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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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2
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Sapiets SJ, Hastings RP, Totsika V. Predictors of Access to Early Support in Families of Children with Suspected or Diagnosed Developmental Disabilities in the United Kingdom. J Autism Dev Disord 2024; 54:1628-1641. [PMID: 37142908 PMCID: PMC10159231 DOI: 10.1007/s10803-023-05996-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/06/2023]
Abstract
This study examined predictors of access to early support amongst families of 0-6-year-old children with suspected or diagnosed developmental disabilities in the United Kingdom. Using survey data from 673 families, multiple regression models were fitted for three outcomes: intervention access, access to early support sources, and unmet need for early support sources. Developmental disability diagnosis and caregiver educational level were associated with intervention access and early support access. Early support access was also associated with child physical health, adaptive skills, caregiver ethnicity, informal support, and statutory statement of special educational needs. Unmet need for early support was associated with economic deprivation, the number of household caregivers, and informal support. Multiple factors influence access to early support. Key implications include enhancing processes for formal identification of need, addressing socioeconomic disparities (e.g., reducing inequalities, increasing funding for services), and providing more accessible services (e.g., coordinating support across services, flexible service provision).
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Affiliation(s)
- Suzi J Sapiets
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, CV4 7AL, UK.
- Tizard Centre, University of Kent, Canterbury, Kent, CT2 7NZ, UK.
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, CV4 7AL, UK
- Department of Psychiatry, Monash Medical Centre, Monash University, Block P, Level 3 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, CV4 7AL, UK
- Department of Psychiatry, Monash Medical Centre, Monash University, Block P, Level 3 246 Clayton Rd, Clayton, VIC, 3168, Australia
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK
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3
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Sellitto T, Fraser-Thomas J, Bassett-Gunter RL, Lee V, Lunsky Y, Balogh R, Weiss JA. The role of thriving in mental health among people with intellectual and developmental disabilities during the COVID-19 pandemic in Canada. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13177. [PMID: 37987194 DOI: 10.1111/jar.13177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 09/20/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The COVID-19 pandemic has had a negative impact on the mental health of people with intellectual and developmental disabilities. Numerous pandemic-related stressors experienced by people with intellectual and developmental disabilities may have impacted their ability to thrive, which has been linked to mental health outcomes. The current study examined the associations among COVID-19 stressors, thriving, and mental health problems among youth and adults with intellectual and developmental disabilities. METHOD Caregivers of 159 people with intellectual and developmental disabilities between 12 and 35 years of age from Canada completed an online questionnaire. RESULTS A mediation analysis revealed that COVID-19 stressors were positively associated with mental health problems, and that thriving partially mediated this association. CONCLUSION Our findings suggest that experiences of thriving may be an important target for mental health support for people with intellectual and developmental disabilities.
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Affiliation(s)
- Teresa Sellitto
- Department of Psychology, York University, Toronto, Ontario, Canada
| | | | | | - Vivian Lee
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert Balogh
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, Toronto, Ontario, Canada
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4
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Totsika V, Hastings RP, Hatton C, Emerson E. Pathways to social well-being of children with intellectual disability: testing the Family Investment Model. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1354-1366. [PMID: 37648377 DOI: 10.1111/jir.13082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/29/2023] [Accepted: 08/01/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Social well-being, including prosocial and peer relationship skills, independence and co-operation, is a particularly important developmental outcome in intellectual disability (ID). The present study investigated pathways to social well-being through the early years' family environment, particularly the role of parental investments in mediating the path from family poverty to child social well-being. METHODS In line with the Family Investment Model (FIM), we tested whether parental investments between 3 and 5 years of age mediate the impact of family poverty at 9 months of age on children's social well-being at 7 years. Structural equation models were fitted to data from 555 children with ID identified from a UK population-based cohort. RESULTS Findings indicated that home learning investments and the structural home environment (though not play) significantly mediated the effect of family poverty on children's social skills, albeit in different directions. While all parental investments reduced in the presence of poverty, the home learning environment appeared to promote social well-being, whereas the structural home environment did not. Sensitivity analyses controlling for co-occurring autism confirmed the pattern of findings. Child gender, ethnicity and parental educational qualifications did not moderate the mediational relationships, suggesting that FIM pathways to social well-being were relevant to all families. CONCLUSIONS The FIM provides a helpful framework to map developmental pathways for children with an ID. Parental investments related to home learning, the structural home environment and play are reduced in the presence of poverty although their impact on child social well-being appears to differ.
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Affiliation(s)
- V Totsika
- Division of Psychiatry, University College London, London, UK
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - R P Hastings
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - C Hatton
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - E Emerson
- Centre for Disability Research, Division of Health and Medicine, Lancaster University, Lancaster, UK
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Camperdown, NSW, Australia
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5
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Ong N, Mimmo L, Barnett D, Long J, Weise J, Walton M. Reported clinical incidents of children with intellectual disability: A qualitative analysis. Dev Med Child Neurol 2022; 64:1359-1365. [PMID: 35578400 PMCID: PMC9790611 DOI: 10.1111/dmcn.15262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/26/2022] [Accepted: 04/14/2022] [Indexed: 12/30/2022]
Abstract
AIM To qualitatively explore reported clinical incidents of children with intellectual disability aged 0 to 18 years. METHOD A secondary qualitative evaluation using latent content analysis was used on retrospective hospital incident management reporting data (1st January-31st December 2017) on 1367 admissions for 1018 randomly selected patients admitted to two tertiary children's hospitals in New South Wales, Australia. Sex and age at admission in children with and without intellectual disability: 83 (43.7%) versus 507 (43.1%) females and 107 (56.3%) versus 670 (56.9%) males, p=0.875; median age 3 years (0-18y) versus 4 years (0-18y), p=0.122. Of these, 44 patient safety incident reports for children with intellectual disability (sex, SD, and range) and 167 incident reports for children without intellectual disability (sex, SD, and range) were found and analysed. RESULTS Ten themes were synthesized from the data and represented the groups with and without intellectual disability. Children with intellectual disability had a significantly higher proportion of care issues identified by their parents. They also had higher rates of multiple reported clinical incidents per admission compared to children without intellectual disability. INTERPRETATION Mechanisms to advocate and raise patient safety issues for children with intellectual disability are needed. Partnerships with parents and training of staff in reporting clinical incidents for this population would enhance the embedding of reasonable adaptations into incident management systems for ongoing monitoring and improvement. WHAT THIS PAPER ADDS Children with intellectual disability experienced multiple patient safety incidents per admission compared to children without intellectual disability. Children with intellectual disability had significantly increased rates of parent-identified incidents. Issues with medication, communication, delays in diagnosis and treatment, and identification of deterioration were noted.
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Affiliation(s)
- Natalie Ong
- School of Public Health, Faculty of Medicine and HealthUniversity of SydneyCamperdownNSWAustralia,Child Development Unit; Children's Hospital at WestmeadSydney Children's Hospitals NetworkWestmeadNSWAustralia
| | - Laurel Mimmo
- School of Population HealthUniversity of New South Wales Medicine, University of New South WalesKensingtonNSWAustralia,Clinical Governance UnitSydney Children's Hospitals NetworkSydneyNSWAustralia
| | - Diana Barnett
- Child Development Unit; Children's Hospital at WestmeadSydney Children's Hospitals NetworkWestmeadNSWAustralia
| | - Janet Long
- Australian Institute of Health Innovation, Faculty of Medicine and Health SciencesMacquarie UniversityMacquarie ParkNSWAustralia
| | - Janelle Weise
- Department of Developmental Disability Neuropsychiatry (3DN)University of New South Wales Medicine, University of New South WalesRandwickNSWAustralia
| | - Merrilyn Walton
- School of Public Health, Faculty of Medicine and HealthUniversity of SydneyCamperdownNSWAustralia
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6
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Moradi G, Bolbanabad AM, Abdullah FZ, Safari H, Rezaei S, Aghaei A, Hematpour S, Farshadi S, Naleini N, Piroozi B. Catastrophic health expenditures for children with disabilities in Iran: A national survey. Int J Health Plann Manage 2021; 36:1861-1873. [PMID: 34185916 DOI: 10.1002/hpm.3273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/25/2021] [Accepted: 06/22/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the percentage of households with disabled children aged 0-8 years who had faced catastrophic health expenditures (CHEs) due to the health costs of these children in Iran. METHODS This cross-sectional study was carried out on 2000 households with disabled children aged 0-8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Determinants of CHE were identified using logistic regression. RESULTS 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR = 18.89, 95%CI: 10.88-29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR = 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR = 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR = 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR = 2.71, 95%CI, 1.60-4.69), and type of basic health insurance (having Iranian Health Insurance: Adjusted OR = 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR = 1.66, 95%CI, 1.06-2.61) significantly increased the chances of facing CHE. CONCLUSION A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.
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Affiliation(s)
- Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amjad Mohamadi Bolbanabad
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farman Zahir Abdullah
- College of Education and Language, Charmo University, Chamchamal, Kurdistan Region, Iraq
| | - Hossein Safari
- Health Promotion Research Cente, Iran University of Medical Science, Tehran, Iran
| | - Satar Rezaei
- Department of Public Health, School of Health, Research Center for Environmental Determinants of Health, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abbas Aghaei
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Siros Hematpour
- Department of Pediatrics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Salahaddin Farshadi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Nima Naleini
- Research Student Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bakhtiar Piroozi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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7
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Huang SY, Chang CC, Lin CS, Yeh CC, Lin JA, Cherng YG, Chen TL, Liao CC. Adverse outcomes after major surgery in children with intellectual disability. Dev Med Child Neurol 2021; 63:211-217. [PMID: 33131081 DOI: 10.1111/dmcn.14715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate outcomes after major surgery in children and adolescents with intellectual disability. METHOD We used 2004 to 2013 claims data from Taiwan's National Health Insurance programme to conduct a nested cohort study, which included 220 292 surgical patients aged 6 to 17 years. A propensity score matching procedure was used to select 2173 children with intellectual disability and 21 730 children without intellectual disability for comparison. Logistic regression was used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of the postoperative complications and 30-day mortality associated with intellectual disability. RESULTS Children with intellectual disability had a higher risk of postoperative pneumonia (OR 2.16, 95% CI 1.48-3.15; p<0.001), sepsis (OR 1.67, 95% CI 1.28-2.18; p<0.001), and 30-day mortality (OR 2.04, 95% CI 1.05-3.93; p=0.013) compared with children without intellectual disability. Children with intellectual disability also had longer lengths of hospital stay (p<0.001) and higher medical expenditure (p<0.001) when compared with children with no intellectual disability. INTERPRETATION Children with intellectual disability experienced more complications and higher 30-day mortality after surgery when compared with children without intellectual disability. There is an urgent need to revise the protocols for the perioperative care of this specific population. WHAT THIS PAPER ADDS Surgical patients with intellectual disability are at increased risk of postoperative pneumonia, sepsis, and 30-day mortality. Intellectual disability is associated with higher medical expenditure and increased length of stay in hospital after surgical procedures. The influence of intellectual disability on postoperative outcomes is consistent in both sexes and those aged 10 to 17 years. Low income and a history of fractures significantly impacts postoperative adverse events for patients with intellectual disability.
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Affiliation(s)
- Shih-Yu Huang
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chuen-Chau Chang
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.,Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chao-Shun Lin
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.,Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Chieh Yeh
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan.,Department of Surgery, University of Illinois, Chicago, IL, USA
| | - Jui-An Lin
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Center of Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yih-Giun Cherng
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chien-Chang Liao
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.,Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Center of Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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8
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Rydzewska E, Fleming M, Mackay D, Young-Southward G, Blacher J, Bolourian Y, Widaman K, Cooper SA. General health status in young people with intellectual disabilities with and without Down syndrome in, and transitioning from, special education: findings from the National Longitudinal Transitions Study-2. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:895-907. [PMID: 33047429 DOI: 10.1111/jir.12781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND There has been little prior investigation of the general health of young people with intellectual disabilities across transition, nor separately for youth with intellectual disabilities with or without Down syndrome, despite general health being a strong predictor of subsequent health service use, hospital admissions and mortality in the general population. We aimed to investigate general health status in youth with intellectual disabilities with and without Down syndrome over the transitional period and quantify the extent to which personal characteristics, parental relationship and household income are associated with general health status. METHODS The National Longitudinal Transitions Study-2 includes a nationally representative sample of youth receiving special education services aged 13-17 years at wave 1, followed up over 10 years in five waves of data collection. Data on general health status of youth with intellectual disabilities with and without Down syndrome were obtained from parent reports. We summarised overall demographics and general health status and plotted general health status for those who had health data available for all five waves. We then used random-effects ordered logistic regression to investigate whether wave of data collection, age, sex, Down syndrome, ethnicity, parental relationship status and household income are associated with general health status. RESULTS At wave 1, data on intellectual disabilities were available on 9008/9576 (94.1%) young people, and 871/9008 (9.7%) of them had intellectual disabilities, of whom 125/871 (14.4%) had Down syndrome. Youth with intellectual disabilities with or without Down syndrome had low rates of excellent or very good health. Across waves 1-5, there was a shallow gradient in the proportion of youth with intellectual disabilities reporting excellent/very good health, from 57.7% at 13-17 years to 52.6% at 21-25 years, being more marked for those without Down syndrome (57.8% at 13-17 years to 51.8% at 21-25 years). However, contrary to our expectations, an ordinal measure of general health status did not decline over this transitional period and did not differ between youth with and without Down syndrome. There was a gradient with higher income associated with better health, significantly so over $50 001 (odds ratio = 0.559, 95% confidence interval 0.366-0.854). Poorer health was experienced by youth with Hispanic, Latino or Spanish ethnicity (odds ratio = 1.790, 95% confidence interval 1.051-3.048). Female sex and parental relationship status were not associated with health status. CONCLUSIONS Young people with intellectual disabilities have bad health, and require support across all ages, including transition. Schools, teachers and staff in transitional services should consider health, and health care and support during transitional planning due to change in service provision and be aware of ethnicity and the stressful effects of low household income. This is important as interventions based on provision of greater support can prevent adverse consequences.
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Affiliation(s)
- E Rydzewska
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - M Fleming
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - D Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - G Young-Southward
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - J Blacher
- Graduate School of Education, University of California, Riverside, CA, USA
| | - Y Bolourian
- Graduate School of Education, University of California, Riverside, CA, USA
| | - K Widaman
- Graduate School of Education, University of California, Riverside, CA, USA
| | - S-A Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Nicholson E, Doherty E, Somanadhan S, Guerin S, Schreiber J, Bury G, Kroll T, Raley M, McAuliffe E. Health inequities in unscheduled healthcare for children with intellectual disabilities in Ireland: a study protocol. HRB Open Res 2020; 3:3. [PMID: 32832849 PMCID: PMC7431971 DOI: 10.12688/hrbopenres.12973.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Health inequities for children with intellectual disabilities are prevalent within different health systems, and children with intellectual disabilites have shorter life expectancies than the general population, higher mortality rates before the age of 17 and have a greater risk of potentially preventable hospitalisations. A health systems approach to research in this area provides a useful means through which research can inform policy and practice to ensure people with intellectual disabilities receive equitable healthcare; however, there is a paucity of evidence regarding how to address differences that have been described in the literature to date. The overall aim of this research is to establish the extent of health inequities for children with intellectual disabilities in Ireland compared to children without intellectual disabilities with respect to their utilisation of primary care and rates of hospitalisation, and to gain a better understanding of what influences utilisation of primary care and emergency department services in this population. Methods and analysis: The design of this research adopts a multi-methods approach: statistical analysis of health data to determine the extent of health inequities in relation to healthcare utilisation; discrete choice experiments to explore General Practitioners' decision making and parental preferences for optimal care; and concept mapping to develop consensus between stakeholders on how to address current healthcare inequities. Discussion: By applying a systems lens to the issue of health inequities for children with intellectual disabilities, the research hopes to gain a thorough understanding of the varying components that can contribute to the maintenance of such healthcare inequities. A key output from the research will be a set of feasible solutions and interventions that can address health inequities for this population.
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Affiliation(s)
- Emma Nicholson
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), University College Dublin, Belfield, Dublin 4, Ireland
| | - Edel Doherty
- J.E. Cairnes School of Business and Economics, National University of Ireland, Galway, University Road, Galway, Ireland
| | - Suja Somanadhan
- UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Suzanne Guerin
- UCD Centre for Disability Studies, University College Dublin, Belfield, Dublin 4, Ireland
| | | | - Gerard Bury
- UCD School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Thilo Kroll
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), University College Dublin, Belfield, Dublin 4, Ireland
| | - Meredith Raley
- Disability Federation of Ireland, Fumbally Court, Dublin 8, Ireland
| | - Eilish McAuliffe
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), University College Dublin, Belfield, Dublin 4, Ireland
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10
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Nicholson E, Doherty E, Somanadhan S, Guerin S, Schreiber J, Bury G, Kroll T, Raley M, McAuliffe E. Health inequities in unscheduled healthcare for children with intellectual disabilities in Ireland: a study protocol. HRB Open Res 2020; 3:3. [PMID: 32832849 PMCID: PMC7431971 DOI: 10.12688/hrbopenres.12973.1] [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] [Accepted: 12/17/2019] [Indexed: 03/30/2024] Open
Abstract
Background: Health inequities for children with intellectual disabilities (ID) are prevalent within different health systems, and children with ID have shorter life expectancies than the general population, higher mortality rates before the age of 17 and have a greater risk of potentially preventable hospitalisations. A health systems approach to research in this area provides a useful means through which research can inform policy and practice to ensure people with ID receive equitable healthcare; however, there is a paucity of evidence regarding how to address differences that have been described in the literature to date. The overall aim of this research is to establish the extent of health inequities for children with ID in Ireland compared to children without ID with respect to their utilisation of primary care and rates of hospitalisation, and to gain a better understanding of what influences utilisation of primary care and ED services in this population. Methods and analysis: The design of this research adopts a mixed-methods approach: statistical analysis of health data to determine the extent of health inequities in relation to healthcare utilisation; discrete choice experiments to explore General Practitioners' decision making and parental preferences for optimal care; and concept mapping to develop consensus between stakeholders on how to address current healthcare inequities. Discussion: By applying a systems lens to the issue of health inequities for children with ID, the research hopes to gain a thorough understanding of the varying components that can contribute to the maintenance of such healthcare inequities. A key output from the research will be a set of feasible solutions and interventions that can address health inequities for this population.
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Affiliation(s)
- Emma Nicholson
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), University College Dublin, Belfield, Dublin 4, Ireland
| | - Edel Doherty
- J.E. Cairnes School of Business and Economics, National University of Ireland, Galway, University Road, Galway, Ireland
| | - Suja Somanadhan
- UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Suzanne Guerin
- UCD Centre for Disability Studies, University College Dublin, Belfield, Dublin 4, Ireland
| | | | - Gerard Bury
- UCD School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Thilo Kroll
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), University College Dublin, Belfield, Dublin 4, Ireland
| | - Meredith Raley
- Disability Federation of Ireland, Fumbally Court, Dublin 8, Ireland
| | - Eilish McAuliffe
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), University College Dublin, Belfield, Dublin 4, Ireland
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Reppermund S, Srasuebkul P, Dean K, Trollor JN. Factors associated with death in people with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 33:420-429. [DOI: 10.1111/jar.12684] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 10/09/2019] [Accepted: 10/24/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Simone Reppermund
- Department of Developmental Disability Neuropsychiatry School of Psychiatry UNSW Sydney Sydney NSW Australia
- Centre for Healthy Brain Ageing School of Psychiatry UNSW Sydney Sydney NSW Australia
| | - Preeyaporn Srasuebkul
- Department of Developmental Disability Neuropsychiatry School of Psychiatry UNSW Sydney Sydney NSW Australia
| | - Kimberlie Dean
- School of Psychiatry UNSW Sydney Sydney NSW Australia
- Justice Health & Forensic Mental Health Network Sydney NSW Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry School of Psychiatry UNSW Sydney Sydney NSW Australia
- Centre for Healthy Brain Ageing School of Psychiatry UNSW Sydney Sydney NSW Australia
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Marquis SM, McGrail K, Hayes M. Mental health of parents of children with a developmental disability in British Columbia, Canada. J Epidemiol Community Health 2019; 74:173-178. [PMID: 31744849 PMCID: PMC6993017 DOI: 10.1136/jech-2018-211698] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 09/26/2019] [Accepted: 11/08/2019] [Indexed: 01/23/2023]
Abstract
Background There is evidence in the literature that parents of children who have a developmental disability experience an increased risk of mental health problems. Methods This study used population-level administrative data from the Ministry of Health, British Columbia, Canada, to assess the mental health of parents of children who have a developmental disability compared with the mental health of parents of children who do not have a developmental disability. Population-level and individual explanatory variables available in the data were included in the models. Results At a population level, the study found strong evidence that parents of children who have a developmental disability experience higher odds of depression or other mental health diagnoses compared with parents of children who do not have a developmental disability. Age of the parent at birth of the child, income and location of healthcare services were all associated with outcomes. Conclusion Parents of children who have a developmental disability may be in need of programmes and services that support their mental health.
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Affiliation(s)
- Sandra Maureen Marquis
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Hayes
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
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Balogh R, Leonard H, Bourke J, Brameld K, Downs J, Hansen M, Glasson E, Lin E, Lloyd M, Lunsky Y, O'Donnell M, Shooshtari S, Wong K, Krahn G. Data Linkage: Canadian and Australian Perspectives on a Valuable Methodology for Intellectual and Developmental Disability Research. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:439-462. [PMID: 31568733 DOI: 10.1352/1934-9556-57.5.439] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Data linkage holds great promise for generating new information about people with intellectual and developmental disabilities (IDD) as a population, yet few centers have developed the infrastructure to utilize this methodology. Two examples, from Canada and Australia, describe their efforts in building data linkage capabilities, and how linked databases can be used to identify persons with IDD and used for population-based research. The value of data linkage is illustrated through new estimates of prevalence of IDD; health service utilization patterns; associations with sociodemographic characteristics, and with physical and mental health conditions (e.g., chronic diseases, injury, fertility, and depression); and findings on equity in medical treatments. Examples are provided of findings used for governmental policy and program planning.
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Affiliation(s)
- Robert Balogh
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Helen Leonard
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Jenny Bourke
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Kate Brameld
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Jenny Downs
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Michele Hansen
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Emma Glasson
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Elizabeth Lin
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Meghann Lloyd
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Yona Lunsky
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Melissa O'Donnell
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Shahin Shooshtari
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Kingsley Wong
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
| | - Gloria Krahn
- Robert Balogh, Ontario Tech University, Oshawa, Ontario, Canada; Helen Leonard and Jenny Bourke, Telethon Kids Institute, The University of Western Australia, Perth; Kate Brameld, Curtin University, Perth, Western Australia; Jenny Downs, Michele Hansen, and Emma Glasson, Telethon Kids Institute, The University of Western Australia, Perth; Elizabeth Lin, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Meghann Lloyd, Ontario Tech University, Oshawa, Ontario, Canada; Yona Lunsky, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Melissa O'Donnell, Telethon Kids Institute, The University of Western Australia, Perth; Shahin Shooshtari, University of Manitoba, Winnipeg, Manitoba, Canada; Kingsley Wong, Telethon Kids Institute, The University of Western Australia, Perth; and Gloria Krahn, Oregon State University, Corvallis
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Behavioral analyses of animal models of intellectual and developmental disabilities. Neurobiol Learn Mem 2019; 165:107087. [PMID: 31499164 DOI: 10.1016/j.nlm.2019.107087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Intellectual and developmental disabilities (IDDs) are a common group of disorders that frequently share overlapping symptoms, including cognitive deficits, altered attention, seizures, impaired social interactions, and anxiety. The causes of these disorders are varied ranging from early prenatal/postnatal insults to genetic variants that either cause or are associated with an increased likelihood of an IDD. As many of the symptoms observed in individuals with IDDs are a manifestation of altered nervous system function resulting in altered behaviors, it should not be surprising that the field is very dependent upon in vivo model systems. This special issue of Neurobiology of Learning and Memory is focused on the methods and approaches that are being used to model and understand these disorders in mammals. While surveys by the Pew Foundation continue to find a high degree of confidence/trust in scientists by the public, several recent studies have documented issues with reproducibility in scientific publications. This special issue includes both primary research articles and review articles in which careful attention has been made to transparently report methods and use rigorous approaches to ensure reproducibility. Although there have been and will continue to be remarkable advances for treatment of subset of IDDs, it is clear that this field is still in its early stages. There is no doubt that the strategies being used to model IDDs will continue to evolve. We hope this special issue will support this evolution so that we can maintain the trust of the public and elected officials, and continue developing evidence-based approaches to new therapeutics.
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Marquis S, Hayes MV, McGrail K. Factors that May Affect the Health of Siblings of Children Who Have an Intellectual/Developmental Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12309] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sandra Marquis
- Social Dimensions of HealthUniversity of Victoria Victoria BC Canada
| | - Michael V. Hayes
- School of Public Health and Social Policy University of VictoriaUniversity of Victoria Victoria BC Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy ResearchUniversity of British Columbia Vancouver BC Canada
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Oulton K, Wray J, Hassiotis A, Kenten C, Russell J, Tuffrey-Wijne I, Whiting M, Gibson F. Learning disability nurse provision in children's hospitals: hospital staff perceptions of whether it makes a difference. BMC Pediatr 2019; 19:192. [PMID: 31182066 PMCID: PMC6558867 DOI: 10.1186/s12887-019-1547-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 05/20/2019] [Indexed: 12/16/2022] Open
Abstract
Background In response to multiple United Kingdom investigations and inquiries into the care of adults with learning disabilities, Mencap produced the Getting it Right Charter which campaigned for the appointment of a Learning Disability Liaison Nurse in every hospital. More recent best practice guidelines from the Care Quality Commission included the need for all children’s units to have access to a senior learning disability nurse who can support staff and help them manage difficult situations. However, little evidence exists of the extent of learning disability nurse provision in children’s hospitals or the nature and impact of this role. Here we report selected findings from a national mixed methods study of hospital care for children and young people with and without learning disabilities in England. The extent of learning disability nurse provision in children’s hospitals is described and perceptions of staff working in hospitals with and without such provision is compared. Methods Semi-structured interviews were conducted with senior staff across 15 children’s hospitals and an anonymous survey was sent to clinical and non-clinical staff with patient (children and young people) contact within these hospitals. The survey focused on six different elements of care for those with and without learning disability, with additional questions concerning identifying and tracking those with learning disabilities and two open-ended questions. Results Forty-eight senior staff took part in interviews, which included a subset of nine nurses and one allied health professional employed in a dedicted learning disability nurse role, or similar. Surveys were completed by 1681, of whom 752 worked in a hospital with dedicated learning disability nurse provision. We found evidence of limited and varied learning disability nurse provision which was valued by hospital staff and shown to positively impact their perceptions of being capable to care for children and young people with learning disabilities, but not shown to increase staff perceptions of capacity or confidence, or how children and young people are valued within the hospital, their safety or access to appointments. Conclusion Further consideration must be given to how learning disability nurse roles within children’s hospitals are best operationalised in practice to have the greatest impact on staff and families, as well as how we monitor and evaluate them to ensure they are being utilised effectively and efficiently. Trial registration The study has been registered on the NIHR CRN portfolio 20,461 (Phase 1), 31,336 (Phases 2–4).
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Affiliation(s)
- Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England.
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England
| | - Angela Hassiotis
- UCL Division of Psychiatry, London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, England
| | - Charlotte Kenten
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England
| | - Jessica Russell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England
| | - Irene Tuffrey-Wijne
- Faculty of Health, Social Care & Education, Cranmer Terrace, Kingston University & St George's, University of London, 6th floor Hunter Wing, London, SW17 0RE, UK
| | - Mark Whiting
- Health Research Building, University of Hertfordshire, College Lane Campus, Hatfield, Hertfordshire, AL10 9AB, England
| | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England.,School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, England
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Marquis S, Hayes MV, McGrail K. Factors Affecting the Health of Caregivers of Children Who Have an Intellectual/Developmental Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12283] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sandra Marquis
- School of Public Health and Social PolicyUniversity of Victoria Victoria BC Canada
| | - Michael V. Hayes
- School of Public Health and Social PolicyUniversity of Victoria Victoria BC Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy ResearchUniversity of British Columbia Vancouver BC Canada
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Perceptions of ageing and future aspirations by people with intellectual disability: a grounded theory study using photo-elicitation. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18001460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractInternationally, 1 per cent of the general population are living with an intellectual disability and life expectancy is increasing in line with global trends. The majority of people with an intellectual disability live with family. This represents a growing and largely ‘hidden’ population who have, or will have, additional needs as they and their family age. There is limited research about what is important for people with intellectual disability when thinking about getting older. This article reports on a study which explored the concept of ageing and future aspirations with 19 people living with an intellectual disability, aged 37–58 years of age (mean 48 years) and living with someone they identify as family. Using Charmaz's constructivist grounded theory approach and photo-elicitation, constant comparative analysis generated four themes: reciprocating relationships, emerging (in)dependence, configuring ageing and entertaining possibilities. As part of the interview process, photo-elicitation facilitated the expression of associations and perspectives about ageing and conceptualising the future for participants. The findings demonstrate the engagement of people with intellectual disabilities in research and provided unique insights into both their experiences and perspectives on ageing in the context of family. The need for greater flexibility in service planning and delivery are identified, alongside ensuring the meaningful inclusion of people with intellectual disability in decision-making about their own lives as they age.
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19
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Durkin MS, Yeargin-Allsopp M. Socioeconomic Status and Pediatric Neurologic Disorders: Current Evidence. Semin Pediatr Neurol 2018; 27:16-25. [PMID: 30293586 PMCID: PMC8340602 DOI: 10.1016/j.spen.2018.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Socioeconomic status (SES) is an important risk factor for many neurological disorders and a determinant of health outcomes and quality of life, especially for individuals with neurologic disorders and developmental disabilities. This article focuses on the relationship between SES and pediatric epilepsy, cerebral palsy, autism spectrum disorder, and intellectual disability. Disparities in the prevalence and long-term impact of SES on functioning in persons with disabilities are observed worldwide. Clinicians can use the information presented in the article to target early identification and interventions for improving outcomes in populations most at risk for these disorders and for poor health, social, and economic outcomes.
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Affiliation(s)
- Maureen S Durkin
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, Wisconsin
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
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20
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Eisenbaum E. Tobacco product use and smoking frequency among US adults with intellectual and developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:709-718. [PMID: 29920831 DOI: 10.1111/jir.12507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 04/19/2018] [Accepted: 05/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND People with intellectual and developmental disabilities (IDD) have been overlooked in tobacco use research although they are likely to experience tobacco-related health disparities. This study examined tobacco product use and smoking frequency and amount among a sample of US Special Olympics athletes with IDD. METHODS Multiple regression analysis was used to test whether age, gender, body mass index, blood pressure, bone density, eating fruits and vegetables and family member tobacco use were correlated with the number of cigarettes smoked per day. RESULTS The sample of people with IDD who used tobacco (n = 501) were aged 18-75 (M = 33.37) and 76.4% were male. About 73.6% reported cigarette use only, 10.6% reported dual or poly use of cigarettes and other tobacco products (cigars, pipe, and chewing tobacco) and 15.8% reported using only tobacco products other than cigarettes. Men were more likely than women to use tobacco products other than cigarettes. Of the cigarette smokers, 79.6% were daily smokers, and their mean cigarettes per day was 10.08 (SD = 9.50). Special Olympics athletes who did not have low bone density and those who consumed fruits and vegetables less than daily reported higher numbers of cigarettes per day. CONCLUSIONS Although people with IDD are less likely to use tobacco than the general population, study results suggest that people with IDD who smoke cigarettes are just as likely as smokers in the general US population to smoke daily. Improving overall health behaviours may be important in helping smokers with IDD to reduce their tobacco use. Research is needed to understand longitudinal patterns of tobacco use and how to prevent tobacco use among people with IDD.
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Affiliation(s)
- E Eisenbaum
- Human Development Institute, University of Kentucky, Lexington, KY, USA
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21
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Grey JM, Totsika V, Hastings RP. Living with family: perceptions of health and subjective well-being of adults with an intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:474-485. [PMID: 29479860 DOI: 10.1111/jir.12479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 11/05/2017] [Accepted: 01/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Little is known about the role of living circumstances to the perception of subjective well-being (SWB) and health of adults with intellectual disability (ID). The aim of the present study was to examine whether living circumstances impact differently on the perception of health and SWB and whether potential differences persist after accounting for other variables (e.g. level of support needs and reporting method). METHODS Secondary data analysis was undertaken of a large national survey of adults with an ID in England, aged 16 years and over. Participants were identified as living with family (N = 1528) or living out of home (N = 874). RESULTS The results of t-test and chi-square revealed that levels of health and SWB were perceived as being higher for people living with family than those living in out-of-home settings. Multiple linear regression analyses fitted to explore factors associated with these reported differences revealed that, when controlling for other variables, living with family was highly associated with reports of better SWB. Multiple logistic regression revealed that whilst the health status of people living with families were perceived as better, this was only true when their support needs were low. Poorest health outcomes were found for people with highest support needs who lived with family. CONCLUSIONS On the whole, the health and well-being of adults living with family were perceived more positively than those living out of home. However, potential health disparities exist for those with high support needs who live with family. Further longitudinal research is needed to explore causes and potential solution to these inequalities.
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Affiliation(s)
- J M Grey
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - V Totsika
- Centre for Educational Development, Appraisal and Research (CEDAR), Social Sciences, University of Warwick, Coventry, UK
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), Social Sciences, University of Warwick, Coventry, UK
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Taheri A, Perry A, Minnes P. Exploring factors that impact activity participation of children and adolescents with severe developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:1151-1161. [PMID: 29154492 DOI: 10.1111/jir.12437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Despite the benefits of social participation, children and adolescents with developmental disabilities (DD) are often excluded from taking part in social activities. There is a gap in the literature about the factors that contribute to adequate participation of children with severe DD in particular and the barriers to their participation. Taking an ecological perspective, the purpose of this study was to examine child, family and community variables that may impact the activity participation of children and adolescents with severe DD. METHODS A total of 197 parents of children with severe DD (4-19 years) completed a survey, addressing a wide range of child, family and community related variables, as well as a measure of activity participation. RESULTS Overall, the final model significantly accounted for 30% of the variance in activity participation. Higher adaptive behaviour, greater parental socialisation and placement in an integrated school programme were significant predictors of greater activity participation. CONCLUSION Child, family and community factors were all important in understanding the activity participation of children with severe DD, thus supporting the value of an ecological approach. Suggestions for future research and clinical implications are discussed.
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Affiliation(s)
- A Taheri
- Department of Psychology, York University, Ontario, Canada
| | - A Perry
- Department of Psychology, York University, Ontario, Canada
| | - P Minnes
- Psychology, Queen's University, Ontario, Canada
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Hughes-McCormack LA, Rydzewska E, Henderson A, MacIntyre C, Rintoul J, Cooper SA. Prevalence and general health status of people with intellectual disabilities in Scotland: a total population study. J Epidemiol Community Health 2017; 72:78-85. [DOI: 10.1136/jech-2017-209748] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/08/2017] [Accepted: 10/09/2017] [Indexed: 11/04/2022]
Abstract
BackgroundPrevalence of intellectual disabilities varies considerably between studies. People with intellectual disabilities experience health inequalities, but most studies comprise small or incomplete populations. We investigated in a whole country population the (1) prevalence of intellectual disabilities and (2) general health status compared with the general population.MethodData were from Scotland’s Census, 2011. We calculated the prevalence of intellectual disabilities, reported general health status of people with and without intellectual disabilities and the extent of health-related limitations to daily activities. We conducted logistic regressions to determine the ORs of intellectual disabilities predicting poor health and associations with age and gender.ResultsOf Scotland’s 5 295 403 population, 26 349 (0.5%) had intellectual disabilities; 15 149 (57.5%) were males and 11 200 (42.5%) were females; 5234 (0.6%) were children/youth (0–15) and 21 115 (0.5%) were adults (16–75+ years). Identification of intellectual disabilities rises until age 5 years, with a further small rise by age 9 years. Children and adults with intellectual disabilities reported more poor health (47.9% and 40.3%) than the general population (2.1% and 13.8%) and were more limited in activities by their health. Intellectual disabilities had an OR of 43.2 (95% CI 40.8 to 45.7) in predicting poor health; the influence of increasing age on poor health was markedly interacted by presence of intellectual disabilities, likely to be due to a ‘healthy survivor’ effect within the intellectual disabilities population.ConclusionPeople with intellectual disabilities have poorer general health than other people, especially children and young people. Accurate information on population prevalence and health status is essential to plan appropriate resources.
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Zeedyk SM, Blacher J. Longitudinal Correlates of Maternal Depression Among Mothers of Children With or Without Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 122:374-391. [PMID: 28846040 DOI: 10.1352/1944-7558-122.5.374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This study identified trajectories of depressive symptoms among mothers of children with or without intellectual disability longitudinally across eight time points. Results of fitting a linear growth model to the data from child ages 3-9 indicated that child behavior problems, negative financial impact, and low dispositional optimism all significantly related to initial maternal depressive symptoms. Child behavior problems were significantly associated with changes in depressive symptoms over time, relating above and beyond child disability status. When looking from late childhood into early adolescence, hierarchical linear regression analysis revealed that maternal depressive symptoms at child age 9 and perceived financial impact significantly related to maternal depressive symptoms at child age 13. Implications for practice and future research directions are discussed.
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Affiliation(s)
- Sasha M Zeedyk
- Sasha M. Zeedyk, California State University, Fullerton, and Jan Blacher, University of California, Riverside
| | - Jan Blacher
- Sasha M. Zeedyk, California State University, Fullerton, and Jan Blacher, University of California, Riverside
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25
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Stough LM, Ducy EM, Kang D. Addressing the Needs of Children With Disabilities Experiencing Disaster or Terrorism. Curr Psychiatry Rep 2017; 19:24. [PMID: 28405894 DOI: 10.1007/s11920-017-0776-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW This paper reviews the empirical literature on psychosocial factors relating to children with disabilities in the context of disaster or terrorism. RECENT FINDINGS Research indicates adults with disabilities experience increased exposure to hazards due to existing social disparities and barriers associated with disability status. However, studies on the psychological effects of disaster/terrorism on children with pre-existing disabilities are exceedingly few and empirical evidence of the effectiveness of trauma-focused therapies for this population is limited. Secondary adversities, including social stigma and health concerns, also compromise the recovery of these children post-disaster/terrorism. Schools and teachers appear to be particularly important in the recovery of children with disabilities from disaster. Disasters, terrorism, and war all contribute to increased incidence of disability, as well as disproportionately affect children with pre-existing disabilities. Disaster preparedness interventions and societal changes are needed to decrease the disproportionate environmental and social vulnerability of children with disabilities to disaster and terrorism.
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Affiliation(s)
- Laura M Stough
- Department of Educational Psychology, Center on Disability and Development, Texas A&M University, Mail Stop 4225, College Station, TX, 77843, USA.
| | - Elizabeth McAdams Ducy
- Department of Educational Leadership and Special Education, School of Education, Sonoma State University, 1801 East Cotati Ave, Rohnert Park, CA, 94928, USA
| | - Donghyun Kang
- Department of Educational Psychology, Center on Disability and Development, Texas A&M University, Mail Stop 4225, College Station, TX, 77843, USA
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26
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Pownall J, Wilson S, Jahoda A. Health knowledge and the impact of social exclusion on young people with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 33:29-38. [DOI: 10.1111/jar.12331] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/30/2022]
Affiliation(s)
| | - Sarah Wilson
- Institute of Health and Wellbeing University of Glasgow Glasgow UK
| | - Andrew Jahoda
- Institute of Health and Wellbeing University of Glasgow Glasgow UK
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Oulton K, Wray J, Carr L, Hassiotis A, Jewitt C, Kerry S, Tuffrey-Wijne I, Gibson F. Pay More Attention: a national mixed methods study to identify the barriers and facilitators to ensuring equal access to high-quality hospital care and services for children and young people with and without learning disabilities and their families. BMJ Open 2016; 6:e012333. [PMID: 27940626 PMCID: PMC5168702 DOI: 10.1136/bmjopen-2016-012333] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Despite evidence of health inequalities for adults with intellectual disability (ID) there has yet to be a comprehensive review of how well hospital services are meeting the needs of children and young people (CYP) with ID and their families. We do not know how relevant existing recommendations and guidelines are to CYP, whether these are being applied in the paediatric setting or what difference they are making. Evidence of parental dissatisfaction with the quality, safety and accessibility of hospital care for CYP with ID exists. However, the extent to which their experience differs from parents of CYP without ID is not known and the views and experiences of CYP with ID have not been investigated. We will compare how services are delivered to, and experienced by CYP aged 5-15 years with and without ID and their families to see what inequalities exist, for whom, why and under what circumstances. METHODS AND ANALYSIS We will use a transformative, mixed methods case study design to collect data over four consecutive phases. We will involve CYP, parents and hospital staff using a range of methods; interviews, parental electronic diary, hospital and community staff questionnaire, patient and parent satisfaction questionnaire, content analysis of hospital documents and a retrospective mapping of patient hospital activity. Qualitative data will be managed and analysed using NVivo and quantitative data will be analysed using parametric and non-parametric descriptive statistics. ETHICS AND DISSEMINATION The study will run from December 2015 to November 2018. We have Health Authority Approval (IRAS project ID: 193932) for phase 1 involving staff only and ethical and Health Authority Approval for phases 2-4 (IRAS project ID: 178525). We will disseminate widely to relevant stakeholders, using a range of accessible formats, including social media. We will publish in international peer-reviewed journals and present to professional, academic and lay audiences through national and international conferences.
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Affiliation(s)
- Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital NHS Foundation Trust, London, UK
- JM Barrie Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Lucinda Carr
- JM Barrie Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | | | - Carey Jewitt
- UCL Knowledge Lab, UCL Institute of Education, London, UK
| | - Sam Kerry
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | | | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital NHS Foundation Trust, London, UK
- School of Health Science, University of Surrey, Surrey, UK
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LaMontagne AD, Krnjacki L, Milner A, Butterworth P, Kavanagh A. Psychosocial job quality in a national sample of working Australians: A comparison of persons working with versus without disability. SSM Popul Health 2016; 2:175-181. [PMID: 29349138 PMCID: PMC5757884 DOI: 10.1016/j.ssmph.2016.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/29/2016] [Accepted: 03/07/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES There is growing international policy interest in disability employment, yet there has been little investigation of job quality among people working with disability. This study uses Australian national data to compare the psychosocial job quality of people working with versus without disability. METHODS We used 10 annual waves of data from a large representative Australian panel survey to estimate the proportion of the population experiencing poorer psychosocial job quality (overall and by individual 'adversities' of low job control, high demands, high insecurity, and low fairness of pay) by disability status and impairment type. We used logistic regression to examine the pooled cross-sectional associations between disability and job quality, adjusting for age, sex, education and job type. RESULTS Those working with any disability showed approximately 25% higher odds of reporting one or more adversity at work (OR: 1.23, 95% CI: 1.15, 1.31), and this finding was consistent across impairment types with the exception of intellectual/developmental disability. Estimates were largely unchanged after adjustments. Similar results were found for reporting two or more adversities compared one or more. CONCLUSIONS We observed that working people with a disability in Australia reported systematically poorer psychosocial job quality than those working without disability. These results suggest the need for further research to understand the reasons for these patterns, as well as policy and practice efforts to address this inequity.
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Affiliation(s)
- Anthony D. LaMontagne
- Work, Health & Wellbeing Unit, Centre for Population Health Research, Building BC3.213, School of Health & Social Development, Deakin University, Burwood, VIC 3125, Australia
| | - L. Krnjacki
- Gender and Women’s Health Unit, Academic Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - A. Milner
- Work, Health & Wellbeing Unit, Centre for Population Health Research, Building BC3.213, School of Health & Social Development, Deakin University, Melbourne, Australia
| | | | - A. Kavanagh
- Gender and Women’s Health Unit, Academic Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
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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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Trollor J, Salomon C, Curtis J, Watkins A, Rosenbaum S, Samaras K, Ward PB. Positive cardiometabolic health for adults with intellectual disability: an early intervention framework. Aust J Prim Health 2016; 22:288-293. [PMID: 27444634 DOI: 10.1071/py15130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 06/05/2016] [Indexed: 12/26/2022]
Abstract
Cardiometabolic morbidity is a significant contributor to the poorer health outcomes experienced by people with intellectual disability (ID). Tailoring cardiometabolic monitoring tools developed for the general population to better fit the altered risk profiles and extra needs of people with ID may help to improve health outcomes. This paper describes a new cardiometabolic monitoring framework designed to address the extra needs of people with ID. The framework was adapted from a generalist guideline after a process of extensive consultation with the original authors and over 30 ID and cardiometabolic experts. In addition to standard cardiometabolic monitoring practice, the framework encourages clinicians to: anticipate and address barriers to care such as communication difficulties and fear of blood tests; account for socioeconomic and genetic factors altering baseline cardiometabolic risk; and carefully rationalize psychotropic prescription. Together with this framework, a toolkit of free cardiometabolic resources tailored for people with ID and formal and informal carers is included. The monitoring framework promotes a multidisciplinary and holistic approach to cardiometabolic care for people with ID.
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Affiliation(s)
- Julian Trollor
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, 34 Botany Street, Sydney, NSW 2052, Australia
| | - Carmela Salomon
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, 34 Botany Street, Sydney, NSW 2052, Australia
| | - Jackie Curtis
- South Eastern Sydney Local Health District, Prince of Wales Mental Health, 26 Llandaff Street, Bondi Junction, NSW 2022, Australia
| | - Andrew Watkins
- South Eastern Sydney Local Health District, Prince of Wales Mental Health, 26 Llandaff Street, Bondi Junction, NSW 2022, Australia
| | - Simon Rosenbaum
- South Eastern Sydney Local Health District, Prince of Wales Mental Health, 26 Llandaff Street, Bondi Junction, NSW 2022, Australia
| | - Katherine Samaras
- Department of Endocrinology, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Wallace Wurth Building, 18 High Street, Kensington, NSW 2052, Australia
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Kavanagh AM, Aitken Z, Baker E, LaMontagne AD, Milner A, Bentley R. Housing tenure and affordability and mental health following disability acquisition in adulthood. Soc Sci Med 2016; 151:225-32. [DOI: 10.1016/j.socscimed.2016.01.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/19/2015] [Accepted: 01/07/2016] [Indexed: 11/29/2022]
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Kavanagh AM, Aitken Z, Krnjacki L, LaMontagne AD, Bentley R, Milner A. Mental Health Following Acquisition of Disability in Adulthood--The Impact of Wealth. PLoS One 2015; 10:e0139708. [PMID: 26444990 PMCID: PMC4596479 DOI: 10.1371/journal.pone.0139708] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/16/2015] [Indexed: 11/24/2022] Open
Abstract
Background Acquisition of a disability in adulthood has been associated with a reduction in mental health. We tested the hypothesis that low wealth prior to disability acquisition is associated with a greater deterioration in mental health than for people with high wealth. Methods We assess whether level of wealth prior to disability acquisition modifies this association using 12 waves of data (2001–2012) from the Household, Income and Labour Dynamics in Australia survey–a population-based cohort study of working-age Australians. Eligible participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (1977 participants, 13,518 observations). Fixed-effects linear regression was conducted with a product term between wealth prior to disability (in tertiles) and disability acquisition with the mental health component score of the SF–36 as the outcome. Results In models adjusted for time-varying confounders, there was evidence of negative effect measure modification by prior wealth of the association between disability acquisition and mental health (interaction term for lowest wealth tertile: -2.2 points, 95% CI -3.1 points, -1.2, p<0.001); low wealth was associated with a greater decline in mental health following disability acquisition (-3.3 points, 95% CI -4.0, -2.5) than high wealth (-1.1 points, 95% CI -1.7, -0.5). Conclusion The findings suggest that low wealth prior to disability acquisition in adulthood results in a greater deterioration in mental health than among those with high wealth.
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Affiliation(s)
- Anne Marie Kavanagh
- Gender and Women’s Health, Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, 207 Bouverie St, Carlton, 3010 VIC, Australia
- * E-mail:
| | - Zoe Aitken
- Gender and Women’s Health, Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, 207 Bouverie St, Carlton, 3010 VIC, Australia
| | - Lauren Krnjacki
- Gender and Women’s Health, Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, 207 Bouverie St, Carlton, 3010 VIC, Australia
| | - Anthony Daniel LaMontagne
- Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, Building BC3.213, 221 Burwood Highway, Burwood, VIC 3125, Australia
- McCaughey VicHealth Centre for Community Wellbeing, Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, 207 Bouverie St, Carlton, 3010 VIC, Australia
| | - Rebecca Bentley
- Gender and Women’s Health, Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, 207 Bouverie St, Carlton, 3010 VIC, Australia
| | - Allison Milner
- McCaughey VicHealth Centre for Community Wellbeing, Centre for Health Equity, Melbourne School of Population and Global Health, the University of Melbourne, 207 Bouverie St, Carlton, 3010 VIC, Australia
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Spencer NJ, Blackburn CM, Read JM. Disabling chronic conditions in childhood and socioeconomic disadvantage: a systematic review and meta-analyses of observational studies. BMJ Open 2015; 5:e007062. [PMID: 26338834 PMCID: PMC4563224 DOI: 10.1136/bmjopen-2014-007062] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 07/23/2015] [Accepted: 07/30/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine the association of socioeconomic disadvantage with the prevalence of childhood disabling chronic conditions in high-income countries. STUDY DESIGN Systematic review and meta-analyses. DATA SOURCES 6 electronic databases, relevant websites, reference lists and experts in the field. STUDY SELECTION 160 observational studies conducted in high-income countries with data on socioeconomic status and disabling chronic conditions in childhood, published between 1 January 1991 and 31 December 2013. DATA EXTRACTION AND SYNTHESIS Abstracts were reviewed, full papers obtained, and papers identified for inclusion by 2 independent reviewers. Inclusion decisions were checked by a third reviewer. Where reported, ORs were extracted for low versus high socioeconomic status. For studies reporting raw data but not ORs, ORs were calculated. Narrative analysis was undertaken for studies without data suitable for meta-analysis. RESULTS 126 studies had data suitable for meta-analysis. ORs for risk estimates were: all-cause disabling chronic conditions 1.72 (95% CI 1.48 to 2.01); psychological disorders 1.88 (95% CI 1.68 to 2.10); intellectual disability 2.41 (95% CI 2.03 to 2.86); activity-limiting asthma 2.20 (95% CI 1.87 to 2.85); cerebral palsy 1.42 (95% CI 1.26 to 1.61); congenital abnormalities 1.41 (95% CI 1.24 to 1.61); epilepsy 1.38 (95% CI 1.20 to 1.59); sensory impairment 1.70 (95% CI 1.39 to 2.07). Heterogeneity was high across most estimates (I(2)>75%). Of the 34 studies without data suitable for meta-analysis, 26 reported results consistent with increased risk associated with low socioeconomic status. CONCLUSIONS The findings indicate that, in high-income countries, childhood disabling chronic conditions are associated with social disadvantage. Although evidence of an association is consistent across different countries, the review provides limited evidence to explain the association; future research, using longitudinal data, will be required to distinguish low socioeconomic status as the cause or consequence of childhood disabling chronic conditions and the aetiological pathways and mechanisms.
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Affiliation(s)
| | | | - Janet M Read
- Warwick Medical School, University of Warwick, Coventry, UK
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Abstract
Most research on mental health in individuals with autism spectrum disorder (ASD) and intellectual disability (ID) has focused on deficits. We examined individual (i.e., sociocommunicative skills, adaptive behavior, functional cognitive skills) and contextual (i.e., home, school, and community participation) correlates of thriving in 330 youth with ID and ASD compared to youth with ID only, 11-22 years of age (M = 16.74, SD = 2.95). Youth with ASD and ID were reported to thrive less than peers with ID only. Group differences in sociocommunicative ability and school participation mediated the relationship between ASD and less thriving. Research is needed to further elucidate a developmental-contextual framework that can inform interventions to promote mental health and wellness in individuals with ASD and ID.
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Affiliation(s)
- Jonathan A Weiss
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada,
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Lennox N, Van Driel ML, van Dooren K. Supporting primary healthcare professionals to care for people with intellectual disability: a research agenda. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 28:33-42. [PMID: 25530572 DOI: 10.1111/jar.12132] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The vast health inequities experienced by people with intellectual disability remain indisputable. Persistent and contemporary challenges exist for primary healthcare providers and researchers working to contribute to improvements to the health and well-being of people with intellectual disability. Over two decades after the only review of supports for primary healthcare providers was published, this paper contributes to an evolving research agenda that aims to make meaningful gains in health-related outcomes for this group. METHODS The present authors updated the existing review by searching the international literature for developments and evaluations of multinational models of care. RESULTS Based on our review, we present three strategies to support primary healthcare providers: (i) effectively using what we know, (ii) considering other strategies that offer support to primary healthcare professionals and (iii) researching primary health care at the system level. CONCLUSIONS Strengthening primary care by supporting equitable provision of health-related care for people with intellectual disability is a much needed step towards improving health outcomes among people with intellectual disability. More descriptive quantitative and qualitative research, as well as intervention-based research underpinned by rigorous mixed-methods evaluating these strategies at the primary care level, which is sensitive to the needs of people with intellectual disability will assist primary care providers to provide better care and achieve better health outcomes. ACCESSIBLE ABSTRACT Many people with intellectual disability have poor health. The authors reviewed what has been written by other researchers about how to improve the health of people with intellectual disability. In the future, people who support adults with intellectual disability should continue doing what they do well, think of other ways to improve health, and do more research about health. At all times, the needs of people with intellectual disability should be the greatest concern for those trying to support them.
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Affiliation(s)
- Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
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Gore N, Emerson E, Brady S. Rates of breastfeeding and exposure to socio-economic adversity amongst children with intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 39:12-19. [PMID: 25613368 DOI: 10.1016/j.ridd.2014.12.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/19/2014] [Accepted: 12/19/2014] [Indexed: 06/04/2023]
Abstract
Children with intellectual disability are at increased risk of experiencing poor health relative to their typically developing peers. Previous research indicates that exposure to socio-economic disadvantage contributes towards this disparity but that additional factors (including parenting practices) may be involved in mediating/moderating pathways. This study examined duration of breastfeeding amongst children with and without intellectual disability by a secondary analysis of data from the UK Millennium Cohort Study. Children with intellectual disability were significantly less likely to have been ever breastfed; breastfed exclusively or at all at 3 months or breastfed at all at 6 months relative to children without intellectual disability. None of these differences remained significant when other psycho-social risk factors for reduced breastfeeding were controlled for. The study adds to both the sparse literature on breastfeeding practices amongst families of children with intellectual disability and research demonstrating relationships between socio-economic disadvantage and wellbeing for children with intellectual disability.
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Affiliation(s)
- Nick Gore
- Tizard Centre, University of Kent, United Kingdom.
| | - Eric Emerson
- University of Sydney, Australia; University of Lancaster, United Kingdom
| | - Serena Brady
- Tizard Centre, University of Kent, United Kingdom
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Emerson E, Brigham P. Exposure of children with developmental delay to social determinants of poor health: cross-sectional case record review study. Child Care Health Dev 2015; 41:249-57. [PMID: 24797435 DOI: 10.1111/cch.12144] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research on child development in general has highlighted the importance that the family environment plays in mediating the pathway between exposure to low socio-economic position (SEP) and child well-being. While child developmental models in intellectual disability have highlighted the interplay between social context, family environment and child development, little empirical work has attempted to formally evaluate the evidence in support of specific mediating pathways between low SEP and child outcomes. METHODS Secondary analysis of cross-sectional confidentialized needs analysis data collected in three Primary Care Trusts in England covering a total population of 1.25 million people. Case record reviews were undertaken for 46 023 households, 2236 (4.9%) of which contained a child in the target age range with developmental delay. RESULTS Children with developmental delay, when compared with their non-disabled peers, were at significantly increased risk of poorer health outcomes and of being exposed to a wide range of social determinants of poor health. Controlling for between-group differences in exposure to social determinants of poor health reduced the risk of developmental delay being associated with poorer health outcomes by 45% for behaviour problems and 89% for risk of significant harm. For children with developmental delay, parenting difficulties appears to play a particularly significant role in partially mediating the effects of low SEP. CONCLUSIONS The findings of the present study point to the potential effectiveness of family-focused early intervention to prevent the emergence and escalation of behavioural difficulties and health problems in children with developmental delay.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, NSW, Australia
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Mithen J, Aitken Z, Ziersch A, Kavanagh AM. Inequalities in social capital and health between people with and without disabilities. Soc Sci Med 2014; 126:26-35. [PMID: 25500164 DOI: 10.1016/j.socscimed.2014.12.009] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The poor mental and physical health of people with disabilities has been well documented and there is evidence to suggest that inequalities in health between people with and without disabilities may be at least partly explained by the socioeconomic disadvantage (e.g. low education, unemployment) experienced by people with disabilities. Although there are fewer studies documenting inequalities in social capital, the evidence suggests that people with disabilities are also disadvantaged in this regard. We drew on Bourdieu's conceptualisation of social capital as the resources that flow to individuals from their membership of social networks. Using data from the General Social Survey 2010 of 15,028 adults living in private dwellings across non-remote areas of Australia, we measured social capital across three domains: informal networks (contact with family and friends); formal networks (group membership and contacts in influential organisations) and social support (financial, practical and emotional). We compared levels of social capital and self-rated health for people with and without disabilities and for people with different types of impairments (sensory and speech, physical, psychological and intellectual). Further, we assessed whether differences in levels of social capital contributed to inequalities in health between people with and without disabilities. We found that people with disabilities were worse off than people without disabilities in regard to informal and formal networks, social support and self-rated health status, and that inequalities were greatest for people with intellectual and psychological impairments. Differences in social capital did not explain the association between disability and health. These findings underscore the importance of developing social policies which promote the inclusion of people with disabilities, according to the varying needs of people with different impairments types. Given the changing policy environment, ongoing monitoring of the living circumstances of people with disabilities, including disaggregation of data by impairment type, is critical.
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Affiliation(s)
- Johanna Mithen
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, VIC 3010, Australia
| | - Zoe Aitken
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, VIC 3010, Australia
| | - Anne Ziersch
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA 5001, Australia
| | - Anne M Kavanagh
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, VIC 3010, Australia.
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Lindblad I, Billstedt E, Gillberg C, Fernell E. A register study of life events in young adults born to mothers with mild intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2014; 18:351-363. [PMID: 25253089 DOI: 10.1177/1744629514552150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Young adults, born to population-representative mothers with intellectual disability (ID), were targeted for psychosocial/life event follow-up. METHODS The whole group originally comprised 42 individuals but 3 had died and 1 had moved abroad. The remaining 38 were approached and 10 consented to participate in an interview study. However, of the remaining 28, it was not possible to establish contact with 21 who were instead searched for in various official registers. RESULTS Most (n = 18) individuals in the study group had been in contact with different authorities and clinics. Of the 21 individuals, 10 had contact with social services since childhood and 4 of these had been taken into care (foster family) and 6 had had contact families during childhood. One individual had been taken into a treatment centre and one grew up mainly with the father. Altogether 12 (57%) of 21 individuals did not grow up full-time with their biological mother. Twelve (57%) had major neurodevelopmental/neuropsychiatric conditions, including five with ID and seven with attention-deficit hyperactivity disorder (ADHD). Four individuals were registered within the Prison and Probation Service due to various types of crimes. CONCLUSION Individuals born to mothers with ID in our study group were at high risk of adverse experiences and negative outcomes, such as increased childhood mortality, a relatively large proportion of children taken into care, high rates of ID and ADHD in the children and of criminality in young adulthood. Taken together with the results obtained in an in-depth interview study of those in the originally targeted sample with whom it was possible to obtain contact, the present findings suggest that it will be important to provide early support and longitudinal developmental follow-up in groups of children growing up with a mother with ID. Children in this situation appear to be at a number of risks, probably related both to hereditary factors and to social disadvantage.
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Interventions to promote health: crossing networks of intellectual and developmental disabilities and aging. Disabil Health J 2014; 7:S24-32. [PMID: 24456681 DOI: 10.1016/j.dhjo.2013.06.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 05/14/2013] [Accepted: 06/10/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND People with intellectual and developmental disabilities experience lower levels of healthy behaviors as do older persons, making health promotion a key priority for these populations. OBJECTIVE The aim of this paper is to review the two fields of developmental disability and aging health promotion research in order to understand strategies used by both and to identify emerging and innovative practices that disability researchers can learn from each other. METHODS We conducted scoping reviews of health promotion intervention peer reviewed articles in English from 1991 to 2011 for intellectual and developmental disabilities and from 2007 to 2011 for the more extensive gerontological literature. Two reviewers extracted data. RESULTS The disability review identified 34 studies and three main types of interventions: exercise, multi-component, and health screens. The aging review identified 176 articles which had a wider variety of intervention topics and techniques, with more articles including innovative approaches to bringing interventions to community settings across a wider variety of populations. CONCLUSIONS As people with intellectual and developmental disabilities are living longer, disability health promotion can look to the aging literature for ideas to incorporate in future interventions for people with intellectual and developmental disabilities, while the gerontological research can learn from the research in intellectual and developmental disabilities on ways to adapt health promotion interventions to people with cognitive and physical limitations. Use of universal design principles could enable greater inclusion of people with disabilities in health promotion interventions for the general aging population.
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Gray KM, Piccinin A, Keating CM, Taffe J, Parmenter TR, Hofer S, Einfeld SL, Tonge BJ. Outcomes in young adulthood: are we achieving community participation and inclusion? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:734-745. [PMID: 23865802 DOI: 10.1111/jir.12069] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/24/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Despite recognition of the importance of integrated community living and support, there is evidence that parents remain the primary caregivers of young adults with intellectual disability (ID). In addition, employment rates remain low in this population. This study aimed to investigate the changes in living arrangements and participation in daytime activities over time in a community population of young people with ID. METHOD The sample consisted of 536 participants aged 4.0-18.9 years at Wave 1, followed up at Wave 5 when aged 20.5-37.6 years. Information was collected on their living arrangements and daytime activities at both time points, along with living skills and information on community social inclusion at Wave 5. For parents still caring for their adult child with ID, information was also collected on parental ratings of their own mental and physical health, and their satisfaction with the long-term care arrangements for their adult child. RESULTS A significant proportion of young people were still living with their parents at Wave 5. A greater proportion of those with a severe-profound degree of ID were living in residential care. Parents caring for their adult child reported high levels of mental health problems and dissatisfaction with the long-term care arrangements for their child. A small proportion of young people were in paid employment, and the majority was engaged in structured activities provided for those with an ID. Over one-third of the sample participated in a structured daytime activity for 10 or fewer hours per week, and 7% were not engaged in any structured daytime activity. CONCLUSIONS These results suggest that adequate provision of accommodation and employment services for young adults with an ID is lacking. In many cases the responsibility of care continues to reside with parents as their children transition from childhood to adulthood. Greater attention is needed to address these issues and facilitate social inclusion and integration for young people with ID.
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Affiliation(s)
- K M Gray
- Centre for Developmental Psychiatry & Psychology, School of Psychology & Psychiatry, Monash University, Melbourne, Vic., Australia
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Azad G, Blacher J, Marcoulides G. Longitudinal models of socio-economic status. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2014. [DOI: 10.1177/0165025414532172] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parenting research is frequently conducted without a thorough examination of socio-economic characteristics. In this study, longitudinal observations of positive parenting were conducted across six time points. Participants were 219 mothers of children with and without developmental delays. Mothers’ positive parenting increased during early and middle childhood in children with and without developmental delays. Mothers who reported more education had significantly higher levels of positive parenting when their children were 3 years old. Mothers who reported more family income grew at a significantly faster rate in positive parenting. There was preliminary support that mothers with more income were more likely to be members of a class that started off and remained at a higher level of positive parenting over time. Implications are discussed.
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Emerson E, Robertson J, Baines S, Hatton C. The self-rated health of British adults with intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:591-596. [PMID: 24480610 DOI: 10.1016/j.ridd.2014.01.005] [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] [Received: 11/21/2013] [Accepted: 01/03/2014] [Indexed: 06/03/2023]
Abstract
People with intellectual disability have significantly higher age-adjusted rates of mortality and morbidity than their non-disabled peers. While self-rated health status is commonly used as an indicator of the health status of populations of interest, few studies have explored the self-rated health of adults with intellectual disability. We undertook secondary analysis of de-identified cross-sectional data from the first waves of two contemporary UK surveys: the Life Opportunities Survey (n=37,513) and Understanding Society (n=50,976). In the Life Opportunities Survey we identified 316 participants age 16-49 (1.7% of the age-restricted sample) as having intellectual disability. In Understanding Society we identified 415 participants age 16-49 (1.5% of the age-restricted sample) as having intellectual disability. Participants with intellectual disability were significantly more likely to report having fair or worse health than their peers (Life Opportunities Survey OR=8.86 (6.54-12.01), p<0.001; Understanding Society OR=13.14 (10.65-16.21), p<0.001). However the strength of this association was significantly attenuated when risk estimates were adjusted to take account of the increased rates of exposure of participants with intellectual disability to socio-economic disadvantage and (in the Life Opportunities Survey) exposure to discrimination and violence.
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Affiliation(s)
- Eric Emerson
- Centre for Disability Research, Lancaster University, UK; Centre for Disability Research and Policy, University of Sydney, Australia.
| | | | | | - Chris Hatton
- Centre for Disability Research, Lancaster University, UK.
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Brown M, Karatzias T, O'Leary L. The health role of local area coordinators in Scotland: a mixed methods study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2013; 17:387-402. [PMID: 24166152 DOI: 10.1177/1744629513509795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The study set out to explore whether local area coordinators (LACs) and their managers view the health role of LACs as an essential component of their work and identify the health-related activities undertaken by LACs in Scotland. A mixed methods cross-sectional phenomenological study involving local authority service managers (n = 25) and LACs (n = 40) was adopted. Quantitative data from LACs were obtained using online and postal questionnaires. Qualitative data from local authority service managers and LACs were collected using one-to-one interviews and focus groups. Thematic analysis was undertaken of the qualitative data. The results indicate that there is a need to develop further the wider public health role of LACs to incorporate health-related activities focused on broader community-based outcomes such as empowerment and community integration. By adopting a public health role, LACs will be able to contribute to the reduction of health inequalities in people with learning disabilities.
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Affiliation(s)
- Michael Brown
- Edinburgh Napier University, UK, and NHS Lothian, UK
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Emerson E, Brigham P. Health behaviours and mental health status of parents with intellectual disabilities: cross sectional study. Public Health 2013; 127:1111-6. [PMID: 24275031 DOI: 10.1016/j.puhe.2013.10.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 10/02/2013] [Accepted: 10/04/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The authors sought to: (1) estimate the prevalence of health behaviours, mental health and exposure to social determinants of poorer health among parents with and without intellectual disability; and (2) determine the extent to which between-group differences in health behaviours/status may be attributable to differential exposure to social determinants of poorer health. STUDY DESIGN Cross sectional survey. METHODS Secondary analysis of confidentialized needs analysis data collected in three Primary Care Trusts in England on 46,023 households with young children. RESULTS Households containing a parent with intellectual disabilities are at increased risk of: (1) poorer parental mental health, parental drug and alcohol abuse and smoking; (2) exposure to a range of environmental adversities. Controlling for the latter eliminated the increased risk of poorer health for single parent households headed by a person with intellectual disabilities. For two parent headed households, risk of poorer parental mental health remained elevated. CONCLUSIONS The poorer health of parents with intellectual disability may be accounted for by their markedly greater risk of exposure to common social determinants of poorer health rather than being directly attributable to their intellectual disability.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, NSW 2141, Australia.
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Uphoff EP, Pickett KE, Cabieses B, Small N, Wright J. A systematic review of the relationships between social capital and socioeconomic inequalities in health: a contribution to understanding the psychosocial pathway of health inequalities. Int J Equity Health 2013; 12:54. [PMID: 23870068 PMCID: PMC3726325 DOI: 10.1186/1475-9276-12-54] [Citation(s) in RCA: 212] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 07/09/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction Recent research on health inequalities moves beyond illustrating the importance of psychosocial factors for health to a more in-depth study of the specific psychosocial pathways involved. Social capital is a concept that captures both a buffer function of the social environment on health, as well as potential negative effects arising from social inequality and exclusion. This systematic review assesses the current evidence, and identifies gaps in knowledge, on the associations and interactions between social capital and socioeconomic inequalities in health. Methods Through this systematic review we identified studies on the interactions between social capital and socioeconomic inequalities in health published before July 2012. Results The literature search resulted in 618 studies after removal of duplicates, of which 60 studies were eligible for analysis. Self-reported measures of health were most frequently used, together with different bonding, bridging and linking components of social capital. A large majority, 56 studies, confirmed a correlation between social capital and socioeconomic inequalities in health. Twelve studies reported that social capital might buffer negative health effects of low socioeconomic status and five studies concluded that social capital has a stronger positive effect on health for people with a lower socioeconomic status. Conclusions There is evidence for both a buffer effect and a dependency effect of social capital on socioeconomic inequalities in health, although the studies that assess these interactions are limited in number. More evidence is needed, as identified hypotheses have implications for community action and for action on the structural causes of social inequalities.
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Affiliation(s)
- Eleonora P Uphoff
- Department of Health Sciences, University of York, Seebohm Rowntree Building, York YO10 5DD, UK.
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Emerson E. Commentary: Childhood exposure to environmental adversity and the well-being of people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:589-600. [PMID: 22676228 DOI: 10.1111/j.1365-2788.2012.01577.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
People with intellectual disabilities have poorer health than their non-disabled peers. They are also more likely to be exposed to a wide range of environmental adversities in childhood. Research undertaken in the general population has demonstrated that exposure to environmental adversity in childhood can have an adverse impact on health and well-being across the life course. Recently, research in this area has added new breadth and depth to our understanding of: (1) the extent to which cumulative exposure to environmental adversities across the life course, but especially in early childhood, can reduce health and well-being; (2) the social, psychological and biological mediating pathways through which environmental adversities may impair health; (3) the processes associated with resilience and vulnerability in the face of exposure to adversity; and (4) the social significance of these effects in accounting for the magnitude of the inequalities in health that are apparent both between and within populations. This new knowledge is making a significant contribution to the development of social policies that seek to combine health gain with the reduction in health inequalities. This paper attempts to apply this knowledge to research aimed at understanding and improving the health and well-being of people with intellectual disabilities.
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Affiliation(s)
- E Emerson
- Centre for Disability Research, Lancaster University, Lancaster, UK.
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Caton S, Chadwick D, Chapman M, Turnbull S, Mitchell D, Stansfield J. Healthy lifestyles for adults with intellectual disability: knowledge, barriers, and facilitators. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2012; 37:248-259. [PMID: 22852820 DOI: 10.3109/13668250.2012.703645] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND People with intellectual disability (ID) are more likely to have health problems than people without disability. Little previous research has investigated health from the perspective of the people with ID themselves. We aimed to focus on what people with ID understand being healthy to mean and what their experiences are of healthy lifestyles. METHOD Semistructured interviews were conducted with 13 adults with ID to ask them about their health and healthy lifestyles. Data were analysed thematically. RESULTS Participants demonstrated understanding of what it means to be healthy, have a healthy diet, the dangers of substance misuse, and the benefits of exercise. Participants demonstrated some knowledge about rationales for engaging in healthy behaviours. The idea of moderation was raised, along with barriers and facilitators to engaging in a healthy lifestyle. CONCLUSIONS Findings suggest that people with ID demonstrate some understanding of what constitutes being healthy and are aware of healthy lifestyles, the consequences of unhealthy behaviours, and of the need for moderation.
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Affiliation(s)
- Sue Caton
- Research Institute for Health and Social Change, Manchester Metropolitan University, UK.
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McClimens A, Hyde M. Intellectual disability, consumerism and identity: to have and have not? JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2012; 16:135-144. [PMID: 22544482 DOI: 10.1177/1744629512445844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Here we consider the consumer society as it currently exists in the UK and examine its relationship and relevance to the population of individuals with intellectual disability. We do this through a reading of the associated literature on theories of shopping and consumption which we then contrast with research evidence as it applies to the lives of people with intellectual disability. By brining together these two perspectives we hope to shine some light on ideas around identity and choice. We then transfer these arguments to the health and social care sector. Here we ask whether an economic model which has been exposed as divisive and exclusionary should be used in the administration of social secutity benefits of the kind accesed by people with a range of disabilities. We conclude that the unchallenged advance of marketisation within health and social care may benefit those who are financially able but for those who are economically disadvantaged the choices offered are illusory at best.
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Gray K, Keating C, Taffe J, Brereton A, Einfeld S, Tonge B. Trajectory of behavior and emotional problems in autism. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 117:121-133. [PMID: 22515827 DOI: 10.1352/1944-7588-117-2.121] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
High rates of behavior and emotional problems have been consistently reported in children and adolescents with autism. Elevated rates of mental health problems have also been reported in adults with autism. Little is known, however, about the longitudinal development of behavior and emotional problems in autism. This study followed a cohort of children and adolescents over 18 years. Outcomes were evaluated in terms of behavior and emotional problems and autism symptomatology. The role of childhood factors (age, gender, IQ, behavior, and emotional problems) and the environment (socioeconomic disadvantage) were considered in terms of adult outcomes. Overall, improvements in comorbid behavior and emotional problems and autism symptomatology were observed. However, rates of comorbid behavior and emotional problems in adulthood remained high.
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Affiliation(s)
- Kylie Gray
- Monash University, Clayton, Victoria, Australia
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