESULTS The study included 27 192 children born with a major CA. Twelve variables led to a 4-class solution (entropy = 0.74): (1) children born with higher income and fewer comorbidities (55.4%), (2) children born to young mothers with lower income (24.8%), (3) children born prematurely (10.0%), and (4) children with multiorgan involvement and developmental disability (9.8%). Compared with those in Class 1, mortality and ICU admissions were highest in Class 4 (HR = 8.9, 95% CI = 6.4-12.6 and HR = 4.1, 95% CI = 3.6-4.7, respectively). More modest increases were observed among the other classes for mortality and ICU admissions (Class 2: HR = 1.7, 95% CI = 1.1-2.5 and HR = 1.3, 95% CI = 1.1-1.4, respectively; Class 3: HR = 2.5, 95% CI = 1.5-4.2 and HR = 1.5, 95% CI = 1.3-1.9, respectively). CONCLUSIONS Children with a major CA can be categorized into meaningful subgroups with good discriminative ability. These groupings may be useful for risk-stratification in outcome studies.
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Affiliation(s)
- Christina Belza
- Edwin S.H. Leong Centre for Health Children, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Péter Szentkúti
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Erzsébet Horváth-Puhó
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Joel G Ray
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; St. Michael's Hospital Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katherine E Nelson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sonia M Grandi
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Hilary K Brown
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark; Clinical Excellence Research Center, Stanford University, Stanford, CA
| | - Eyal Cohen
- Edwin S.H. Leong Centre for Health Children, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
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3
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Täljedal T, Granlund M, Osman F, Norén Selinus E, Fängström K. Parenting children with disabilities in Sweden: a cluster-analysis of parenting stress and sufficiency of informal and formal support. Front Psychol 2024; 15:1389995. [PMID: 38882520 PMCID: PMC11177875 DOI: 10.3389/fpsyg.2024.1389995] [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: 02/22/2024] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Objective To investigate patterns of parenting stress and access to sufficient informal and formal support among parents of children with disabilities. To explore whether child cognitive level, conduct problems and the need of language interpretation in contacts between parents and professionals are associated with patterns of parenting stress and support. Method Parents (N = 140) of children with disabilities in Sweden completed a questionnaire about parenting stress and support. Patterns of three variables-parenting stress and access to sufficient informal and formal support-were investigated using cluster analysis. The relationship of child cognitive level, level of conduct problems and of language interpretation needs between parents and professionals to cluster membership was explored using multinomial logistic regression. Results Five different clusters of parenting stress and support emerged. Parents in cluster 1 had lower than sample mean ratings on all three variables. Cluster 2 had elevated parenting stress, cluster 3 had elevated insufficient informal support and cluster 4 had elevated insufficient formal support. Cluster 5 had elevated ratings on all three variables. Greater child cognitive difficulties increased the likelihood of parent membership in cluster 2 (elevated stress), cluster 3 (elevated insufficient informal support), or cluster 5 (elevated ratings on all variables). Child conduct problems increased the likelihood of membership in cluster 2 (elevated stress) or cluster 5 (elevated ratings on all variables). No relationship between language interpretation needs and cluster membership was found. Conclusions Patterns of parenting stress and sufficiency of support, and their associations with child characteristics, vary substantially. However, families of children with conduct problems experiencing elevated parenting stress in combination with insufficient informal and formal support, may be particularly vulnerable. The results of the current study highlight the clinical importance of exploring and identifying individual parenting stressors and perceived levels of support, to be able to adapt services to better suit a variety of needs, and thus promote equitable care.
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Affiliation(s)
- Torun Täljedal
- Region Västmanland-Uppsala University, Centre for Clinical Research, Västmanland Hospital Västerås, Västerås, Sweden
- CHAP, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mats Granlund
- CHILD Research Environment, Jönköping University, Jönköping, Sweden
- Department of Mental Health, Norway Technical and Natural Sciences University, Trondheim, Norway
| | - Fatumo Osman
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Eva Norén Selinus
- Region Västmanland-Uppsala University, Centre for Clinical Research, Västmanland Hospital Västerås, Västerås, Sweden
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Karin Fängström
- CHAP, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Mafuba K, Kiernan J, Chapman HM, Kupara D, Kudita C, Chester R. Understanding the contribution of intellectual disability nurses. Paper 2 of 4 - Survey. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231213434. [PMID: 37956695 DOI: 10.1177/17446295231213434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The objective was to identify ID nursing interventions and their impact on the health and healthcare of people with IDs. Data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. We identified 878 interventions that could be undertaken by ID nurses from 7 countries. We categorised the interventions into five themes: effectuating nursing procedures, enhancing impact of ID services, enhancing impact of mainstream services, enhancing quality of life, and enhancing ID nursing practice. Findings demonstrate that ID nurses play important roles in improving the health and healthcare experiences of people with IDs.
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Affiliation(s)
| | - Joann Kiernan
- Edge Hill University and Alder Hey Children's Hospital, UK
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Griffith SF, Magariño LS, Pedraza FDM, Frazier SL, Berkovits MD, Bagner DM. Surveying Early Intervention Providers to Identify Opportunities for Workforce Support to Strengthen Family-Centered Care. INFANTS AND YOUNG CHILDREN 2023; 36:314-332. [PMID: 38107032 PMCID: PMC10723819 DOI: 10.1097/iyc.0000000000000247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Traditional provider-to-child models of early intervention (EI) service provision have been increasingly replaced by service guidelines that promote a broader family-centered approach to support improvement in the child's primary area of delay. These guidelines include working directly with caregivers and addressing needs of the family that might impact a caregivers' capacity to engage in developmentally supportive interactions with children (e.g., caregiver distress). Knowledge of provider skills, practices, and attitudes would inform efforts to broaden and enhance practice in line with these guidelines. Within an academic-community partnership to support EI, we surveyed 88 providers in Miami and Boston about their usual practice, perceptions of their skills, general attitudes towards evidence-based practices, and interest in specific training opportunities. Findings indicated that providers spent more time working directly with children than caregivers. Providers reported high interest in training to manage caregiver distress, support preschool readiness, and align work with family culture. Negative overall attitudes towards using evidence-based interventions and provider exhaustion were related to less interest in obtaining training in culturally-responsive practice. Exhaustion also related to less interest in training on other topics that represent a broadened scope of care, including building warm parent-child relationships. Findings are informing efforts to design EI training opportunities to improve parent-provider relations, enhance parent-child interactions, and reduce caregiver stress.
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Affiliation(s)
- Shayl F. Griffith
- Department of Counseling, Recreation, and School Psychology, Florida International University, Miami, FL
| | | | | | - Stacy L. Frazier
- Department of Psychology, Florida International University, Miami, FL
| | | | - Daniel M. Bagner
- Department of Psychology, Florida International University, Miami, FL
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Filakovska Bobakova D, Chovan S, Bosakova L, Koky R, de Kroon MLA, Dankulincova Veselska Z. Desirable but not feasible: Measures and interventions to promote early childhood health and development in marginalized Roma communities in Slovakia. Front Public Health 2022; 10:942550. [PMID: 36276342 PMCID: PMC9580395 DOI: 10.3389/fpubh.2022.942550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/07/2022] [Indexed: 01/21/2023] Open
Abstract
Roma are the largest and most disadvantaged ethnic minority in Europe often facing generational poverty, and limited access to education, employment, housing, and various types of services. Despite many international and national initiatives, children from marginalized Roma communities face multiple risks and are being disadvantaged as early as from conception onward. We, therefore, aimed to identify measures and/or interventions targeting equity in early childhood health and development in marginalized Roma communities which implementation is considered to be urgent but not feasible. We used a group concept mapping approach-a participatory mixed research method-and involved 40 experts and professionals from research, policy and practice. From 90 measures and interventions proposed to achieve early childhood equity for children from marginalized Roma communities, 23 measures were identified as urgent but not feasible. These concerned particularly measures and interventions targeting living conditions (including access to income, access to housing, and basic infrastructure for families) and public resources for instrumental support (covering mainly topics related to financial and institutional frameworks). Our results reflect the most pressing issues in the area of equality, inclusion and participation of Roma and expose barriers to implementation which are likely to arise from public and political discourses perpetrating a negative image of Roma, constructing them as less deserving. Measures to overcome persistent prejudices against Roma need to be implemented along with the measures targeting equity in early childhood health and development.
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Affiliation(s)
- Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia,Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia,*Correspondence: Daniela Filakovska Bobakova
| | - Shoshana Chovan
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Lucia Bosakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia,Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia
| | - Richard Koky
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Marlou L. A. de Kroon
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands,Department of Public Health and Primary Care, Centre for Environment and Health, Catholic University Leuven, Leuven, Belgium
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
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7
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Ledoux AA, Webster RJ, Clarke AE, Fell DB, Knight BD, Gardner W, Cloutier P, Gray C, Tuna M, Zemek R. Risk of Mental Health Problems in Children and Youths Following Concussion. JAMA Netw Open 2022; 5:e221235. [PMID: 35254429 PMCID: PMC8902648 DOI: 10.1001/jamanetworkopen.2022.1235] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Concussion may exacerbate existing mental health issues. Little evidence exists on whether concussion is associated with the onset of new psychopathologies or long-term mental health problems. OBJECTIVE To investigate associations between concussion and risk of subsequent mental health issues, psychiatric hospitalizations, self-harm, or suicides. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study including children and youths aged 5 to 18 years with a concussion or orthopedic injury incurred between April 1, 2010, and March 31, 2020, in Ontario, Canada. Participants had no previous mental health visit in the year before the index event for cohort entry and no prior concussion or traumatic brain injury 5 years before the index visit. Data were collected from provincewide health administrative databases. Participants with concussion were included in the exposed cohort, and those with an orthopedic injury were included in the comparison cohort; these groups were matched 1:2, respectively, on age and sex. EXPOSURES Concussion or orthopedic injury. MAIN OUTCOMES AND MEASURES The primary outcome was mental health problems, such as psychopathologies and psychiatric disorders, identified from health care visits in emergency departments, hospitalizations, or primary care settings. Secondary outcomes were psychiatric hospitalizations, self-harm health care visits, and death by suicide (identified in health care or vital statistics databases). RESULTS A total of 152 321 children and youths with concussion (median [IQR] age, 13 [10-16] years; 86 423 [56.7%] male) and 296 482 children and youths with orthopedic injury (median [IQR] age, 13 [10-16] years; 171 563 [57.9%] male) were matched by age and sex. The incidence rates of any mental health problem were 11 141 per 100 000 person-years (exposed group) and 7960 per 100 000 person-years (unexposed group); with a difference of 3181 (95% CI, 3073-3291) per 100 000 person-years. The exposed group had an increased risk of developing a mental health issue (adjusted hazard ratio [aHR], 1.39; 95% CI, 1.37-1.40), self-harm (aHR, 1.49; 95% CI, 1.42-1.56), and psychiatric hospitalization (aHR, 1.47; 95% CI, 1.41-1.53) after a concussion. There was no statistically significant difference in death by suicide between exposed and unexposed groups (HR, 1.54; 95% CI, 0.90-2.61). CONCLUSIONS AND RELEVANCE Among children and youths aged 5 to 18 years, concussion was associated with an increased risk of mental health issues, psychiatric hospitalization, and self-harm compared with children and youths with an orthopedic injury.
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Affiliation(s)
- Andrée-Anne Ledoux
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Cellular Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Richard J. Webster
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Deshayne B. Fell
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Braden D. Knight
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa, Ontario, Canada
| | - William Gardner
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Paula Cloutier
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Clare Gray
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Psychiatry, Children’s Hospital of Eastern, Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Meltem Tuna
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Roger Zemek
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, Children’s Hospital of Eastern, Ontario, University of Ottawa, Ottawa, Ontario, Canada
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Roording‐Ragetlie S, Spaltman M, de Groot E, Klip H, Buitelaar J, Slaats‐Willemse D. Working memory training in children with borderline intellectual functioning and neuropsychiatric disorders: a triple-blind randomised controlled trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:178-194. [PMID: 34755919 PMCID: PMC9298879 DOI: 10.1111/jir.12895] [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: 10/25/2020] [Revised: 09/20/2021] [Accepted: 10/08/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND Poor working memory, lower IQ and maladaptive behaviour form a triple disability known to have negative effects on the academic and social development of children with borderline intellectual functioning (BIF; IQ: 70 < IQ < 85) and neuropsychiatric disorders [attention-deficit hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD)]. Treatment possibilities for these children are scarce and hardly evidence based. This study primarily investigated whether adaptive computerised working memory training (WMT) may lead to significantly more improvement on a non-trained visuospatial WM task compared with a non-adaptive control WMT (placebo) in children with BIF and neuropsychiatric disorders. As secondary outcome measures, we used the scores on several non-trained neuropsychological near-transfer and far-transfer tasks as well as behavioural measures. METHOD We conducted a triple-blind placebo-controlled randomised clinical trial in 72 children (aged 10;0-13;11 years, 53 boys, 19 girls) with BIF and comorbid neuropsychiatric disorders (ADHD = 37, ASD = 21, both = 14) that were referred to child and adolescent psychiatry care, between May 2012 and March 2019. Children completed the Dutch version of Cogmed WMT, either the adaptive training version or the non-adaptive placebo version, 25 sessions (30-45 min a day), for 5 weeks. The primary outcome measure was the score on a non-trained visuospatial working memory task. The primary outcome was measured before and directly after 5 weeks of WMT and again 6 months after training. RESULTS A total of 375 children were screened for eligibility and 72 were randomised. No significantly higher levels of improvement over time were found on our primary outcome measure in the experimental WMT group compared with the placebo control WMT, nor in the secondary (near-transfer and far-transfer tasks) or tertiary (behavioural measures) outcome measures. However, this study did show changes over time for these measurements for both the experimental and placebo conditions. CONCLUSIONS This study was unable to document superior training effects over time of an adaptive WMT in children with BIF and neuropsychiatric disorders, compared with a placebo (non-adaptive) WMT. The objectively documented changes over time in the non-adaptive WMT arm suggest that these children with persistent impairments in WM may benefit from a structured learning environment that is associated with improvement of neurocognitive functioning and coping strategies. Further research is needed to examine which elements of cognitive training may be useful for which specific patients and to study long-term effects of training.
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Affiliation(s)
- S. Roording‐Ragetlie
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryNijmegenThe Netherlands
| | - M. Spaltman
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryNijmegenThe Netherlands
| | - E. de Groot
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryNijmegenThe Netherlands
| | - H. Klip
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryNijmegenThe Netherlands
| | - J. Buitelaar
- Department of Mild Intellectual DisabilitiesKarakter Child and Adolescent PsychiatryNijmegenThe Netherlands
- Department of Cognitive NeuroscienceRadboud University Medical Centre, Donders Institute for Brain, Cognition and BehaviourNijmegenThe Netherlands
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and BehaviourRadboud University NijmegenNijmegenThe Netherlands
| | - D. Slaats‐Willemse
- Department of PsychiatryRadboud University Medical Centre, Donders Institute for Brain, Cognition and BehaviourNijmegenThe Netherlands
- DenkkrachtDepartment of Karakter Child and Adolescent PsychiatryNijmegenThe Netherlands
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Zhang L, Ssewanyana D, Martin MC, Lye S, Moran G, Abubakar A, Marfo K, Marangu J, Proulx K, Malti T. Supporting Child Development Through Parenting Interventions in Low- to Middle-Income Countries: An Updated Systematic Review. Front Public Health 2021; 9:671988. [PMID: 34336768 PMCID: PMC8322584 DOI: 10.3389/fpubh.2021.671988] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/15/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Over 250 million children in low- and middle-income countries are at risk of not achieving their fullest developmental potential due to co-occurring risks such as poor nutrition and inadequate learning opportunities. Early intervention programs integrating the aspects of nurturing care, that is, good health, adequate nutrition, safety and security, responsive caregiving, and learning opportunities, may ameliorate against the negative impact of these adverse conditions. Methods: This meta-analytic review updates the evidence base of parenting interventions comprising stimulation and responsive caregiving components on developmental outcomes for children under age 2 years in low- and middle-income countries. It also describes and assesses the moderation effects of population characteristics and implementation features on the intervention effectiveness. Studies were identified based on previous systematic reviews and an updated literature search in eight databases and the gray literature up to December 2020. A random-effect model was used to explore the pooled effect sizes accounted for by the intervention for developmental outcome of cognition, language, motor, and social-emotional capacities. Exploratory moderation analyses were also conducted. Results: Twenty-one randomized controlled trials representing over 10,400 children from 12 low- and middle-income countries and regions across three continents (Africa, Latin America, and Asia) were identified. The interventions showed overall small-to-moderate effects on children's cognitive development (ES = 0.44; 95% CI = [0.30, 0.57]); language development (ES = 0.33; 95% CI = [0.18, 0.49]); and motor skills (ES = 0.21; 95% CI = [0.10, 0.32]). The overall effect on social-emotional development was non-significant (ES = 0.17; 95% CI = [-0.01, 0.34]). Effect sizes (ES) varied significantly across the studies. Parenting programs that targeted vulnerable groups, including rural communities and caregivers with lower education levels, had more significant effects on children's development. Group sessions (vs. individual visits) and high program dose (≥12 sessions) were also associated with stronger effects on child development. Further research is needed to determine the effectiveness of the workforce and training on programmatic outcomes. Conclusion: The findings indicate that parenting interventions that encourage nurturing care are effective in improving the early development of children, especially among vulnerable populations. We discuss opportunities to strengthen the implementation of research-based parenting interventions in such contexts.
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Affiliation(s)
- Linlin Zhang
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Derrick Ssewanyana
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Marie-Claude Martin
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Stephen Lye
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Greg Moran
- Department of Psychology, Western University, London, ON, Canada
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Kofi Marfo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Joyce Marangu
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Kerrie Proulx
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Tina Malti
- Centre for Child Development, Mental Health, and Policy, University of Toronto Mississauga, Mississauga, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
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Goad E. Working alongside people with intellectual disabilities who have had difficult experiences: Reflections on trauma-informed care within a service context. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 26:1744629520987717. [PMID: 33615861 DOI: 10.1177/1744629520987717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
People with intellectual disabilities are more likely to experience adverse childhood experiences than those in the general population. Additionally, the conceptualization of 'trauma' is far broader than traditionally understood in order to encompass the far reaching relational nature of people with intellectual disabilities traumatic experiences. This reflective account details the first steps one service took to embrace trauma-informed care as a whole systems approach. The paper is a response to calls following conference presentations about our work, to share the process of the beginning of this journey, it also aims to provide key learning points, practical considerations and questions for reflection in order to support other services to begin their own relationships with trauma-informed care.
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Affiliation(s)
- Elisabeth Goad
- 9490Surrey and Borders Partnership NHS Foundation Trust, UK
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Mental Health of Parents of Special Needs Children in China during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249519. [PMID: 33353165 PMCID: PMC7765938 DOI: 10.3390/ijerph17249519] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 12/21/2022]
Abstract
We assessed the mental health of parents (N = 1450, Mage = 40.76) of special needs children during the COVID-19 pandemic. We conducted an online survey comprising items on demographic data; two self-designed questionnaires (children’s behavioral problems/psychological demand of parents during COVID-19); and four standardized questionnaires, including the General Health Questionnaire, Perceived Social Support, Parenting Stress Index, and Neuroticism Extraversion Openness Five Factor Inventory. The results showed that there were significant differences among parents of children with different challenges. Parents of children with autism spectrum disorder were more likely to have mental health problems compared to parents whose children had an intellectual disability or a visual or hearing impairment. Behavioral problems of children and psychological demands of parents were common factors predicting the mental health of all parents. Parent–child dysfunctional interactions and parenting distress were associated with parents of children with autism spectrum disorder. Family support, having a difficult child, and parenting distress were associated with having children with an intellectual disability. It is necessary to pay attention to the parents’ mental health, provide more social and family support, and reduce parenting pressures.
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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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Filipe AM, Bogossian A, Zulla R, Nicholas D, Lach LM. Developing a Canadian framework for social determinants of health and well-being among children with neurodisabilities and their families: an ecosocial perspective. Disabil Rehabil 2020; 43:3856-3867. [DOI: 10.1080/09638288.2020.1754926] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Angela M. Filipe
- Department of Sociology, McGill University, Montréal, Canada
- Centre for Research on Children and Families, McGill University, Montréal, Canada
| | - Aline Bogossian
- École de Travail Social, Université de Montréal, Montréal, Canada
| | - Rosslynn Zulla
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - David Nicholas
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Lucyna M. Lach
- Centre for Research on Children and Families, McGill University, Montréal, Canada
- School of Social Work, Faculty of Arts, McGill University, Montréal, Canada
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Smit MJ, Scheffers M, Emck C, van Busschbach JT, Beek PJ. Clinical characteristics of individuals with intellectual disability who have experienced sexual abuse. An overview of the literature. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 95:103513. [PMID: 31654947 DOI: 10.1016/j.ridd.2019.103513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/13/2019] [Accepted: 10/04/2019] [Indexed: 05/24/2023]
Abstract
BACKGROUND Sexual abuse in individuals with average IQ or above is associated with a wide range of behavioural, psychological and body-related characteristics. It is unknown whether individuals with intellectual disability (ID) and a history of sexual abuse suffer from similar clinical characteristics. OBJECTIVE The aim of the review is to provide an overview of the literature on the clinical characteristics of individuals with ID who have experienced sexual abuse. METHOD PubMed, Embase, PsycInfo, CINAHL, Cochrane Library and Web of Sciences were searched for relevant publications using terms related to concepts of "intellectual disability" and "sexual abuse". Two independent reviewers screened and selected articles for inclusion in the study, resulting in seven studies. RESULTS The studies mostly reported behavioural and psychological characteristics such as aggression, self-injury, or posttraumatic stress, anxiety or depressive symptoms associated with sexual abuse in individuals with ID. None mentioned body-related characteristics. CONCLUSIONS Similar to individuals with average IQ or above, sexual abuse in individuals with ID is associated with a broad range of behavioural and psychological characteristics. Conduct disorders, self-injury, inappropriate sexualised talk and poor feelings of personal safety seem to be more indicative for the ID population. Anxiety, depression and PTSD are prevalent in individuals with and without ID who both have experienced sexual abuse. Whether individuals with ID experience body-related characteristics is unclear.
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Affiliation(s)
- Manon J Smit
- Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, the Netherlands; VU Amsterdam, Faculty of Behavioural and Movement Sciences, Van der Boechorstraat 7, 1081 BT Amsterdam, the Netherlands.
| | - Mia Scheffers
- Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, the Netherlands.
| | - Claudia Emck
- VU Amsterdam, Faculty of Behavioural and Movement Sciences, Van der Boechorstraat 7, 1081 BT Amsterdam, the Netherlands.
| | | | - Peter J Beek
- VU Amsterdam, Faculty of Behavioural and Movement Sciences, Van der Boechorstraat 7, 1081 BT Amsterdam, the Netherlands.
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Marquis SM, McGrail K, Hayes MV. Mental health outcomes among parents of a child who has a developmental disability: Comparing different types of developmental disability. Disabil Health J 2019; 13:100874. [PMID: 31796336 DOI: 10.1016/j.dhjo.2019.100874] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND There is very little information on the effects of different types of developmental disability on the mental health of parents of children who have a DD. OBJECTIVE This paper compared the mental health of parents of children with Autism Spectrum Disorder (ASD), Down syndrome, Fetal Alcohol Syndrome (FAS) and other types of DD. METHODS A cross-sectional design was used to examine population-level administrative health data for mental health outcomes in cohorts of fathers and mothers of children with four different types of a DD. As well as type of DD, additional variables were examined, these included: sex of the parent, age of the parent at birth of the child with the DD, income, sex of the child with the DD, number of children in the family and place of residence. RESULTS For both fathers and mothers odds of a diagnosis of depression or another mental health problem were associated with type of DD. Parents of children with FAS experienced the greatest odds of a depression or other mental health diagnosis. Odds of a diagnosis for fathers were associated with low income. Odds of a diagnosis for mothers were associated with the sex of the child with the DD. CONCLUSIONS These findings are important for understanding families which include a child with a DD, as a guide for future research, and for developing effective programs and services for these parents.
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Affiliation(s)
- Sandra M Marquis
- School of Public Health and Social Policy, University of Victoria, PO BOX 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada.
| | - Kimberlyn McGrail
- School of Population and Public Health, University of British Columbia, 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Michael V Hayes
- School of Public Health and Social Policy, University of Victoria, PO BOX 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada.
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Berg KL, Medrano J, Acharya K, Lynch A, Msall ME. Health Impact of Participation for Vulnerable Youth With Disabilities. Am J Occup Ther 2018; 72:7205195040p1-7205195040p9. [PMID: 30157012 DOI: 10.5014/ajot.2018.023622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We investigated the mental health impact of participation for youth with disabilities (YWD) in the child welfare system who had experienced victimization in the previous year. METHOD Nationally representative data were obtained from the second National Survey of Child and Adolescent Well-Being. Our sample consisted of 247 YWD ages 11-17 yr. Multivariable probit regression analysis and a robust variance estimator were used to test the relationships among disability status, participation, and clinical depression. RESULTS The probability of reporting clinical depression was 4 times higher for victimized YWD who reported lower breadth of participation than for victimized YWD who reported higher breadth of participation (6% vs. 26%; p = .03). CONCLUSION Occupational therapy aimed at increasing opportunities for engagement in activities may enhance the mental health of the most vulnerable YWD. Participation in meaningful activities can improve both overall health and transition to independence for vulnerable YWD.
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Affiliation(s)
- Kristin L Berg
- Kristin L. Berg, AM, PhD, is Assistant Professor, Department of Social Work, School of Health Sciences, University of South Dakota, Sioux Falls;
| | - Jonathon Medrano
- Jonathon Medrano, PhD, is Assistant Professor of Pediatrics and Training Associate, Center for Disabilities, University of South Dakota School of Medicine, Sioux Falls
| | - Kruti Acharya
- Kruti Acharya, MD, is Assistant Professor and LEND Director, Department of Disability and Human Development and Pediatrics, University of Illinois at Chicago
| | - Amy Lynch
- Amy Lynch, PhD, OTR/L, is Assistant Professor, Department of Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, PA
| | - Michael E Msall
- Michael E. Msall, MD, is Chief of Developmental and Behavioral Pediatrics, University of Chicago Medicine, Comer Children's Hospital, and Kennedy Research Center on Intellectual and Developmental Disabilities, Chicago, IL
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Cluver L, Meinck F, Toska E, Orkin FM, Hodes R, Sherr L. Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa. AIDS 2018; 32:975-983. [PMID: 29547438 PMCID: PMC6037279 DOI: 10.1097/qad.0000000000001795] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/11/2018] [Accepted: 02/26/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES HIV-positive adolescents have low-ART adherence, with consequent increased risks of mortality, morbidity, and viral resistance. Despite high rates of violence against children in the Africa region, no known studies have tested impacts on HIV-positive adolescents. We examine associations of ART adherence with adolescent violence victimization by caregivers, teachers, peers, community members, and healthcare providers. DESIGN AND METHODS HIV-positive adolescents were interviewed (n = 1060), and clinic biomarker data collected. We sampled all 10-19-year olds ever ART-initiated within 53 clinics in 180 South African communities (90.1% reached). Analyses examined associations between nonadherence and nine violence types using sequential multivariate logistic regressions. Interactive and additive effects were tested with regression and marginal effects. RESULTS Past-week self-reported ART nonadherence was 36%. Nonadherence correlated strongly with virologic failure (OR 2.3, CI 1.4-3.8) and symptomatic pulmonary tuberculosis (OR 1.49, CI 1.18-2.05). Four violence types were independently associated with nonadherence: physical abuse by caregivers (OR 1.5, CI 1.1-2.1); witnessing domestic violence (OR 1.8, CI 1.22-2.66); teacher violence (OR 1.51, CI 1.16-1.96,) and verbal victimization by healthcare staff (OR 2.15, CI 1.59-2.93). Past-week nonadherence rose from 25% with no violence to 73.5% with four types of violence exposure. CONCLUSION Violence exposures at home, school, and clinic are major and cumulating risks for adolescent antiretroviral nonadherence. Prevention, mitigation, and protection services may be essential for the health and survival of HIV-positive adolescents.
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Affiliation(s)
- Lucie Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town
| | - Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
- OPTENTIA Research Focus Group, School of Behavioural Sciences, North-West University, Vanderbeijlpark
| | - Elona Toska
- AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town
| | - F. Mark Orkin
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
- MRC Development Pathways to Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Rebecca Hodes
- AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town
| | - Lorraine Sherr
- Department of Global Health, University College London, UK
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Hatton C, Emerson E, Robertson J, Baines S. The mental health of adolescents with and without mild/moderate intellectual disabilities in England: Secondary analysis of a longitudinal cohort study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:768-777. [PMID: 29171141 DOI: 10.1111/jar.12428] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children with mild/moderate intellectual disabilities are at greater risk for mental health problems, with socio-economic factors and adversity partly accounting for this. Fewer data are available for adolescents. METHODS Secondary analysis was undertaken of the Next Steps annual panel study following a cohort through adolescence into adulthood containing self-report mental health data up to age 16/17. Participants with mild/moderate intellectual disabilities were identified through data linkage with educational records. RESULTS Adolescents with mild/moderate intellectual disabilities were more likely than non-disabled peers to experience socio-economic disadvantage and bullying. Incidence rates of mental health problems were generally not significantly different between adolescents with and without intellectual disabilities. CONCLUSIONS These findings are consistent with higher rates of persistent mental health problems beginning earlier among children with intellectual disabilities. Greater attention needs to be paid to the timecourse of mental health problems, and the impact of socio-economic factors, family and peers on mental health.
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Affiliation(s)
- Chris Hatton
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Eric Emerson
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.,Centre for Disability Research and Policy, University of Sydney, Lidcombe, NSW, Australia
| | - Janet Robertson
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Susannah Baines
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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19
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Patton KA, Ware R, McPherson L, Emerson E, Lennox N. Parent-Related Stress of Male and Female Carers of Adolescents with Intellectual Disabilities and Carers of Children within the General Population: A Cross-Sectional Comparison. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 31:51-61. [DOI: 10.1111/jar.12292] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Kiri A. Patton
- School of Psychology; The University of Queensland; St Lucia Brisbane Qld Australia
| | - Robert Ware
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
- School of Population Health; The University of Queensland; Herston Qld Australia
| | - Lyn McPherson
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
| | - Eric Emerson
- Centre for Disability Research & Policy; University of Sydney; Sydney NSW Australia
- Centre for Disability Research; Lancaster University; UK
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
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Kacenelenbogen N, Dramaix-Wilmet M, Schetgen M, Roland M, Godin I. Parental separation: a risk for the psychomotor development of children aged 28 to 32 months? A cross-sectional study. BMC Pediatr 2016; 16:89. [PMID: 27401899 PMCID: PMC4940882 DOI: 10.1186/s12887-016-0621-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 06/24/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In Western countries, about a quarter of children are affected by parental separation and a number of authors have previously investigated how familial structure impacts children's health. The purpose of the work: to analyze the psychomotor development of children aged 28 to 32 months based on family structure (parents together or separated), independently of the influence of socio-economic environment that is well documented. To analyse the psychomotor development of children younger than 3 years based on family structure (parents together or separated) independently of the influence of socio-economic environment that is well documented. METHODS Cross-sectional study by examination of 28 871 children as part of a free preventive medicine consultation. The data came from an assessment conducted 28 to 32 months after birth during which information was collected about the psychomotor development: to perform a standing jump, dress themselves, draw a vertical line and circle, use the "I" pronoun, build a three-word sentence, and say their first name RESULTS Ten percent of the children had separated parents. Compared to parents who were together, when adjusting for the socioeconomic environment, as well as all potential confounders, the adjusted odds ratios (ORs) (95 % confidence interval [CI]) for children with separated parents, in terms of their ability to perform a standing jump, dress themselves, and draw a vertical line and circle were respectively 0.9 (0.7-1.1), 1.1 (0.9-1.2), 1.3 (1.1-1.4) and 1.2 (1.1-1.4). The adjusted ORs (95 % CI) for children's inability to say the "I" pronoun, build a three-word sentence, and say their first name were respectively 1.2 (1.1-1.3), 1.3 (1.2-1.5), and 1.2 (0.9-1.5). CONCLUSIONS After adjusting for sociocultural factors and other potential confounders, we observed that the children exhibited slower progression in psychomotor development, especially in language and graphic abilities when their parents were separated. While the implications of our study are somewhat limited, they do provide us with the necessary arguments enabling us to set up a prospective cohort study. Such a study should be able to better assess the impact of parental separation on the child's development, confirming our preliminary results.
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Affiliation(s)
- Nadine Kacenelenbogen
- Département de Médecine Générale, Université Libre de Bruxelles, Campus Facultaire Erasme, Route de Lennik 808/612, Bruxelles, 1070, Belgium.
- , Avenue Molière 179, Bruxelles, 1190, Belgium.
| | - Michèle Dramaix-Wilmet
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de santé publique, Université Libre de Bruxelles, Campus Erasme CP598, Route de Lennik 808, Bruxelles, 1070, Belgium
| | - M Schetgen
- Département de Médecine Générale, Université Libre de Bruxelles, Campus Facultaire Erasme, Route de Lennik 808/612, Bruxelles, 1070, Belgium
| | - M Roland
- Département de Médecine Générale, Université Libre de Bruxelles, Campus Facultaire Erasme, Route de Lennik 808/612, Bruxelles, 1070, Belgium
| | - Isabelle Godin
- Service d'Information Promotion Education Santé-SIPES, Ecole de santé publique, Université Libre de Bruxelles, Campus Erasme CP598, Route de Lennik 808, Brussels, B-1070, Belgium
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Lakhan R, Ekúndayò OT, Shahbazi M. An estimation of the prevalence of intellectual disabilities and its association with age in rural and urban populations in India. J Neurosci Rural Pract 2016; 6:523-8. [PMID: 26752897 PMCID: PMC4692010 DOI: 10.4103/0976-3147.165392] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Intellectual disability (ID) is a global public health concern. Prevalence of ID and its association with age and other demographic factors is required for planning purposes in India. Objective: This study analyzed the age-adjusted prevalence of ID in rural and urban populations and its correlation with age in children and adults. Materials and Methods: Disability data published in the report (2002) of National Sample Survey Organization were analyzed, using Z-test to measure differences in age-adjusted prevalence. Spearman rho was calculated to determine strength and direction of the association, and regression analysis was used to predict prevalence rate, based on age in rural and urban population settings. Results: Overall, India has a prevalence of 10.5/1000 in ID. Urban population has slightly higher rate (11/1000) than rural (10.08/1000; P = 0.044). Age was found to be highly correlated with prevalence of ID in rural children (ϱ =0.981, P = 0.019) as well as in children (ϱ = −0.954, P = 0.000) and adults (ϱ = −0.957, P = 0.000) in urban population. The possibility of confounding or the existence of covariates for children in urban settings was noted. Conclusion: Results of this study match findings in other epidemiological studies. However, multistage, large-scale studies are recommended for investigating prevalence rates with different severity levels of ID.
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Affiliation(s)
- Ram Lakhan
- Department of Epidemiology, School of Health Sciences, College of Public Service, Jackson State University, Jackson, USA
| | | | - Mohammad Shahbazi
- Department of Behavioral Health and Education, School of Health Sciences, College of Public Service, Jackson State University, Jackson, Mississippi, USA
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Emerson E, Llewellyn G, Hatton C, Hindmarsh G, Robertson J, Man WYN, Baines S. The health of parents with and without intellectual impairment in the UK. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:1142-1154. [PMID: 26365876 DOI: 10.1111/jir.12218] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/24/2015] [Accepted: 07/28/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Little is known about the health and well-being of the 'hidden majority' of parents with mild intellectual disability (ID), who are less likely to be in contact with disability services. METHOD We sought to add to knowledge in this area by examining the health and living conditions of parents with and without intellectual impairment in a large contemporary nationally representative sample of UK parents aged between 16 and 49 years old (n = 14 371). RESULTS Our results indicated that, as expected, parents with intellectual impairment were at significantly greater risk than other parents of having poorer self-reported general, mental and physical health. They were also at significantly greater risk of experiencing higher rates of household socio-economic disadvantage and environmental adversities and lower rates of neighbourhood social capital and intergenerational support. Adjusting risk estimates to take account of between group differences in household socio-economic disadvantage eliminated statistically significant differences in health status between parents with and without intellectual impairment on all but one indicator (obesity). Further adjusting risk estimates to take account of between group differences in neighbourhood adversity, neighbourhood social capital and intergenerational support had minimal impact on the results. CONCLUSIONS That controlling for between-group differences in exposure to socio-economic disadvantage largely eliminated evidence of poorer health among parents with intellectual impairment is consistent with the view that a significant proportion of the poorer health of people with IDs may be attributable to their poorer living conditions rather than biological factors associated with ID per se.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - G Llewellyn
- Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia
| | - C Hatton
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - G Hindmarsh
- Australian Family & Disability Studies Research Collaboration, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - J Robertson
- Institute for Health Research, Lancaster University, Lancaster, UK
| | - W Y N Man
- Australian Family & Disability Studies Research Collaboration, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - S Baines
- Centre for Disability Research, Lancaster University, Lancaster, UK
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Berg KL, Shiu CS, Msall ME, Acharya K. Victimization and depression among youth with disabilities in the US child welfare system. Child Care Health Dev 2015; 41:989-99. [PMID: 25761940 DOI: 10.1111/cch.12233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2015] [Indexed: 12/01/2022]
Abstract
AIM This study aimed to examine the prevalence of victimization among a United States-wide cohort of youth with disabilities (YWD) investigated for maltreatment in the child welfare system (CWS) and their correlation with mental health. METHODS Data were drawn from baseline interviews in the second National Survey of Child and Adolescent Well-Being, a national representative survey of youth involved in the CWS. Interviews took place between 2008 and 2009 and included 675 youth, 11-17 years old and residing with biological families across 83 counties nationwide. The sample consisted of 405 females (60.1%) and 270 males (39.9%), mean age = 13.5 years. We identified YWD if they reported one or more physical or neurodevelopmental health condition (n = 247). Reported victimization experiences and Children's Depression Inventory (CDI) scores were analysed using weighted regression analyses. RESULTS One-quarter of YWD in the CWS reported three or more victimizations during the prior year compared with 19% of youth without disabilities. The odds of YWD reporting a one-unit increase in level of victimization was 75% higher (P < 0.05) than youth without disabilities. Prevalence of clinical depression was significantly higher among YWD (14 vs. 5.5%; P < 0.05). Unlike youth without disabilities, the odds of clinical depression were 92% higher for every one-unit increase in victimization among YWD, controlling for covariates (P < 0.05). Of CWS-involved youth who reported three or more victimizations, 24.4% of YWD and 2.2% of non-disabled youth had CDI scores in the clinical range. CONCLUSION YWDs in the US CWS are at high risk of experiencing victimization and clinical depression. Our findings suggest that health professionals need to screen CWS-involved YWD for multiple forms of victimization, and develop and implement trauma-informed services that target the mental health sequelae that may jeopardize their independence in adulthood.
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Affiliation(s)
- K L Berg
- The College of Public Health, Temple University, Philadelphia, PA, USA
| | - C-S Shiu
- Social Work, University of Washington, Seattle, WA, USA
| | - M E Msall
- Developmental & Behavioral Pediatrics at University of Chicago Medicine, University of Chicago Medicine, Chicago, IL, USA.,Kennedy Research Center on Intellectual and Developmental Disabilities, Comer Children's Hospital, Chicago, IL, USA
| | - K Acharya
- Department of Disability and Human Development and Pediatrics, University of Illinois-Chicago, Chicago, IL, USA.,Department of Health and Human Services, Leadership Education in Neurodevelopmental and Related Disorders Training Program (LEND), Chicago, IL, USA
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Emerson E, Hatton C, Robertson J, Baines S. Perceptions of neighbourhood quality, social and civic participation and the self rated health of British adults with intellectual disability: cross sectional study. BMC Public Health 2014; 14:1252. [PMID: 25491787 PMCID: PMC4295228 DOI: 10.1186/1471-2458-14-1252] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 12/03/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is extensive evidence from research undertaken on general population samples that people who have more extensive and closer social networks and people who report feeling connected to their local community tend to have better health. However, relatively few studies have examined the relationship between the social connectedness of people with intellectual disabilities and their health. METHODS Secondary analysis of data from Understanding Society, a new longitudinal study focusing on the life experiences of UK citizens. We identified 279 participants aged 16-49 (1.1% of the unweighted age-restricted sample) as having intellectual disability, and 22,927 as not having intellectual disability. Multivariate logistic regression was used to investigate between group differences adjusting for potential confounding personal characteristics (e.g., gender). RESULTS British adults with intellectual disability had less favorable perceptions of important neighborhood characteristics and lower levels of social and civic participation than their non-disabled peers. Favorable perceptions of important neighborhood characteristics and higher levels of social and civic participation were associated with more positive self-rated health for adults with and without intellectual disability. For adults with intellectual disability this was particularly the case with regard to employment, feeling safe outside in the dark and being able to access services when needed. The between-group differences in perceptions of important neighborhood characteristics and levels of social and civic participation accounted for a significant proportion of the elevated risk for poorer self-rated health observed among adults with intellectual disability. CONCLUSIONS This study provides evidence to suggest that the health inequalities experienced by people with intellectual disabilities may be partially attributable to their less favorable perceptions of important neighborhood characteristics and lower levels of social and civic participation.
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Affiliation(s)
- Eric Emerson
- />Centre for Disability Research, Lancaster University, Lancaster, LA1 4YT UK
- />Centre for Disability Research and Policy, University of Sydney, Sydney, Australia
| | - Chris Hatton
- />Centre for Disability Research, Lancaster University, Lancaster, LA1 4YT UK
| | - Janet Robertson
- />Centre for Disability Research, Lancaster University, Lancaster, LA1 4YT UK
| | - Susannah Baines
- />Centre for Disability Research, Lancaster University, Lancaster, LA1 4YT UK
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