Development of a New Attention Rating Scale for Children With Intellectual Disability: The Scale of Attention in Intellectual Disability (SAID)

Measuring psychological, cognitive, and social domains of physical literacy in school-aged children with neurodevelopmental disabilities: a systematic review and decision tree

PURPOSE

To identify and assess the clinimetric properties of psychological, cognitive, and social competence assessment tools relevant to physical activity for school-aged children (5-17 years) with neurodevelopmental disabilities.

METHODS

Seven electronic databases were searched. Study findings and methodologies were evaluated using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. Psychometric strength of assessment tools was determined using Grading of Recommendations Assessment, Development and Evaluation principles (GRADE) (Trial registration: CRD42020180616).

RESULTS

Study criteria were met by eight subscales from the BRIEF2, DMQ17, QI-Disability, SAID, and SDQ. Most subscales examined psychological competence (n = 5), with fewer addressing social competence (n = 2), or cognitive competence (n = 1). Validity was moderate to high strength for most subscales. Reliability was of moderate and unclear strength for two subscales. A five-level decision tree was devised to summarise: (1) physical literacy domains/elements, (2) populations, (3) assessment focus, (4) required resources, and (5) psychometric evidence.

CONCLUSIONS

Subscales are available to assess psychological, cognitive, or social competence. For school-aged children with neurodevelopmental disabilities, these have moderate to high strength psychometric support. A decision tree will assist practitioners in subscale selection. Future studies are needed to establish gold standard assessment of physical literacy for this population.IMPLICATIONS FOR REHABILITATIONPsychological Activity Competence can be measured for children with neurodevelopmental disabilities, subscales from The Behaviour Rating Inventory of Executive Function, Second Edition (BRIEF2; The Dimensions of Mastery Questionnaire 17.0 (DMQ17); and The Quality of Life Inventory-Disability (QI-Disability).Cognitive Activity Competence can be measured using a subscale from The Scale of Attention in Intellectual Disability (SAID).Social Activity Competence can be measured using subscales from the BRIEF2, and The Strengths and Difficulties Questionnaire (SDQ).Clinicians can use the Physical Literacy decision tree to guide selection of these tools.

Epilepsy and Attention Deficit Hyperactivity Disorder: Connection, Chance, and Challenges

Comorbidities are common in children with epilepsy, with nearly half of the patients having at least one comorbidity. Attention deficit hyperactivity disorder (ADHD) is a psychiatric disorder characterized by hyperactivity and inattentiveness level disproportional to the child’s developmental stage. The burden of ADHD in children with epilepsy is high and can adversely affect the patients’ clinical outcomes, psychosocial aspects, and quality of life. Several hypotheses were proposed to explain the high burden of ADHD in childhood epilepsy; the well-established bidirectional connection and shared genetic/non-genetic factors between epilepsy and comorbid ADHD largely rule out the possibility of a chance in this association. Stimulants are effective in children with comorbid ADHD, and the current body of evidence supports their safety within the approved dose. Nonetheless, safety data should be further studied in randomized, double-blinded, placebo-controlled trials. Comorbid ADHD is still under-recognized in clinical practice. Early identification and management of comorbid ADHD are crucial to optimize the prognosis and reduce the risk of adverse long-term neurodevelopmental outcomes. The identification of the shared genetic background of epilepsy and ADHD can open the gate for tailoring treatment options for these patients through precision medicine.

Working Memory Training in Youth With Autism, Fragile X, and Intellectual Disability: A Pilot Study

This pilot study sought to identify potential markers of improvement from pre-post treatment in response to computerized working memory (WM) training for youth (ages 8-18) with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) in a single arm, pre-post design. Participants included 26 children with ASD and 18 with comorbid ASD and fragile X syndrome (ASD+FXS). Analyses were adjusted for age and IQ. The ASD group demonstrated greater improvement on WM training relative to the ASD+FXS group. Participants improved on WM and far transfer outcomes, however, there were no significant group differences in improvement except for repetitive behavior. Higher hyperactivity/impulsivity ratings predicted lower performance on visuospatial WM. Findings suggest cognitive training may be beneficial for youth with ASD and ID, warranting further exploration.

The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project design and methodologies: a dimensional approach to understanding neurobiological and genetic aetiology

Background

ASD and ADHD are prevalent neurodevelopmental disorders that frequently co-occur and have strong evidence for a degree of shared genetic aetiology. Behavioural and neurocognitive heterogeneity in ASD and ADHD has hampered attempts to map the underlying genetics and neurobiology, predict intervention response, and improve diagnostic accuracy. Moving away from categorical conceptualisations of psychopathology to a dimensional approach is anticipated to facilitate discovery of data-driven clusters and enhance our understanding of the neurobiological and genetic aetiology of these conditions. The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project is one of the first large-scale, family-based studies to take a truly transdiagnostic approach to ASD and ADHD. Using a comprehensive phenotyping protocol capturing dimensional traits central to ASD and ADHD, the MAGNET project aims to identify data-driven clusters across ADHD-ASD spectra using deep phenotyping of symptoms and behaviours; investigate the degree of familiality for different dimensional ASD-ADHD phenotypes and clusters; and map the neurocognitive, brain imaging, and genetic correlates of these data-driven symptom-based clusters.

Methods

The MAGNET project will recruit 1,200 families with children who are either typically developing, or who display elevated ASD, ADHD, or ASD-ADHD traits, in addition to affected and unaffected biological siblings of probands, and parents. All children will be comprehensively phenotyped for behavioural symptoms, comorbidities, neurocognitive and neuroimaging traits and genetics.

Conclusion

The MAGNET project will be the first large-scale family study to take a transdiagnostic approach to ASD-ADHD, utilising deep phenotyping across behavioural, neurocognitive, brain imaging and genetic measures.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13229-021-00457-3.

Invariance of parent ratings of attention deficit hyperactivity disorder symptoms for children with and without intellectual disability

BACKGROUND

Although attention deficit hyperactivity disorder (ADHD) is considered a valid diagnosis for children with intellectual disability, no studies have evaluated the invariance of ADHD symptom ratings across children with and without intellectual disability.

METHOD

Parents completed ratings on the ADHD symptoms for 189 children with intellectual disability and for 474 children without intellectual disability. Differential item functioning analysis was used to determine the equivalence of the ADHD symptoms across the two groups.

RESULTS

The symptoms loses things, talks too much, and blurts out answers showed significant bias against children with intellectual disability. The prevalence of ADHD in children with intellectual disability was 18% (according to the symptom criterion), and 7.4% when the academic and/or social impairment criterion was also considered.

CONCLUSIONS

Most of the ADHD symptoms can be valid for the assessment of ADHD in children with mild and moderate intellectual disability. ADHD symptoms may be used in further studies to establish base rates of the disorder in the intellectual disability population.

A cross-syndrome evaluation of a new attention rating scale: The Scale of Attention in Intellectual Disability

Whilst neuropsychological research has enhanced our understanding of inattentive and hyperactive behaviours among children with intellectual disability (ID), the absence of rating scales developed for this group continues to be a gap in knowledge. This study examined these behaviours in 176 children with autism spectrum disorder (ASD), Down Syndrome (DS), or idiopathic ID using a newly developed teacher rating scale, the Scale of Attention in Intellectual Disability. Findings suggested that children with ASD had a significantly greater breadth of hyperactive/impulsive behaviours than those with DS or idiopathic ID. These findings support existing research suggesting differing profiles of attention and activity across groups. Understanding disorder-specific profiles has implications for developing strategies to support students with ID in the classroom.