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Harper L, McAnelly S, Walshe I, Ooms A, Tuffrey-Wijne IM. Behavioural sleep problems in children and adults with intellectual disabilities: An integrative literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:916-928. [PMID: 37177858 DOI: 10.1111/jar.13116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well-being. METHODS An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015. RESULTS Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability. CONCLUSION A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep.
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Affiliation(s)
- Lynette Harper
- Health and Life Sciences, Northumbria University, London, UK
| | - Su McAnelly
- Health and Life Sciences, Northumbria University, London, UK
| | - Ian Walshe
- Health and Life Sciences, Northumbria University, London, UK
| | - Ann Ooms
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
| | - Irene M Tuffrey-Wijne
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
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Rispoli M, Shannon E, Voorhis C, Lang R, Mason R, Kelleher B. Telehealth Training in Naturalistic Communication Intervention for Mothers of Children with Angelman Syndrome. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 6:549-566. [PMID: 36160311 PMCID: PMC9483349 DOI: 10.1007/s41252-022-00284-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Young children with Angelman syndrome have significant delays in expressive communication. Parents of children with Angelman syndrome require training to support their child's communication development. Unfortunately, parent training focused on the needs of families of children with rare genetic syndromes is unavailable to many families. The purpose of this study was to evaluate a telehealth parent training program on naturalistic communication intervention for young children with Angelman syndrome. METHODS Using two single-case multiple baseline designs across a total of six parent-child dyads, we evaluated the effects of a telehealth parent training program on parent implementation fidelity of a naturalistic communication intervention, child communication, and child engagement. RESULTS With the telehealth parent training program, parent implementation fidelity of naturalistic communication intervention improved, maintained and generalized to untrained home routines. Small effects on child communication and engagement were observed during the program. CONCLUSIONS Parents of children with Angelman syndrome were successfully taught via telehealth to implement a naturalistic communication intervention with their child at home. Additional research is needed to promote positive child communication outcomes through parent-mediated intervention.
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Affiliation(s)
- Mandy Rispoli
- Department of Curriculum, Instruction, and Special Education, University of Virginia, PO Box 400273, Charlottesville, VA 22904 USA
| | | | | | | | - Rose Mason
- Purdue University, West Lafayette, IN USA
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Awan N, Pearson E, Shelley L, Greenhill C, Tarver J, Waite J. The behavioral phenotype of Rubinstein-Taybi syndrome: A scoping review of the literature. Am J Med Genet A 2022; 188:2536-2554. [PMID: 35730128 PMCID: PMC9542155 DOI: 10.1002/ajmg.a.62867] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 01/24/2023]
Abstract
Rubinstein-Taybi syndrome (RTS) is a rare genetic syndrome associated with growth delay, phenotypic facial characteristics, microcephaly, developmental delay, broad thumbs, and big toes. Most research on RTS has focused on the genotype and physical phenotype; however, several studies have described behavioral, cognitive, social, and emotional characteristics, elucidating the behavioral phenotype of RTS. The reporting of this review was informed by PRISMA guidelines. A systematic search of CINAHL, Medline, and PsychINFO was carried out in March 2021 to identify group studies describing behavioral, cognitive, emotional, psychiatric, and social characteristics in RTS. The studies were quality appraised. Characteristics reported include repetitive behavior, behaviors that challenge, intellectual disability, mental health difficulties, autism characteristics, and heightened sociability. Findings were largely consistent across studies, indicating that many characteristics are likely to form part of the behavioral phenotype of RTS. However, methodological limitations, such as a lack of appropriate comparison groups and inconsistency in measurement weaken these conclusions. There is a need for multi-disciplinary studies, combining genetic and psychological measurement expertise within single research studies. Recommendations are made for future research studies in RTS.
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Affiliation(s)
- Neelam Awan
- School of Life Sciences and EducationStaffordshire UniversityStoke‐on‐TrentUK,School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK,Present address:
Royal Manchester Children's HospitalManchesterUK
| | - Effie Pearson
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Lauren Shelley
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Courtney Greenhill
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Joanne Tarver
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Jane Waite
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
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Moavero R, Voci A, La Briola F, Matricardi S, Toldo I, Mancardi MM, Negrin S, Messana T, Mazzone L, Valeriani M, Curatolo P, Bruni O. Sleep disorders and neuropsychiatric disorders in a pediatric sample of tuberous sclerosis complex: a questionnaire-based study. Sleep Med 2021; 89:65-70. [PMID: 34915263 DOI: 10.1016/j.sleep.2021.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE AND BACKGROUND Sleep disorders (SD) are very common in childhood, especially in certain genetic syndromes. Tuberous Sclerosis Complex (TSC) is a genetic syndromesassociated with a high rate of SD, although these are still under-recognized. The aim of this study was to assess the prevalence of SD in TSC, and to evaluate the relationship between sleep, epilepsy and TSC-associated neuropsychiatric disorders (TAND). METHODS We administered the Sleep Disturbance Scale for Children (SDSC) and the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) to parents of 177 children with TSC referring to different Italian centers. We also collected information on epilepsy and TAND. RESULTS SDSC score was positive in 59.3% of patients, being positive in 30.4% of patients without and in 63.6% of those with epilepsy (p = 0.005). However, in a multivariate logistic model considering antiseizure medications and nocturnal seizures, epilepsy ceased to be a significant risk factor for positive SDSC (OR = 2.4; p = 0.17). As for TAND, SDSC was positive in 67.9% of patients with and in 32.5% of those without TAND (p < 0.001). After adding in a multivariate logistic model active epilepsy, age, and pharmacotherapies, TAND continued to be a significant risk factor for positive SDSC (p = 0.01, OR = 1.11). CONCLUSIONS Our results revealed a high prevalence of SD in children with TSC. Epilepsy didn't increase the risk for SD, while a very strong association was found with TAND. An early detection of SD is of utmost importance in order to plan an individualized treatment, that in some cases might also ameliorate behavior and attention.
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Affiliation(s)
- Romina Moavero
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Via Montepellier 1, 00133, Rome, Italy; Child Neurology Unit, Neuroscience Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
| | - Alessandra Voci
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Via Montepellier 1, 00133, Rome, Italy
| | - Francesca La Briola
- Child Neuropsychiatry Unit - Epilepsy Center, ASST SS. Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Sara Matricardi
- Child Neurology and Psychiatry Unit, Children's Hospital "G. Salesi", Ospedali Riuniti Ancona, Via Corridoni 11, 60123, Ancona, Italy
| | - Irene Toldo
- Pediatric Neurology and Neurophysiology Unit, Department of Woman's and Child Health, Padua University Hospital, Via N. Giustiniani 3, 35128, Padua, Italy
| | - Maria Margherita Mancardi
- Unit of Child Neuropsichiatry, Department of Clinical and Surgical Neurosciences and Rehabilitation, IRCCS Gaslini, Via Gerolamo Gaslini 5, 16147, Genova, Italy
| | - Susanna Negrin
- Epilepsy and Clinical Neurophysiology Unit, Scientific Institute, IRCCS Eugenio Medea, Conegliano, Treviso, Italy
| | - Tullio Messana
- IRCCS Istituto Delle Scienze Neurologiche, UOC Neuropsichiatria Dell'età Pediatrica, Via Altura 3, 40139, Bologna, Italy
| | - Luigi Mazzone
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Via Montepellier 1, 00133, Rome, Italy
| | - Massimiliano Valeriani
- Child Neurology Unit, Neuroscience Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy; Center for Sensory-Motor Interaction, Aalborg University, Fredrik Bajers Vej 7 D3, Aalborg, D-9220, Denmark
| | - Paolo Curatolo
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Via Montepellier 1, 00133, Rome, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
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Agar G, Brown C, Sutherland D, Coulborn S, Oliver C, Richards C. Sleep disorders in rare genetic syndromes: a meta-analysis of prevalence and profile. Mol Autism 2021; 12:18. [PMID: 33632309 PMCID: PMC7908701 DOI: 10.1186/s13229-021-00426-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/16/2021] [Indexed: 11/22/2022] Open
Abstract
Background Sleep disorders are common in people with intellectual disability (ID) and autism, with growing evidence of diverse sleep profiles across ID associated genetic syndromes. Documenting the prevalence and profile of specific sleep disorders in syndromes will quantify syndrome-driven ‘risk’, inform prognosis and enhance understanding of aetiology of sleep disorders. Method Following PRISMA guidelines for meta-analysis, we searched Ovid PsycINFO, Ovid MEDLINE, Ovid Embase, Web of Science and PubMed Central with use of syndrome-specific keywords and 60 sleep-related search terms. We screened and extracted papers that reported sleep disorder prevalence data for five or more individuals within a genetic syndrome, and applied quality criteria to produce a quality-effects prevalence model of six types of sleep disorder across nineteen syndromes. Relative risk estimates were calculated for the prevalence of each sleep disorder in each syndrome. Results Two hundred and seventy three papers were identified, generating 463 prevalence estimates for Angelman, CHARGE, Cornelia de Lange, Down, fragile X, Prader–Willi, Rett, Smith–Magenis and Williams syndromes, mucopolysaccharidoses (MPS disorders), neurofibromatosis and tuberous sclerosis complex. Prevalence estimates were higher in genetic syndromes than published equivalents for typically developing individuals, with few exceptions. Between-syndrome differences for some disorders were evident; sleep-disordered breathing was most prevalent in MPS disorders (72–77%), while excessive daytime sleepiness was highest in Smith–Magenis syndrome (60%). Conversely, insomnia, which was reported at a higher rate than TD estimates in all syndromes except fragile X, was not associated with specific genetic risk. This suggests insomnia could emerge because of the individual’s environment or associated developmental delay, rather than any specific genetic syndromes. Limitations Due to the broad scope of the meta-analysis, only syndromes previously identified as reporting preliminary sleep research were included. Other syndromes may also experience elevated prevalence rates of specific types of sleep disorder. Only English language papers were included. Conclusions Differing prevalence rates between types of sleep disorder suggest differing causal mechanisms, such as cranio-facial morphology in Down and Prader–Willi syndromes and the build-up of mucopolysaccharides in MPS disorders. Priorities for clinical assessment and intervention for sleep disorders are discussed.
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Affiliation(s)
- Georgie Agar
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Chloe Brown
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.,South West Yorkshire Partnership NHS Foundation Trust, Wakefield, WF1 3SP, UK
| | - Daniel Sutherland
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Sean Coulborn
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
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New Insights into Immunological Involvement in Congenital Disorders of Glycosylation (CDG) from a People-Centric Approach. J Clin Med 2020; 9:jcm9072092. [PMID: 32635232 PMCID: PMC7408855 DOI: 10.3390/jcm9072092] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 02/08/2023] Open
Abstract
Congenital disorders of glycosylation (CDG) are rare diseases with variable phenotypes and severity. Immunological involvement remains a largely uncharted topic in CDG, mainly due to lack of robust data. To better characterize immune-related manifestations’ prevalence, relevance, and quality-of-life (QoL) impact, we developed electronic questionnaires targeting (1) CDG patients and (2) the general “healthy” population. Two-hundred and nine CDG patients/caregivers and 349 healthy participants were included in this study. PMM2-CDG was the most represented CDG (n = 122/209). About half of these participants (n = 65/122) described relevant infections with a noteworthy prevalence of those affecting the gastrointestinal tract (GI) (63.1%, n = 41/65). Infection burden and QoL impact were shown as infections correlated with more severe clinical phenotypes and with a set of relevant non-immune PMM2-CDG signs. Autoimmune diseases had only a marginal presence in PMM2-CDG (2.5%, n = 3/122), all being GI-related. Allergy prevalence was also low in PMM2-CDG (33%, n = 41/122) except for food allergies (26.8%, n = 11/41, of PMM2-CDG and 10.8%, n = 17/158, of controls). High vaccination compliance with greater perceived ineffectiveness (28.3%, n = 17/60) and more severe adverse reactions were described in PMM2-CDG. This people-centric approach not only confirmed literature findings, but created new insights into immunological involvement in CDG, namely by highlighting the possible link between the immune and GI systems in PMM2-CDG. Finally, our results emphasized the importance of patient/caregiver knowledge and raised several red flags about immunological management.
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Nag HE, Hoxmark LB, Nærland T. Parental experiences with behavioural problems in Smith-Magenis syndrome: The need for syndrome-specific competence. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2019; 23:359-372. [PMID: 31046579 PMCID: PMC6734585 DOI: 10.1177/1744629519847375] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
The experience of having a rare disorder was summarised in a large study as 'falling outside the vast field of knowledge of the professionals'. Parents (31 mothers and 17 fathers) of 32 persons with Smith-Magenis syndrome (SMS) participated in this study. A phenomenological approach was used to analyse the data into topics and themes. Four themes emerged: behavioural challenges displayed, parents' strategies for meeting the challenging behaviours, parents' experiences of their own competence and parents' experiences of professionals' competence and understanding regarding children with SMS and their behaviour challenges. We found that parents of children with SMS experience that they are exposed to severe challenging behaviours from their child. The parents believe that they experience more misunderstandings with professionals and that the challenging behaviours increase because there are some specific characteristics of SMS that professionals are not aware of or do not consider in their support services.
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Affiliation(s)
- Heidi Elisabeth Nag
- Frambu Resource Centre for Rare Disorders, Norway; University of Stavanger, Norway
| | | | - Terje Nærland
- Oslo University Hospital, Norway; University of Oslo, Norway
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Adams D, Hastings RP, Alston-Knox C, Cianfaglione R, Eden K, Felce D, Griffith G, Moss J, Stinton C, Oliver C. Using Bayesian methodology to explore the profile of mental health and well-being in 646 mothers of children with 13 rare genetic syndromes in relation to mothers of children with autism. Orphanet J Rare Dis 2018; 13:185. [PMID: 30359268 PMCID: PMC6203267 DOI: 10.1186/s13023-018-0924-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/02/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND It is well documented that mothers of children with intellectual disabilities or autism experience elevated stress, with mental health compromised. However, comparatively little is known about mothers of children with rare genetic syndromes. This study describes mental health and well-being in mothers of children with 13 rare genetic syndromes and contrasts the results with mothers of children with autism. METHODS Mothers of children with 13 genetic syndromes (n = 646; Angelman, Cornelia de Lange, Down, Fragile-X, Phelan McDermid, Prader-Willi, Rett, Rubenstein Taybi, Smith Magenis, Soto, Tuberous Sclerosis Complex, 1p36 deletion and 8p23 deletion syndromes) and mothers of children with autism (n = 66) completed measures of positive mental health, stress and depression. Using Bayesian methodology, the influence of syndrome, child ability, and mother and child age were explored in relation to each outcome. Bayesian Model Averaging was used to explore maternal depression, positive gain and positive affect, and maternal stress was tested using an ordinal probit regression model. RESULTS Different child and mother factors influenced different aspects of mental well-being, and critically, the importance of these factors differed between syndromes. Maternal depression was influenced by child ability in only four syndromes, with the other syndromes reporting elevated or lower levels of maternal depression regardless of child factors. Maternal stress showed a more complex pattern of interaction with child ability, and for some groups, child age. Within positive mental health, mother and child age were more influential than child ability. Some syndromes reported comparable levels of depression (SMS, 1p36, CdLS) and stress (SMS, AS) to mothers of children with autism. CONCLUSIONS Bayesian methodology was used in a novel manner to explore factors that explain variability in mental health amongst mothers of children with rare genetic disorders. Significant proportions of mothers of children with specific genetic syndromes experienced levels of depression and stress similar to those reported by mothers of children with autism. Identifying such high-risk mothers allows for potential early intervention and the implementation of support structures.
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Affiliation(s)
- Dawn Adams
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT UK
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Australia
| | - Richard P Hastings
- Centre for Educational Development Appraisal and Research, University of Warwick, Warwick, UK
| | - Clair Alston-Knox
- Griffith Social and Behavioural Research College, Griffith University, Brisbane, Australia
| | - Rina Cianfaglione
- Welsh Centre for Learning Disabilities, Cardiff University, Cardiff, UK
| | - Kate Eden
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT UK
| | - David Felce
- Welsh Centre for Learning Disabilities, Cardiff University, Cardiff, UK
| | | | - Jo Moss
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT UK
| | - Chris Stinton
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT UK
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT UK
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