Sensory impairment and intellectual disability

The cumulative impact of attention deficit hyperactivity disorder, autism and intellectual disability for young people

BACKGROUND

Neurodevelopmental conditions frequently co-occur. The aim of this paper was to determine whether there is a cumulative association between (1) the number of neurodevelopmental conditions, specifically hyperkinetic disorder (hereafter referred to as attention deficit hyperactivity disorder), autism spectrum disorder (hereafter referred to as autism) and intellectual disability, and (2) behavioural and socio-emotional problems and the level of clinician-rated functioning for young males and females.

METHODS

In this cross-sectional study, diagnostic information, caregiver-rated behavioural and socio-emotional data (as conceptualised by the Strengths and Difficulties Questionnaire) and clinician-rated functioning scores (as conceptualised by the Children's Global Assessment Scale) were extracted from electronic patient records for 2768 young people aged 3-17 years (mean = 11.55, SD = 3.46). All data were extracted at baseline, that is, at the time the young person was diagnosed with attention deficit hyperactivity disorder, autism and/or an intellectual disability. Ordinal regression analyses tested associations between the number of neurodevelopmental conditions met (i.e. 1, 2 or 3) and behavioural and socio-emotional outcomes and functioning.

RESULTS

After controlling for age and biological sex, the number of neurodevelopmental conditions was associated with higher levels of inattention/hyperactivity and peer problems, lower levels of prosocial behaviour and poorer clinician-rated functioning. Although these findings were consistent for males, a cumulative association was not identified for females, except for clinician-rated functioning.

CONCLUSIONS

For young people, the presence of multiple neurodevelopmental conditions may have a cumulative impact across domains, but this may differ between males and females.

Evaluating the Compatibility of the Digit-in-Noise Test with Hearing Screening in Individuals with Intellectual Disabilities: A Pilot Study

Hearing impairment among adults with intellectual disability (ID) is notably prevalent yet frequently underdiagnosed due, in part, to the challenges associated with traditional hearing screening methods in this population. This study explores the effectiveness of the Digit-in-Noise (DIN) test as a viable alternative for hearing screening within natural settings and with familiar personnel. A total of 16 Hebrew-speaking adults with ID were recruited from supported employment programs, 10 of whom completed the study. The DIN test, which was administered in a daily environment using a simple digital device, evaluated the speech recognition threshold in noise. Results indicated that while some participants performed comparably to typically developing individuals, others showed varying levels of hearing thresholds, suggesting diverse auditory capabilities within the ID population. This pilot study confirms that the DIN test can be feasibly integrated into routine care settings, offering a friendly and accessible method for assessing hearing abilities in adults with ID. The findings advocate for the broader adoption of and potential modifications to the DIN Test to enhance its applicability and inclusiveness, thereby improving diagnostic accuracy and subsequent auditory care for this underserved population.

The role of intellectual disability with autism spectrum disorder and the documented cooccurring conditions: A population-based study

Previous research has identified that patterns of cooccurring conditions (CoCs) associated with autism spectrum disorder (ASD) differ based on the presence of intellectual disability (ID). This study explored the association of documented CoCs among 8-year-old children with ASD and ID (ASD+ID, n = 2416) and ASD without ID (ASD-ID, n = 5372) identified by the Autism and Developmental Disabilities Monitoring Network, surveillance years (SYs) 2012 and 2014. After adjusting for demographic variables, record source, surveillance site, and SY, children with ASD+ID, as compared with children with ASD-ID, were more likely to have histories of nonspecific developmental delays and neurological disorders documented in their records but were less likely to have behavioral and psychiatric disorders. ID plays a key role on how children with ASD would experience other CoCs. Our results emphasize how understanding the pattern of CoCs in ASD+ID and ASD-ID can inform comprehensive and multidisciplinary approaches in assessment and management of children in order to develop targeted interventions to reduce possible CoCs or CoCs-related impairments.

Developing an arabic questionnaire to assess sensory processing disorders among preschool Egyptian children

BACKGROUND

Sensory processing disorder (SPD) is a neurophysiologic disorder in which sensory input is poorly detected, modulated, interpreted and/or to which atypical responses occur. The objective of this study was to validate an Arabic questionnaire for identification of SPD among preschool Arabic-speaking children with Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).

METHODS

A newly constructed Arabic questionnaire for assessment of SPD was completed by parents of 100 Egyptian Arabic-speaking children including 40 typically-developing children (control group), 30 children with ASD, and 30 children with ADHD in the age range 3-6 years RESULTS AND CONCLUSION: Sensory processing differences were detected between typically-developing children and children with ASD and ADHD. Significant differences were found in auditory processing, visual processing, oral sensory processing, olfactory processing, total scores and emotional/social response. The current study revealed non-significant differences between ASD and ADHD children as regards auditory, visual, touch, oral sensory, olfactory and total processing scores. On the other hand, ASD children showed higher scores in proprioceptive processing and lower scores in emotional/social response than children with ADHD. The designed Arabic questionnaire is a valid and reliable assessment tool for identification of SPD in preschool Arabic-speaking children.

Deaf people: What every clinician needs to know

Deafness is a common and varied medical, social and psychological construct that affects a significant proportion of the population. Restricted communication and uninformed attitudes have adverse effects on the physical and mental health of deaf people. Clinicians need to know how to recognise and resolve these difficulties.

Learning Objectives

• Be aware of the high prevalence and diverse nature of deafness

• Recognise the importance of effective communication and how to achieve this with deaf people

• Understand the potential impact of deafness on mental and physical health

Environmental Enrichment Therapy for Autism: Outcomes with Increased Access

We have previously shown in two randomized clinical trials that environmental enrichment is capable of ameliorating symptoms of autism spectrum disorder (ASD), and in the present study, we determined whether this therapy could be effective under real-world circumstances. 1,002 children were given daily Sensory Enrichment Therapy, by their parents, using personalized therapy instructions given over the Internet. Parents were asked to assess the symptoms of their child every 2 weeks for up to 7 months. An intention-to-treat analysis showed significant overall gains for a wide range of symptoms in these children, including learning, memory, anxiety, attention span, motor skills, eating, sleeping, sensory processing, self-awareness, communication, social skills, and mood/autism behaviors. The children of compliant caregivers were more likely to experience a significant improvement in their symptoms. The treatment was effective across a wide age range and there was equal progress reported for males and females, for USA and international subjects, for those who paid and those who did not pay for the therapy, and for individuals at all levels of initial symptom severity. Environmental enrichment, delivered via an online system, therefore appears to be an effective, low-cost means of treating the symptoms of ASD.

The relationship between sensory processing disorders and eating problems among children with intellectual developmental deficits

Introduction

Sensory processing disorders are prevalent among children with intellectual developmental deficits and negatively impact their daily routines. Eating, which is a major part of daily routines, is known to be frequently impaired among children with intellectual developmental deficits. This study aimed to examine the relationships between sensory processing disorders and eating problems in children with different levels of intellectual developmental deficit.

Method

Participants were 91 children aged 4 to 9 years: 25 with mild intellectual developmental deficits, 32 with moderate intellectual developmental deficits and 34 with severe/profound intellectual developmental deficits. All participants were recruited from special education kindergartens/schools for children with intellectual developmental deficits. Participants' primary caregiver in school completed the screening tool of eating problems and the short sensory profile.

Findings

Significant correlations between sensory processing disorders and eating problems were found in each intellectual developmental deficit level ( r = −.40, p ≤ .05 to r = −.57, p ≤ .001), but most correlations were found among children with moderate and severe/profound level. Energy level significantly predicted aspiration frequency; smell/taste sensitivity significantly predicted food selectivity and food refusal frequency.

Conclusion

Eating problems should be screened among children with intellectual developmental deficits according to intellectual developmental deficit severity and other related factors such as sensory processing disorders. Applying this approach in occupational therapy intervention may contribute to a child's adaptive behaviour and performance in daily routines.

Theory-of-mind in adolescents and young adults with Alström syndrome

OBJECTIVE

The study focuses on theory-of-mind in adolescents and young adults with Alström syndrome (ALMS). ALMS, an autosomal recessive syndrome causes juvenile blindness, sensorineural hearing loss, cardiomyopathy, endocrinological disorders and metabolic dysfunction. Theory-of-mind (ToM) refers to the ability to impute mental states to one self and to others. Clinical observations have revealed an increased occurrence of deviances in mental state understanding in ALMS. In the present study ToM will be examined and related to working memory (WM), verbal ability and sensory loss.

METHODS

Twelve young individuals (16-37 years) with ALMS and 24 nondisabled individuals matched on age, gender and educational level participated. ToM was assessed by means of a multiple task that taxes the ability to understand thoughts and feelings of story characters'. WM was examined by means of a reading span task and verbal ability by means of a vocabulary test.

RESULTS

The ALMS group performed at significantly lower levels in ToM tasks and displayed a higher variability in performance than the control group. Individuals with ALMS and a relatively poor level performance provided fewer correct mental state inferences in ToM tasks than ALMS individuals with relatively higher performance levels. ALMS individuals with relatively high performance levels made as many correct inferences in ToM tasks as the control group, but their inferences were more often incomplete. Vocabulary skills and educational level, but not WM-capacity predicted ToM performance. Degree of deafblindness did not have an impact on ToM. Age of onset of visual loss but not hearing loss related to ToM.

CONCLUSIONS

The individuals with ALMS display a high degree of heterogeneity in terms of ToM, where some individuals reached performance levels comparable to nondisabled individuals. The results are discussed with respect to how cognitive and verbal abilities and factors related to the disability affect ToM.