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Peña-Salazar C, Alfonso-Ramos M, Arroyo-Uriarte P, Serrano-Blanco A, Aznar-Lou I. Is epilepsy related to psychiatric disorders in people with intellectual disability? A systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022:17446295221116506. [PMID: 35925864 DOI: 10.1177/17446295221116506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The prevalence of psychiatric disorders in people with Intellectual Disability (ID) is statistically higher than in the general population. There is a lack of consensus on the role that epilepsy plays in psychiatric disorders in people with ID. We carried out a systematic review of articles published between 1960 and 2022, focusing on high-quality, case-control original research studies that only included adult populations. The primary outcome was the prevalence of psychiatric disorders in people with intellectual disability with and without epilepsy. Six articles were finally included. Results were varied; some reported a statistical increase, whereas others did not find any statistical difference. Due to the current controversy on the role of epilepsy in psychiatric disorders in people with ID and the small number of publications on the topic, we cannot affirm a relationship between epilepsy and psychiatric disorders in people with ID.
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Affiliation(s)
- Carlos Peña-Salazar
- Mental Health and Intellectual disability services, 221703Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Neurology Department, 221703Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Teaching, Research & Innovation Unit, 221703Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | - Miqueu Alfonso-Ramos
- Teaching, Research & Innovation Unit, 221703Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Paula Arroyo-Uriarte
- Teaching, Research & Innovation Unit, 221703Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Teaching, Research & Innovation Unit, 221703Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Antoni Serrano-Blanco
- Teaching, Research & Innovation Unit, 221703Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | - Ignacio Aznar-Lou
- Teaching, Research & Innovation Unit, 221703Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
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Furlin V, Bara TS, Felden ÉPG, de Farias AC, Cordeiro ML. Neuropsychological and behavioural profiles of students with intellectual development disorder on parents and teachers' perceptions. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:626-637. [PMID: 33830566 DOI: 10.1111/jir.12837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 02/26/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Children with intellectual development disorder (IDD) have high rates of comorbid neuropsychological and behavioural problems. However, there are not many studies on this population in middle-income and low-income countries. Therefore, we aimed to investigate the prevalence of neuropsychological and behavioural problems in students with and without IDD and to assess the correlation between the responses from informants (parents and teachers) and the clinical diagnoses in Brazil. METHODS After clinical diagnosis, 78 male and female students (7-15 years old) were divided into two groups: children with IDD (n = 39) and children without IDD (n = 39). The Child Behaviour Checklist (CBCL) and Teacher's Report Form (TRF) scales were used to track neuropsychological and behavioural problems. Calculations of prevalence ratios were performed using Poisson regression with Wald tests. The CBCL and TRF results were compared between groups with Mann-Whitney U-tests and receiver operating characteristic (ROC) analyses. The agreement between scales was assessed using the Spearman correlation test. RESULTS Neuropsychological and behavioural problems were significantly more prevalent in students with IDD. The average amount of CBCL problems was significantly higher than that of TRF in the dimensions of thought, attention, somatic, attention deficit/hyperactivity, opposition defiant and total problems. Low-to-moderate correlations between CBCL and TRF dimensions in the IDD group were observed. ROC analyses revealed that the dimensions of internalising problems and total scores reflecting CBCL and TRF problems were the most important factors for identifying neuropsychological and behavioural problems in the IDD group. CONCLUSIONS Students with IDD require early identification of behavioural and emotional symptoms to avoid the underdiagnoses of various mental health problems, especially those with internalising characteristics. The CBCL and TRF may assist in the early screening of these comorbidities.
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Affiliation(s)
- V Furlin
- Pelé Pequeno Príncipe Research Institute, Curitiba, Brazil
- Faculdades Pequeno Príncipe, Curitiba, Brazil
| | - T S Bara
- Pelé Pequeno Príncipe Research Institute, Curitiba, Brazil
- Faculdades Pequeno Príncipe, Curitiba, Brazil
| | - É P G Felden
- Centro de Ciências da Saúde e do Esporte (CEFID), State of Santa Catarina University, Florianópolis, Brazil
| | - A C de Farias
- Pelé Pequeno Príncipe Research Institute, Curitiba, Brazil
- Faculdades Pequeno Príncipe, Curitiba, Brazil
- School of Medicine, University Positivo, Curitiba, Brazil
- Department of Neuropediatrics, Children's Hospital, Pequeno Príncipe, Curitiba, Brazil
| | - M L Cordeiro
- Pelé Pequeno Príncipe Research Institute, Curitiba, Brazil
- Faculdades Pequeno Príncipe, Curitiba, Brazil
- Department of Psychiatry and Biobehavior Sciences, David Geffen School of Medicine, Semel Institute for Neusroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
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Peña-Salazar C, Arrufat F, Santos JM, Fontanet A, González-Castro G, Más S, Roura-Poch P, Valdés-Stauber J. Underdiagnosis of psychiatric disorders in people with intellectual disabilities: Differences between psychiatric disorders and challenging behaviour. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2020; 24:326-338. [PMID: 30185101 DOI: 10.1177/1744629518798259] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to assess the level of mental disorders and challenging behaviour in individuals with intellectual disability (ID) supported by specialized services, but without a prior psychiatric diagnosis, and to compare the levels of different disorders depending on the severity of ID. METHODS This is a cross-sectional study (N = 142) of population with ID. Inclusion criteria were the following: adult patients with ID and with no previous psychiatric diagnosis prior to this survey. The Wechsler Adults Intelligence Scale-II, the Psychiatric Assessment Schedule for Adults with Developmental Disability checklist and clinical interview, the Diagnostic Assessment for the Severely Handicapped scale and the Inventory for Client and Agency Planning were the assessment tools. RESULTS A previously undiagnosed mental disorder was found in 29.6% of the sample. The most prevalent mental disorders were major depressive and anxiety disorders. An association between psychiatric comorbidity and challenging behaviour was found only for mild/moderate ID, especially for affective disorders. CONCLUSIONS The presence of a psychiatric as well as a medical comorbidity is associated with severe ID, unlike challenging behaviour. Clinical limitations of the study have been discussed.
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Affiliation(s)
- Carlos Peña-Salazar
- Hegau-Bodensee-Klinikum Singen, Germany; Universitat de Vic - Central University of Catalonia, Spain
| | | | - Josep Manel Santos
- Universitat de Vic - Central University of Catalonia, Spain; Associació Sant Tomás, Spain
| | | | | | - Silvia Más
- Germanas Hospitalarias Benito Menni, Spain
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Mayes SD, Calhoun SL, Waxmonsky JG, Kokotovich C, Baweja R, Lockridge R, Bixler EO. Demographic Differences in Disruptive Mood Dysregulation Disorder Symptoms in ADHD, Autism, and General Population Samples. J Atten Disord 2019; 23:849-858. [PMID: 27549781 DOI: 10.1177/1087054716664409] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) disruptive mood dysregulation disorder (DMDD) is a controversial new diagnosis. No studies have investigated DMDD symptoms (irritable-angry mood and temper outbursts) and demographics in general population and psychiatric samples. METHOD Maternal ratings of DMDD symptoms and diagnoses, age, gender, IQ, race, and parent occupation were analyzed in general population ( n = 665, 6-12 years) and psychiatric samples ( n = 2,256, 2-16 years). RESULTS Percentage of school-age children with DMDD symptoms were 9% general population, 12% ADHD-I, 39% ADHD-C, and 43% autism. Male, nonprofessional parent, and autism with IQ > 80 were associated with increasing DMDD symptoms, but demographics together explained only 2% to 3% of the DMDD score variance. CONCLUSION Demographics contributed little to the presence of DMDD symptoms in all groups, whereas oppositional defiant disorder (ODD) explained most of the variance. Almost all children with DMDD symptoms had ODD suggesting that DMDD may not be distinct from ODD.
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Affiliation(s)
| | | | | | | | - Raman Baweja
- 1 Penn State Hershey Medical Center, Hershey, USA
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Faria SMM, Esgalhado G, Pereira CMG. Efficacy of a socioemotional learning programme in a sample of children with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:457-470. [PMID: 30453393 DOI: 10.1111/jar.12547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/07/2018] [Accepted: 10/28/2018] [Indexed: 11/27/2022]
Abstract
Socioemotional learning (SEL) is the process of developing social and emotional competences through which the child learns to recognize and manage emotions, care for others, make good decisions, behave responsibly and ethically, develop positive relationships and avoid negative behaviours (Promoting social and emotional learning: Guidelines for educators, 1997). To promote the development of these competences, specific programmes are developed. This study aims to analyse the impact of a SEL programme among children with intellectual disability. Two groups were established, control and experimental, and the Test of Emotion Comprehension (TEC) (Test of emotion comprehension - TEC, 2000; Les émotions à l'école, émotions et apprentissage, 2004) was applied to both as pre- and post-test. The programme was implemented in the experimental group, based on simply illustrated stories alluding the basic emotions. The findings suggest that the programme is effective in the development of socioemotional competences (SEC) in subjects with intellectual disabilities, evidencing the positive effects that the intervention programme had with the experimental group.
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Affiliation(s)
- Sónia M M Faria
- Faculty of Social and Human Sciences, University of Beira Interior, Covilhã, Portugal
| | - Graça Esgalhado
- Faculty of Social and Human Sciences, University of Beira Interior, Covilhã, Portugal
| | - Cristina M G Pereira
- Polytechnic Institute of Castelo Branco- Superior School of Education, Castelo Branco, Portugal
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6
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Feniger-Schaal R, Joels T. Attachment quality of children with ID and its link to maternal sensitivity and structuring. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 76:56-64. [PMID: 29567485 DOI: 10.1016/j.ridd.2018.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Attachment theory produced a fertile field of research and clinical application. Although the topic of attachment of children with intellectual disability (ID) has received increasing research attention over the past 15 years, the empirical evidence is still limited. AIMS We applied theoretical and empirical knowledge of parenting typically developing children to examine the mother-child relationship in the ID population. The aim was to examine maternal sensitivity and structuring and its association with children's attachment classification and their disability. METHODS Forty preschool children (mean age 47.25, range 26-75 months) with non-specific ID and their mothers participated in the study. The mean developmental age was 25.92 months (SD = 10.89), The DQ mean score was 55.45 (SD = 17.28). We assessed children's quality of attachment using the SSP and maternal interactive behavior using the Emotional Availability Scales. OUTCOMES Forty percent of children showed secure attachment, and 32.5% showed disorganized attachment. Attachment classifications correlated significantly with maternal sensitivity and maternal structuring but not with the child's cognitive disability. CONCLUSIONS The results point to the importance of maternal interactive behavior for children with ID. Clinical implication may consider interventions aiming to enhance maternal sensitivity and structuring to improve children's quality of attachment.
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Affiliation(s)
- Rinat Feniger-Schaal
- University of Haifa, The Center for the Study of Child Development, Graduate School of Creative Arts Therapies, University of Haifa, 199 Aba Khoushy Av., Haifa, 3498838, Israel.
| | - Tirtsa Joels
- University of Haifa, The Center for the Study of Child Development, University of Haifa, 199 Aba Khoushy Av., Haifa, 3498838, Israel
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Mazzucchelli TG, Hodges J, Kane RT, Sofronoff K, Sanders MR, Einfeld S, Tonge B, Gray KM. Parenting and family adjustment scales (PAFAS): validation of a brief parent-report measure for use with families who have a child with a developmental disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 72:140-151. [PMID: 29145013 DOI: 10.1016/j.ridd.2017.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/06/2017] [Accepted: 10/11/2017] [Indexed: 05/12/2023]
Abstract
BACKGROUND Children with a developmental disability are three to four times more likely than their typically developing peers of developing significant emotional and behavioural problems. There is strong evidence to suggest that individual biological and psychological factors interact with family functioning to precipitate and perpetuate these problems. AIMS This study examined the psychometric properties of a brief measure, the Parent and Family Adjustment Scales (PAFAS) for use with parents of children with a developmental disability. METHODS A sample of 914 parents of children (M=6.27years) with a developmental disability participated in the study. Disabilities included Autism Spectrum Disorder and Intellectual Disability RESULTS: A confirmatory factor analysis supported a 16-item, four factor model of PAFAS Parenting, and an 11-item, three factor model of PAFAS Family Adjustment. The Parenting Scale measures parental consistency, coercive practices, use of encouragement and the quality of parent-child relationship. The Family Adjustment Scale measures parental emotional adjustment and partner and family support in parenting. CONCLUSIONS The current study indicated that the PAFAS demonstrates promise as a brief measure of multiple domains of family functioning important for families who have a child with a developmental disability.
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Affiliation(s)
- Trevor G Mazzucchelli
- Child and Family Research Group, and Brain, Behaviour and Mental Health Research Group, School of Psychology and Speech Pathology, Western Australia, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia; Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland 4072, Australia.
| | - Julie Hodges
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland 4072, Australia.
| | - Robert T Kane
- Child and Family Research Group, and Brain, Behaviour and Mental Health Research Group, School of Psychology and Speech Pathology, Western Australia, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
| | - Kate Sofronoff
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Matthew R Sanders
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland 4072, Australia.
| | - Stewart Einfeld
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales 2050, Australia.
| | - Bruce Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria 3168, Australia.
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria 3168, Australia; Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK.
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PEÑA SALAZAR C, ARRUFAT NEBOT F, FONTANET A, GARCÍA-LEÓN N, MÁS S, ROURA-POCH P, SANTOS LÓPEZ JM. El infradiagnóstico del trastorno mental en la población con discapacidad intelectual: estudio de prevalencia en población con diferentes grados de discapacidad intelectual. SIGLO CERO. REVISTA ESPAÑOLA SOBRE DISCAPACIDAD INTELECTUAL 2017. [DOI: 10.14201/scero20174832739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Gerstein ED, Crnic KA. Family Interactions and Developmental Risk Associated With Early Cognitive Delay: Influences on Children's Behavioral Competence. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 47:S100-S112. [PMID: 27253206 DOI: 10.1080/15374416.2016.1157755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Family interactions can be important contributors to the development of child psychopathology, yet the mechanisms of influence are understudied, particularly for populations at risk. This prospective longitudinal study addresses differences in whole family interactions in 194 families of young children with and without early-identified developmental risk associated with cognitive delay. The influence of family interactions on children's later externalizing behaviors, internalizing behaviors, and social skills was examined, and developmental risk was tested as a potential moderator of these relations. Results indicated that the presence of cognitive developmental risk was linked to higher levels of family control than in families of typically developing children, but groups did not differ on dimensions of cohesion, warmth, organization, or conflict. Observed cohesion and organization were associated with better social skills for all children, regardless of risk status. Significant interactions emerged, indicating that higher levels of conflict and control were associated with higher levels of behavior problems, but only for families of typically developing children. These findings underscore the importance of family-level assessment in understanding the development of children's behavior and suggest the need for deeper analysis of the nuances of family process over time.
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Affiliation(s)
- Emily D Gerstein
- a Department of Psychological Sciences , University of Missouri-St. Louis
| | - Keith A Crnic
- b Department of Psychology , Arizona State University
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Evers LJM, van Amelsvoort TAMJ, Candel MJJM, Boer H, Engelen JJM, Curfs LMG. Psychopathology in adults with 22q11 deletion syndrome and moderate and severe intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:915-925. [PMID: 24528781 DOI: 10.1111/jir.12117] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/12/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND 22q11 deletion syndrome (22q11DS) is associated with mild or borderline intellectual disability (ID). There are hardly any reports on subjects with 22q11DS with moderate or severe ID, and therefore its behavioural and psychiatric characteristics are unknown. METHOD We describe behavioural and psychiatric characteristics of 33 adults with 22q11DS and a Full-Scale IQ (FSIQ) below 55. Participants were divided into two groups: one group having a FSIQ ≤ 55 caused by intellectual decline (n = 21) and one group with a FSIQ ≤ 55 who had always functioned at this level (n = 12). RESULTS High scores on psychopathology sub-scales were found for both subgroups. 22q11DS patients with intellectual decline showed higher rates of co-morbid psychopathology, particularly psychosis. Furthermore, psychosis and intellectual decline were positive correlated. CONCLUSION This is the first report addressing adult patients with 22q11DS and moderate to severe ID. Overall we found high levels of psychopathology with higher scores of psychopathology in the intellectual decline group. Life time psychosis seems to be related to deterioration.
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Affiliation(s)
- L J M Evers
- MFCG, Koraalgroup, Heel, The Netherlands; Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
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Medeiros K, Rojahn J, Moore LL, van Ingen DJ. Functional properties of behaviour problems depending on level of intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:151-161. [PMID: 23464786 DOI: 10.1111/jir.12025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND Behaviour problems are common among individuals with intellectual disabilities (ID) especially in those with more severe forms. The determination of the functional profile of a targeted behaviour has important implications for the design of customised behavioural interventions. METHOD We investigated the relationship between the level of ID and the functional profile of aggression, stereotypy and self-injurious behaviour (SIB) using the Questions about Behavioural Function (QABF). Two staff members at two time points completed the QABF for each of 115 adults with varying levels of ID participating in a day training and habilitation programme. RESULTS AND CONCLUSIONS Our results suggest that there is a differential relationship between the functions of behaviour problems and level of ID. While SIB is more often seen by raters to be maintained by escape of social demands and by attaining access to tangible items with the decline of the intellectual level, aggressive and stereotypic behaviours were identified more often as serving multiple functions equally across functioning level.
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Affiliation(s)
- K Medeiros
- Applied Developmental Psychology, George Mason University, Fairfax, VA, USA
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Petrenko CLM. A Review of Intervention Programs to Prevent and Treat Behavioral Problems in Young Children with Developmental Disabilities. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2013; 25:10.1007/s10882-013-9336-2. [PMID: 24222982 PMCID: PMC3821779 DOI: 10.1007/s10882-013-9336-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Children with developmental disabilities are at higher risk for internalizing and externalizing behavioral problems than children in the general population. Effective prevention and treatment programs are necessary to reduce the burden of behavioral problems in this population. The current review identified 17 controlled trials of nine intervention programs for young children with developmental disabilities, with parent training the most common type of intervention in this population. Nearly all studies demonstrated medium to large intervention effects on child behavior post-intervention. Preliminary evidence suggests interventions developed for the general population can be effective for children with developmental disabilities and their families. A greater emphasis on the prevention of behavior problems in young children with developmental disabilities prior to the onset of significant symptoms or clinical disorders is needed. Multi-component interventions may be more efficacious for child behavior problems and yield greater benefits for parent and family adjustment. Recommendations for future research directions are provided.
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Affiliation(s)
- Christie L. M. Petrenko
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY 14608, USA
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Szczepaniak D, McHenry MS, Nutakki K, Bauer NS, Downs SM. The prevalence of at-risk development in children 30 to 60 months old presenting with disruptive behaviors. Clin Pediatr (Phila) 2013; 52:942-9. [PMID: 23836809 DOI: 10.1177/0009922813493832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study assessed the prevalence of failed developmental screens in 30- to 60-month-old children who presented with a behavioral complaint of disruptive behavior to a referral clinic. METHODS A retrospective chart review was performed in a specialty behavioral pediatric clinic. Outcome measures were obtained from children referred to the clinic with parental concern of disruptive behavior. RESULTS Out of 151 patients, 66% (99/151) had been screened for developmental delays with a formal screening instrument. Of these, 71% (70/99) failed developmental screening in one or more domains. CONCLUSIONS Preschoolers referred to a behavioral clinic for parental concerns of disruptive behaviors were more than 4 times more likely to be at risk for developmental delays than the general population, with a majority of suspected delays in communication and problem-solving domains. This finding suggests that developmental screening should be a part of the initial workup for children with disruptive behaviors.
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Ciciolla L, Gerstein ED, Crnic KA. Reciprocity among maternal distress, child behavior, and parenting: transactional processes and early childhood risk. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2013; 43:751-64. [PMID: 23819445 DOI: 10.1080/15374416.2013.812038] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Transactional theories support that parent-child processes are best studied in conjunction with one another, addressing their reciprocal influence and change across time. This study tested a longitudinal, autoregressive model exploring bidirectional relations among maternal symptomatology, child internalizing/externalizing symptoms, and maternal sensitivity during the preschool period (child ages 3 to 5 years), comparing relations among families of typically developing children and children with developmental risk. This study included 250 families, 110 of which had a child with early developmental delay. Analyses utilized data from maternal report, father report, and observational methods. The results indicated significant stability in maternal symptomatology, child internalizing/externalizing symptoms, and maternal sensitivity over time. Support for bidirectional effects between maternal symptomatology and child internalizing symptoms was found specifically for mothers of children with developmental risk. Maternal symptomatology was found to mediate the influence of child internalizing and externalizing symptoms on maternal sensitivity. The findings underscore critical transactional processes within families of children with early developmental risk that connect increased maternal symptomatology to emerging child internalizing symptoms during the preschool period.
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Bagner DM, Graziano PA. Barriers to success in parent training for young children with developmental delay: the role of cumulative risk. Behav Modif 2012. [PMID: 23188886 DOI: 10.1177/0145445512465307] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to examine the effect of cumulative risk on dropout and treatment outcome in parent training. Participants were 44 families of young children (mean age of 49.59 months) who presented with elevated externalizing behavior problems and developmental delay or borderline developmental delay. All families were offered to receive Parent-Child Interaction Therapy (PCIT), an evidence-based, behavioral parent-training intervention, at a hospital-based outpatient clinic. Cumulative risk was calculated as a sum of risk variables, including socioeconomic disadvantage (poverty, low maternal education), family structure (single-parent household), and maternal risk characteristics (minority status, lower intelligence, and parental distress). Families with higher cumulative risk scores, especially those with three or more risks, were more likely to drop out of treatment and display diminished treatment response in child behavior and parenting skills compared with families with lower cumulative risk scores. However, only two individual risk factors (i.e., minority status and family structure) predicted dropout, and one individual risk factor (i.e., maternal education) predicted outcome. These findings suggest that it can be useful to conceptualize risk factors as having a cumulative, in addition to individual, influence on parent-training interventions for children with developmental delay and have significant implications for clinical practice. It is important for clinicians to regularly assess for risk factors, and future research should examine ways in which clinicians can improve retention and outcome of parent training in the presence of multiple risk factors.
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Medeiros K, Kozlowski AM, Beighley JS, Rojahn J, Matson JL. The effects of developmental quotient and diagnostic criteria on challenging behaviors in toddlers with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1110-1116. [PMID: 22502836 DOI: 10.1016/j.ridd.2012.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 02/06/2012] [Indexed: 05/31/2023]
Abstract
Previous research has found that individuals with intellectual disability and/or autism spectrum disorder (ASD), and those with greater symptom severity within these diagnoses, show higher rates of aggressive/destructive behavior, stereotypic behavior, and self-injurious behavior. In this exploratory cross-sectional study, toddlers at-risk for a developmental disorder (n=1509) ranging from 17 to 36 months fell into one of three diagnostic categories: Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified [PDD-NOS], and atypically developing - no ASD diagnosis. Mental health professionals from EarlySteps, Louisiana's Early Intervention System, interviewed parents and guardians using the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT) -Part 3 (Matson, Boisjoli, & Wilkins, 2007) to obtain measures of challenging behaviors and the Battelle Developmental Inventory, 2nd Edition (BDI-2) (Newborg, 2005) to obtain developmental quotients (DQ). Toddlers diagnosed with Autistic Disorder or PDD-NOS showed a positive relationship between total DQ and challenging behavior; whereas, atypically developing toddlers with no ASD diagnosis showed a more adaptive, negative relationship. The DQ domains that were most influential on challenging behaviors varied by diagnosis, with communication and motor domains playing greater roles for toddlers with Autistic Disorder or PDD-NOS, and personal-social and cognitive domains playing greater roles for atypically developing toddlers with no ASD diagnosis.
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Sanders MR. Development, Evaluation, and Multinational Dissemination of the Triple P-Positive Parenting Program. Annu Rev Clin Psychol 2012; 8:345-79. [DOI: 10.1146/annurev-clinpsy-032511-143104] [Citation(s) in RCA: 351] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Matthew R. Sanders
- Parenting and Family Support Center, School of Psychology, The University of Queensland, St. Lucia QLD 4072, Australia;
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Neece CL, Green SA, Baker BL. Parenting stress and child behavior problems: a transactional relationship across time. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 117:48-66. [PMID: 22264112 PMCID: PMC4861150 DOI: 10.1352/1944-7558-117.1.48] [Citation(s) in RCA: 377] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Parenting stress and child behavior problems have been posited to have a transactional effect on each other across development. However, few studies have tested this model empirically. The authors investigated the relationship between parenting stress and child behavior problems from ages 3 to 9 years old among 237 children, 144 of whom were typically developing and 93 who were identified as developmentally delayed. Behavior problems and parenting stress covaried significantly across time for both groups of children. Cross-lagged panel analyses generally supported a bidirectional relationship between parenting stress and child behavior problems for mothers and fathers.
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Soenen S, Van Berckelaer-Onnes I, Scholte E. Pathways to Care of Individuals With Mild Intellectual Disability. JOURNAL OF COGNITIVE EDUCATION AND PSYCHOLOGY 2012. [DOI: 10.1891/1945-8959.11.1.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study investigated whether clinical profiles in individuals with mild intellectual disability (MID) could be defined in terms of their histories (e.g., behavioral, social-environmental, educational, and service use characteristics). The clinical psychologists administered the Diagnostic Interview for Social and Communication Disorders to the (substitute) parents and analyzed the clinical records of individuals with MID. Four subtypes of individuals with MID with specific clinical profiles participated in this study. The results of this study, which used discriminant analysis of the individuals’ histories, supported two discriminant functions. The first discriminant function differentiated clinical profiles largely based on developmental disorders from clinical profiles based on personality disorders. The second function differentiated clinical profiles based on personality disorders and externalizing behavioral problems from other clinical profiles. The characteristics in the histories of individuals with MID can be very different and need to be assessed for further understanding of their unique needs.
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Baker BL, Neece CL, Fenning RM, Crnic KA, Blacher J. Mental disorders in five-year-old children with or without developmental delay: focus on ADHD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2010; 39:492-505. [PMID: 20589561 DOI: 10.1080/15374416.2010.486321] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Epidemiological studies of children and adolescents with intellectual disability have found 30 to 50% exhibiting clinically significant behavior problems. Few studies, however, have assessed young children, included a cognitively typical comparison group, assessed for specific disorders, and/or studied family correlates of diagnosis. We assessed 236 5-year-old children--95 with developmental delay (DD) and 141 with typical development--for clinical diagnoses using a structured interview. Every disorder assessed was more prevalent in the DD group. The percent of children meeting criteria for Attention Deficit Hyperactivity Disorder (ADHD) most highly differentiated the two groups (ratio = 3.21:1). There was high stability from externalizing behavior problems at age 3 to ADHD diagnoses at age 5 in both groups. In regression analyses, parenting stress at child age 3 related to later ADHD diagnosis in both groups and maternal scaffolding (sensitive teaching) also predicted ADHD in the DD group.
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Affiliation(s)
- Bruce L Baker
- Department of Psychology, University of California, Los Angeles, 90095, USA.
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Epidemiology of Mental Illness and Maladaptive Behavior in Intellectual Disabilities. INTERNATIONAL REVIEW OF RESEARCH IN MENTAL RETARDATION 2009. [DOI: 10.1016/s0074-7750(08)38009-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Allen D. The relationship between challenging behaviour and mental ill-health in people with intellectual disabilities: a review of current theories and evidence. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2008; 12:267-294. [PMID: 19074934 DOI: 10.1177/1744629508100494] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Challenging behaviours and problems of mental ill-health are common amongst people with intellectual disabilities. The article examines conceptual similarities and differences between these conditions, examines the data on comorbidity, and explores possible hypothetical relationships between behavioural and psychiatric disorder in this population. While there is little evidence at present to suggest that many of the challenging behaviours seen in people with intellectual disabilities are underpinned by problems of mental ill-health, only qualified conclusions are possible because of limitations in the quality and scope of existing research. A conceptual model for looking at the risk variables that may contribute to both conditions is suggested, and requirements for future research and current multi-disciplinary practice are outlined.
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Affiliation(s)
- David Allen
- Abertawe Bro Morgannwg University NHS Trust & Cardiff University, Wales, UK.
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McCarthy J. Behaviour problems and adults with Down syndrome: childhood risk factors. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:877-882. [PMID: 18637062 DOI: 10.1111/j.1365-2788.2008.01104.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Studies of people with intellectual disability suggest that several individual characteristics and environmental factors are associated with behaviour disorder. To date there are few studies looking at risk factors within specific syndromes and the relationship between early risk markers and later behaviour disorder. The key aim of the study was to determine if childhood risk factors were predictors of severe behaviour disorder in young adults with Down syndrome. MATERIALS AND METHODS A longitudinal cohort study of 50 people with Down syndrome was assessed with the same behavioural measure used in both childhood and adult life. The early risk factors which were assessed included childhood functioning, childhood psychopathology and early family environment as determined by measures of parental mental health, quality of parental marriage and social background. RESULTS Childhood psychopathology and functioning were associated with severe behaviour disorder in adult life whereas childhood family environment was not. CONCLUSIONS Children with Down syndrome at risk for severe behaviour disorder in adult life may be identified in childhood and appropriate interventions offered to reduce their risk.
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Affiliation(s)
- J McCarthy
- Institute of Psychiatry, King's College London, London, UK.
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Chadwick O, Kusel Y, Cuddy M. Factors associated with the risk of behaviour problems in adolescents with severe intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:864-876. [PMID: 18647216 DOI: 10.1111/j.1365-2788.2008.01102.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Little is known about the factors affecting the risk of behavioural and emotional problems in young people with severe intellectual disability (ID), although such evidence as there is suggests that there may be differences between the pattern of risk factors in this group and those that operate in general population samples of the same age. METHOD From a sample of 111 children with severe ID who had been initially identified from the registers of six special schools at 4-11 years, 82 were traced and reassessed on average 5 years 4 months later. The relationships between potential risk factors and behaviour problems, reported here for 11:00-17:04 year olds, were assessed by means of parental interview conducted in the family home. RESULTS Behaviour problems were associated with the severity of ID and the severity of autistic symptomatology. Perhaps surprisingly, they were also more common in pre-pubertal than post-pubertal adolescents. Family factors such as a history of interrupted/disrupted maternal care, parental criticism of the child and aggressive parental disciplinary practices were also associated with behaviour problems, although the direction of causation was unclear. Several factors, including gender, social disadvantage and epilepsy, well established as risk factors in children without ID, were not significantly associated with behaviour problems in the present sample. CONCLUSION The findings suggest that the pattern of factors associated with behaviour problems in children with severe ID differs from that found both in the general population and in children with mild ID.
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Affiliation(s)
- O Chadwick
- Institute of Psychiatry, King's College, London, UK.
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Raghavan R, Pawson N. Transition and social networks of young people with learning disabilities. ACTA ACUST UNITED AC 2008. [DOI: 10.1108/17530180200800027] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gadow KD, DeVincent C, Schneider J. Predictors of Psychiatric Symptoms in Children with an Autism Spectrum Disorder. J Autism Dev Disord 2008; 38:1710-20. [DOI: 10.1007/s10803-008-0556-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2007] [Accepted: 02/25/2008] [Indexed: 10/22/2022]
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Abstract
PURPOSE OF REVIEW To critically review recent publications on the relationship between challenging behaviour and psychiatric disorder in people with intellectual disabilities. RECENT FINDINGS Although a number of recent studies have highlighted possible similarities in the aetiology of challenging behaviour and psychiatric disorder, these findings need to be viewed with caution as they do not constitute evidence that the two phenomena are equivalent. While research into their possible interrelationship has produced equivocal findings, there are a number of theoretical perspectives that have been tested to some degree by empirical studies. Intervention studies that attempt to explore these perspectives are rare, however, and there is some evidence that people with complex mental health and behavioural needs are receiving far from optimal treatment. SUMMARY The relationship between challenging behaviour and psychiatric disorder has yet to be adequately explored in the research literature. While both undoubtedly coexist in some people with intellectual disability, available research suggests that it is unlikely that disturbances in psychiatric functioning will underpin the majority of challenging behaviours. Evidence to link specific patterns of behaviour with particular disorders also remains elusive. Recommendations for future research are discussed.
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Affiliation(s)
- David Allen
- Bro Morgannwg NHS Trust & University of Glamorgan Special Projects Team, Cardiff, UK.
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