A systematic review of educational interventions to enhance cancer awareness and screening in individuals with intellectual disabilities: A mixed-methods approach

BACKGROUND

Cancer awareness and screening among individuals with intellectual disabilities face unique challenges. To bridge this gap, educational interventions have been developed.

AIMS

This review comprehensively analyzes educational interventions aimed at enhancing cancer awareness among individuals with intellectual disabilities (IDs). It addresses key questions regarding intervention types and effectiveness, influencing factors, and recommendations for impactful programs.

METHODS AND PROCEDURES

A robust search strategy was deployed across reputable databases yielding 2512 articles. After meticulous screening and eligibility assessments, eight studies met the inclusion criteria, encompassing qualitative research, a feasibility study, and randomized control trials.

OUTCOMES AND RESULTS

The studies employed diverse interventions and assessment methods, leading to varying outcomes. Interventions included educational materials, communication packs, health education DVDs, and healthcare professional support, typically delivered over a short period with limited follow-up. Assessment methods comprised surveys, interviews, and knowledge surveys. However, a comprehensive evaluation of knowledge gains and screening uptake was often absent. While some studies reported modest increases in knowledge, none measured actual screening uptake and long-term effects. The strengths and limitations of these studies underscore the need for more comprehensive research in this area, considering factors such as sample size, study design, and long-term impact.

CONCLUSION AND IMPLICATIONS

In conclusion, this review provides valuable insights into educational interventions for cancer awareness among individuals with intellectual disabilities. Its comprehensive methodology and findings underscore the significance of tailoring interventions, extending their duration, and involving caregivers to optimize outcomes for this vulnerable population.

Family Impact During the Time Between Autism Screening and Definitive Diagnosis

Over the past 10 years, identification of Autism Spectrum Disorder (ASD) risk has dramatically increased due to the wide-spread implementation of screening programs; yet, there is limited understanding about parent perceptions and experiences during the time period when risk is identified, but prior to receiving a formal diagnosis-a period that can last months to years given the long wait-lists for formal ASD evaluations. The current study aimed to examine parent perceptions of family impact (i.e., the impact their child's behaviors have on the family) between the time of risk-identification and formal diagnosis among 277 children identified as at-risk for ASD through screening positive in primary care. We aimed to compare family impact among those whose child met diagnostic criteria for ASD and those who did not. Parents of children who received a non-ASD diagnosis reported a higher baseline level of family impact (F[1, 274] = 5.82, p = .017); however, perceived difficult child behavior was a stronger predictor of family impact (t[6] = 13.11, p < .001) than later diagnostic group (t[6] = - 2.10, p = .037), and child functioning did not predict family impact (t[6] = -0.31, p = .76). These results suggest that in this population, perceived difficult child behavior is a stronger predictor of family impact than later diagnostic category and should be considered an important factor in family support.

Associations Between Religion/Spirituality, Family Characteristics, and Mental Health Among Parents with Children with Developmental Delay

INTRODUCTION

Parenting children with intellectual and developmental disabilities can be stressful; however, families with religious beliefs may have positive ways of viewing their family. This study explored the associations between religious and spiritual involvement (RSI), family characteristics, parent mental health, and child adaptive and problem behaviours among 180 primary caregivers and their 3-year-old children with developmental delay (DD).

METHOD

This study investigated if RSI was related to family characteristics, parent depression and stress, and if RSI predicted parent mental health after accounting for child and family characteristics.

RESULTS

Associations between RSI, family characteristics (parent age, education, income) and parenting stress, but not depression, were found. RSI did not predict parent mental health after accounting for relevant child and family characteristics.

CONCLUSION

RSI may play an important role in the mental health of parents of children with developmental delay; however, other child and contextual factors relate strongly to parent wellbeing.

Recent Developments in Treatment Outcome Measures for Young Children With Autism Spectrum Disorder (ASD)

Significant advancements have been made in early intervention programs for children with Autism spectrum disorder (ASD). However, measuring treatment response for children with ASD is difficult due to the heterogeneity of changes in symptoms, which can be subtle, especially over a short period of time. Here we outline the challenge of evaluating treatment response with currently available measures as well as newly developed or refined measures that may be useful in clinical trials for young children with ASD. Continued development of treatment outcome measures will help the field identify and compare efficacious interventions and tailor treatments for children with ASD.

Early Adaptive Functioning Trajectories in Preschoolers With Autism Spectrum Disorders

Background

In preschoolers with autism spectrum disorder (ASD) symptom, severity has a negative impact on the development of adaptive functioning, with critical consequences on the quality of life of those children. Developmental features such as reduced social interest or the presence of behavioral problems can further impede daily life learning experiences.

Objectives

The first aim of this study is to confirm the negative impact of high symptom severity on adaptive functioning trajectories in preschoolers with ASD. The second objective intends to explore whether reduced social interest and severe behavioral problems negatively affect developmental trajectories of adaptive functioning in young children with ASD.

Methods

In total, 68 children with ASD and 48 age and gender-matched children with typical development (TD) between 1.6 and 6 years were included in our study, and longitudinal data on adaptive functioning were collected (mean length of the longitudinal data collection was 1.4 years ± 0.6). Baseline measures of symptom severity, social interest, and behavioral problems were also obtained.

Results

We confirmed that children with ASD show parallel developmental trajectories but a significantly lower performance of adaptive functioning compared with children with TD. Furthermore, analyses within ASD children demonstrated that those with higher symptom severity, reduced social interest, and higher scores of behavioral problems exhibited especially lower or faster declining trajectories of adaptive functioning.

Conclusions

These findings bolster the idea that social interest and behavioral problems are crucial for the early adaptive functioning development of children with autism. The current study has clinical implications in pointing out early intervention targets in children with ASD.

Accurate assessment of functional abilities in pre-schoolers for diagnostic and funding purposes: A comparison of the Vineland-3 and the PEDI-CAT

AIM

Assessment of functional abilities is an essential component in the diagnosis of neurodevelopmental disorders in young children. Functional abilities, assessed using the Pediatric Evaluation of Disability Inventory-Computer Adapted Test (PEDI-CAT), are used to determine eligibility for early intervention funded under the National Disability Insurance Scheme in Australia (NDIS). This study aims to compare the use of the PEDI-CAT with the Vineland-3, a comprehensive parent interview for the determination of support needs, diagnosis, and eligibility for funding.

METHOD

Seventy-five preschool aged children referred for formal diagnosis were assessed with the Vineland-3, and subscale scores reviewed for clinical judgement. These children were also assessed on the PEDI-CAT speedy version and the results on the two tests compared.

RESULTS

The PEDI-CAT was less sensitive than the Vineland-3 to the functional difficulties being experienced in this population of preschool aged children. The Vineland-3 had floor effects on some scales and deficits masked by skills in other areas in the same domain, but standard subscale scores allowed skills and areas needing support to be defined. Overall 25% of children clinically in need of support were not identified on the Pedi-cat compared to only 4% using Vineland Domain scores and 3% using Vineland-3 subscale scores. The PEDI-CAT also identified significantly lower levels of support required with only 32% of children found to need very substantial support compared to 40% of children on the Vineland Domain scores, and 59% using subscale scores.

CONCLUSION

Based on the results of this study, the Vineland-3 comprehensive interview interpreted using subscale scores as well as domain scores is more sensitive than the PEDI-CAT in identifying young children in need of support as well as the areas and degree of support required.

Social disadvantage and developmental diagnosis in pre-schoolers

AIM

To explore the association between social disadvantage and developmental diagnoses in pre-school children.

METHODS

Between 2012 and 2015, 845 pre-school children were assessed by the Child Assessment Team at Campbelltown Hospital. A social worker interviewed 469 families and these children were eligible for inclusion in the study. Autism spectrum disorder (ASD) was confirmed in 290 children. Of those without ASD, 72 did not have global developmental delay (GDD) and were excluded from the study. The remaining 107 children with GDD were used as the comparison group. Social risk factors in the two groups were compared using χ ² tests. Variables with statistical significance were then entered into a logistic regression.

RESULTS

After logistic regression, children with ASD were more likely to be male (odds ratio (OR) 3.1, 95% CI 0.195-0.529; P < 0.001) and their parents were more likely to have a clinically significant stress score (OR 1.3, 95% CI 0.334-0.992; P = 0.047). Children with GDD were more likely to live in a disadvantaged suburb (OR 1.7, 95% CI 1.042-2.940; P = 0.034), more likely to have a sole parent (OR 1.8, 95% CI 1.062-3.082; P = 0.029) and much more likely to have had involvement with child protection services (OR 3.9, 95% CI 2.044-7.416; P < 0.001).

CONCLUSIONS

Children with GDD without autism were more likely to be disadvantaged and to have had contact with child protection services than children with ASD. This has implications for the assessment, early intervention and support services for children with disabilities and their families.

Predicting neurodevelopmental outcomes at preschool age for children with very low birth weight

The purpose of this study was to examine predictors of neurodevelopmental outcome in very low birth weight children without major impairment at 5 years of age, as well as to identify the contribution of early neurodevelopmental assessment to preterm children's later developmental outcomes. The participants in this study included 126 children who were prematurely born with very low birth weight. Outcomes of the childrens' later development were measured in tests that factored cognitive function, motor performance, and adaptive behavior. The results indicated that more than 50% of full-scale intelligence and 30% of both motor performance and adaptive behavior at the age of 5 can be explained by four predictors. The four predictors include preterm children's medical complications at birth, maternal education, early motor assessments, and cognitive assessments. Adding each test score obtained in early ages provides additional information to predict children's cognitive, motor, and adaptive behavior at 5 years of age. Manifold assessments conducted in multiple time periods strengthen the predictive values of later developmental outcomes. In addition, the findings of this study indicate that very low birth weight children tend to have lower adaptive behavior at 5 years old. With regard to our findings, we believe that having adaptive function is a reflection of a child's overall integrated abilities. Further study is warranted to increase understanding of this topic, as well as to be able to predict adaptive strengths and weakness and pinpoint limiting factors that may be useful for targeting behaviors in intervention.