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Dubé C, Morin AJS, Olivier E, Gilbert W, Tracey D, Craven RG, Maïano C. School Experiences and Anxiety Trajectories Among Youth with Intellectual Disabilities. J Autism Dev Disord 2023:10.1007/s10803-023-06127-y. [PMID: 37898583 DOI: 10.1007/s10803-023-06127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/30/2023]
Abstract
This study investigated how the school experiences and personal characteristics of youth with Intellectual Disabilities (ID) contribute to their longitudinal trajectories of anxiety. To this end, we relied on a sample of 390 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged from 11 to 22 (M = 15.70), and recruited in Canada (n = 140) and Australia (n = 250). Across three yearly time points, all participants completed self-report measures of anxiety, school climate, and victimization. Our results revealed a slight normative decrease in anxiety over time and showed that experiences of school victimization were associated with higher levels of anxiety (initially and momentarily) and increases in victimization were accompanied by increases in anxiety over time. Perceptions of attending a school that fosters security and promotes learning also tended to be accompanied by lower levels of anxiety (initially and momentarily). Momentary increases in perceptions of attending a school that fosters positive peer interactions were associated with momentary decreases in anxiety, whereas momentary increases in perceptions of attending a school characterized by positive teacher-student relationships and an equitable treatment of all students both led to small momentary increases in anxiety once all other components of student school experiences were considered. The theoretical and practical implications of these results are discussed.
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Affiliation(s)
- Céleste Dubé
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke W, Montreal, QC, H4B 1R6, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke W, Montreal, QC, H4B 1R6, Canada.
| | - Elizabeth Olivier
- Département de psychopédagogie et d'andragogie, Université de Montréal, Montréal, Canada
| | - William Gilbert
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, Canada
| | - Danielle Tracey
- School of Education, Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Rhonda G Craven
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO|Campus de Saint-Jérôme), Saint-Jérome, Canada
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Varshney K, Iriowen R, Morrell K, Pillay P, Fossi A, Stephens MM. Disparities and outcomes of patients living with Down Syndrome undergoing healthcare transitions from pediatric to adult care: A scoping review. Am J Med Genet A 2022; 188:2293-2302. [PMID: 35686676 PMCID: PMC9545419 DOI: 10.1002/ajmg.a.62854] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/01/2022] [Accepted: 05/13/2022] [Indexed: 11/11/2022]
Abstract
Down Syndrome (DS) is one of the most common chromosomal disorders worldwide, and people with DS experience more co-morbidities and have poorer health outcomes compared to the general population. An area that is not well understood is how patients with DS transition from pediatric to adult care, as well as the details, barriers, and difficulties of these transitions for patients. Hence, we aimed to provide a scoping review of the literature in PubMed, Scopus, and CINAHL on the topic of healthcare transitions (HCTs) for patients with DS. Findings suggest patients with DS who continued receiving care as an adult from a pediatric care provider tended to experience co-morbidities and other adverse health issues at higher rates than those who entirely switch to an adult-care team. Patients with DS were unable to undergo transition due to multiple barriers, such as low income, limited/public insurance, gender, and race. We propose potential steps for transition, which focus on ensuring early planning, communicating better, coordinating services, assessing decision-making capacity, and providing ongoing social and financial support. Future research must further identify and address barriers to HCTs for people with DS.
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Affiliation(s)
- Karan Varshney
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Rosemary Iriowen
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Kayla Morrell
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Preshon Pillay
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Alexander Fossi
- Center for Autism and Neurodiversity, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mary M Stephens
- Department of Family & Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Center for Special Healthcare Needs, Christiana, Delaware, USA
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Recognition of Basic Emotions with and without the Use of Emotional Vocabulary by Adolescents with Down Syndrome. Behav Sci (Basel) 2022; 12:bs12060167. [PMID: 35735377 PMCID: PMC9220526 DOI: 10.3390/bs12060167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Children with Down syndrome (DS) often experience behavioral and emotional issues that complicate their socialization process and may lead to psychopathological disorders. These problems may be related to deficits affecting emotional knowledge, particularly emotional vocabulary. Because emotional vocabulary makes it easier for typically developing children to identify emotions, a deficit affecting it in DS could be problematic. Methods: Twenty-eight adolescents with DS matched with typically developing (TD) children for their score on the Benton Facial Recognition Test were asked to recognize six emotional expressions presented in the form of filmed sequences, based on (1) nonverbal cues such as prosody, and (2) an emotional label. Results: The adolescents with DS recognized the six basic emotional expressions at a level comparable to that of the TD children in both conditions (with and without emotional vocabulary), but the facilitating effect of vocabulary was lower in that group. Conclusions: This study does not show a deficit affecting emotion recognition in DS, but it emphasizes the importance of early acquisition of emotional knowledge in this syndrome. Regular and varied use of internal state words should be encouraged in familial interactions, and education should include specifically adapted social and emotional learning programs.
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Sideropoulos V, Kye H, Dukes D, Samson AC, Palikara O, Van Herwegen J. Anxiety and Worries of Individuals with Down Syndrome During the COVID-19 Pandemic: A Comparative Study in the UK. J Autism Dev Disord 2022; 53:2021-2036. [PMID: 35106684 PMCID: PMC8806133 DOI: 10.1007/s10803-022-05450-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 11/29/2022]
Abstract
The present study explored the effects of the pandemic on individuals with Down Syndrome (DS; n = 67) compared to other groups with Special Education Needs and Disabilities (SEND; n = 48) and their Typically Developing Siblings (TDS; n = 56). In total, 115 caregivers reported on their own anxiety and worries and of their children. Anxiety levels for individuals with DS appeared to be lower compared to other SEND populations and to TDS. In terms of worries, individuals with DS worried more about social-related worries but worried less about family-related aspects compared to the other groups. In sum, individuals with DS might show less anxiety but still worried more about specific aspects related to the impact of COVID-19 pandemic on their lives.
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Affiliation(s)
- V Sideropoulos
- Department of Psychology and Human Development, UCL, Institute of Education, University College London, London, UK.
| | - H Kye
- Department of Psychology and Human Development, UCL, Institute of Education, University College London, London, UK
| | - D Dukes
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland.,Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - A C Samson
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland.,Faculty of Psychology, Unidistance Suisse, Brig, Switzerland
| | - O Palikara
- Department for Education Studies, University of Warwick, Coventry, UK
| | - J Van Herwegen
- Department of Psychology and Human Development, UCL, Institute of Education, University College London, London, UK
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Robles-Bello MA, Sánchez-Teruel D, Valencia Naranjo N. Adaptation of the Screen for Child Anxiety Related Emotional Disorders in Spanish with Nonspecific Intellectual Disability. Child Psychiatry Hum Dev 2020; 51:742-753. [PMID: 32337661 DOI: 10.1007/s10578-020-00996-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Anxiety continues to be one of the most frequent disorders with typically developing children and youth. However, people with intellectual disability (ID) lack validated diagnostic tests backed by sufficient methodological rigor. Analyze the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in this clinical population, specifically in children and young Spanish with Nonspecific Intellectual Disability. Descriptive statistics and item analysis (N = 542), exploratory factorial analysis (n = 245) and confirmatory (n = 297) and scale reliability analyses were performed and evaluated the internal consistency with various indices (Cronbach's alpha and omega) and the stability of the measurement (test-retest) of the resulting scale with better goodness-of-adjustment indices. A new scale called SCARED-DI was obtained in this clinical sample with three factors and a smaller number of items (22), offering important goodness-of-fit indices (RMSEA [95% CI] 03[0.01; .04]; CFI = 0.99; TLI = 0.98; GFI = 0.88; AGFI = 0.89) and high internal consistency (α = 0.91; ω = 0.93) and adequate measurement stability (rxx = 0.92). The importance of validating psychopathological anxiety tests for children and youth with ID in order to build good mental health is discussed, emphasizing the need to provide easy, short-duration tests on both cognitive and emotional aspects in this clinical sub-population. In addition, the results are assessed in terms of future research and practical implications. This new version of SCARED-ID represents a valid and reliable tool to evaluate the anxiety in people with intellectual disabilities.
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Affiliation(s)
| | - David Sánchez-Teruel
- Department of Psychology, University of Córdoba, Avda. San Alberto Magno s/n, 14071, Cordoba, Spain.
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Sánchez-Teruel D, Robles-Bello MA. Preliminary Study on Psychometric Properties of an Anxiety Scale in Down Syndrome with Anxiety Symptoms. Int J Psychol Res (Medellin) 2020; 13:50-61. [PMID: 32952963 PMCID: PMC7498123 DOI: 10.21500/20112084.4493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 05/11/2019] [Accepted: 11/29/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND anxiety remains one of the most common disorders in typically developing children and young adults. Adolescents with Down syndrome (DS) lack diagnostic tests for evaluation. METHODS this study evaluated the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders inventory in its self-report version in 63 adolescents with anxiety symptoms with DS. The inclusion criteria for the studies were trisomy 21 and a chronological age between 8 and 17 years. Psychometric properties arestrictly evaluated with the sample exceeding a cutoff point in anxiety symptomatology. A confirmatory factorial analysis tested two models for the new evaluation test. RESULTS both models confirmed a four-factor structure (somatic/panic, social phobia, generalized anxiety, and separation anxiety). Model 2, nevertheless, had fewer items and a better fit, and it also showed a high correlation with other anxiety detection measures and adequate internal consistency. CONCLUSIONS the importance of validating psychopathological anxiety tests for children and young people with DS in order to build good mental health is discussed, emphasizing the need to provide easy and short-term tests on cognitive and emotional aspects in people with intellectual disabilities.
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Affiliation(s)
- David Sánchez-Teruel
- Department of Psychology, Universidad de Córdoba, Córdoba, España. Universidad de Córdoba Universidad de Córdoba Córdoba Spain
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Nichols C, Block ME, Bishop JC, McIntire B. Physical activity in young adults with autism spectrum disorder: Parental perceptions of barriers and facilitators. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1398-1407. [PMID: 30486668 DOI: 10.1177/1362361318810221] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The importance of physical activity in persons with disabilities is well known, yet the prevalence of inactivity remains high. The physical activity behaviors among adults on the autism spectrum are largely unexplored. It is presumed that sedentary behavior and obesity are a greater health issue among young adults on the autism spectrum who no longer receive Individuals with Disabilities Education Act services and supports such as school-based physical education. Using a phenomenology approach, the parents of eight young adults on the autism spectrum were interviewed about their perceptions of the barriers and facilitators to getting their young adults on the autism spectrum physically active. The purpose of this study was to investigate parent's perspective of physical activity barriers and facilitators of their adult children on the autism spectrum. Common themes of both physical activity barriers and facilitators included parents, behaviors associated with autism spectrum disorder, and access and opportunities.
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Pop-Tudose ME, Popescu-Spineni D, Armean P, Pop IV. Attitude, knowledge and informed choice towards prenatal screening for Down Syndrome: a cross-sectional study. BMC Pregnancy Childbirth 2018; 18:439. [PMID: 30419853 PMCID: PMC6233289 DOI: 10.1186/s12884-018-2077-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 10/30/2018] [Indexed: 11/17/2022] Open
Abstract
Background Down Syndrome screening test is a bridge between knowledge and uncertainty, safety and risk, unpredictability and desire to know in order to gain control. It may be accepted either not to have a baby with Down syndrome, or to prepare to have a baby with this condition. Every woman should understand that it is an option and should be encouraged to make their own decisions based on information and personal values. The implications and possible subsequent scenarios differentiate this type of test from the common biochemical tests performed during pregnancy, of paramount importance being the right to make informed choices. The aim of this study was to investigate the knowledge and attitude towards prenatal Down syndrome screening in order to asses to what extent the Romanian women make informed choices in this area. Methods A cross-sectional study was carried out that included 530 postpartum women, clients of Romania’ south-east region maternities, during April–September 2016. The level of knowledge and the attitude concerning the Down syndrome screening were evaluated using a questionnaire. Data were analyzed using SPSS version 20.0. Results 48.1% of the women have never heard about any tests for Down Syndrome and from those 51.9% who have heard, only 14.2% made an informed choice, 78.9% had a positive attitude for screening, 88% were classified as having insufficient knowledge and 68.3% made a value-consistent decision to accept or decline prenatal screening. A higher knowledge level was associated with a higher education level and the urban residence. The information satisfaction and confidence in the overall value of screening were predictive factors of positive attitude. More informed choices were made by women monitored by an obstetrician in a private practice. Conclusions The prenatal screening tests for Down Syndrome were mostly unknown and the women who accepted or not to perform a test were insufficiently knowledgeable that means that the ethical concept of the informed choice wasn’t followed. In our opinion the Romanian Health System needs to improve the antenatal policy by developing an adequate information strategy at the reproductive population level based on a network of trained specialists. Electronic supplementary material The online version of this article (10.1186/s12884-018-2077-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Melania Elena Pop-Tudose
- Department of Medical Genetics, "Iuliu Haţieganu" University of Medicine and Pharmacy, Pasteur Louis Street No.6, 400349, Cluj-Napoca, Romania.
| | - Dana Popescu-Spineni
- Department of Specific Disciplines, Faculty of Midwifery and Nursing, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,"Francisc I. Rainer" Anthropology Research Centre, Bucharest, Romania
| | - Petru Armean
- Department of Specific Disciplines, Faculty of Midwifery and Nursing, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Ioan Victor Pop
- Department of Medical Genetics, "Iuliu Haţieganu" University of Medicine and Pharmacy, Pasteur Louis Street No.6, 400349, Cluj-Napoca, Romania
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The Outcomes of Posterior Arthrodesis for Atlantoaxial Subluxation in Down Syndrome Patients: A Meta-Analysis. Clin Spine Surg 2018; 31:300-305. [PMID: 29847415 DOI: 10.1097/bsd.0000000000000658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN This is a meta-analysis. OBJECTIVE To establish rates of (1) neurological complications, (2) bony-related complications, (3) complications delaying recovery, (4) reoperation, and (5) fatalities following posterior cervical arthrodesis in Down syndrome (DS) patients with atlantoaxial subluxation. To determine if presenting symptoms had any relationship to postoperative complications. SUMMARY OF BACKGROUND DATA Posterior arthrodesis is commonly utilized to correct cervical instability secondary to atlantoaxial instability in DS patients. However, there has never been a global evaluation of postoperative complications associated with posterior cervical spinal arthrodesis in DS patients. METHODS A comprehensive search of Medline/PubMed, EMBASE, and Ovid databases between January 1980 and July 2017 was utilized to identify DS patients with atlantoaxial subluxation who underwent posterior cervical arthrodesis. Data were sorted by neurological complications, complications delaying recovery, bony-related complications, reoperations, and fatalities. Patients were sorted into 2 groups based on presentation with or without neurological deficits. RESULTS Twelve studies met inclusion criteria, including 128 DS patients. Mean age was 13.8 years (range: 6.7-32.7 y; 47.8% male). Mean follow-up was 31.7 months (range: 14.9-77 mo). All patients underwent primary posterior cervical arthrodesis with an average of 2.5 vertebrae fused. A total of 39.6% of patients had bony-related complications [95% confidence interval (CI), 31.4%-48.5%], 23.3% had neurological deficits (95% CI, 16.6%-31.6%), and 26.4% experienced complications delaying recovery (95% CI, 19.4%-34.9%). The reoperation rate was 34.9% (95% CI, 25.5%-45.6%). The mortality rate was 3.9% (95% CI, 1.5%-9.7%). Neurological complications were 4-fold (P<0.05) and reoperation was 5.5-fold (P<0.05) more likely in patients presenting with neurological deficits compared with those without. CONCLUSIONS This study detailed global complication rates of posterior arthrodesis for DS patients, identifying bony-related complications and reoperations among the most common. Patients presenting with neurological symptoms and cervical instability have increased postoperative rates of neurological complications and reoperations than patients with instability alone. Further investigation into how postoperative complications effect patient independence is warranted.
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Comparing Parental Well-Being and Its Determinants Across Three Different Genetic Disorders Causing Intellectual Disability. J Autism Dev Disord 2017; 48:1651-1665. [DOI: 10.1007/s10803-017-3420-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Feasibility of Assessing Diet with a Mobile Food Record for Adolescents and Young Adults with Down Syndrome. Nutrients 2017; 9:nu9030273. [PMID: 28335382 PMCID: PMC5372936 DOI: 10.3390/nu9030273] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/09/2017] [Indexed: 11/19/2022] Open
Abstract
Technology-based methods for assessing diet in those with disability remains largely unexplored. The aim was to assess the feasibility of assessing diet with an image-based mobile food record application (mFR) in 51 adolescents and young adults with Down syndrome (PANDs). Adherence was also assessed with the instruction to include a fiducial marker object in the before and after eating images. The PANDs sample completed a four-day mFR and results were compared with a sample of young adults from the Connecting Health and Technology study (CHAT, n = 244). Compared to the CHAT sample, PANDs participants reported more fruit (2.2 ± 1.8 versus 1.0 ± 0.9 serves respectively) and vegetables (2.4 ± 1.3 versus 1.9 ± 1.0 serves, respectively), but no differences in energy-dense nutrient-poor (EDNP) foods and beverages were observed. Compared to CHAT, PANDs participants captured fewer images with the mFR (4.9 ± 2.3 versus 4.0 ± 1.5 images, respectively). Adherence to the instruction to include the fiducial marker in images was lower for PANDs compared with the CHAT sample (90.3% versus 96.5%). Due to the quality of information captured in images and the high acceptability of the fiducial marker, the mFR shows great promise as a feasible method of assessing diet in adolescents and young adults with Down syndrome.
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