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Results for “Intellectual Disability”

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PubMed2005

Professional caretakers as attachment figures in day care centers for children with intellectual disability and behavior problems.

Do children with intellectual disabilities (ID) show attachment behavior towards their professional caretaker? Five children, varying in chronological age, developmental age and DSM-diagnosis, were observed in a day care setting. Their attachment behavior was described by means of the Attachment Q-sort. Attachment behavior varied within and between children, irrespective of their diagnosis. This data indicates that professional caretakers are potential attachment figures for children with ID. Attachment introduces certain considerations for day care for children with ID, as well as opportunities for prevention and intervention. Implications for research and practice are discussed.

Adult↗

PubMed2001

Beyond sex and cooking: health education for individuals with intellectual disability.

Issues of health education programming for people with intellectual disability are discussed. As environments in which such individuals live become more inclusive, and they are encouraged to make their own choices, the issue of whether current health education is sufficient to enable them to make healthy life choices is considered. More attention should be focused on programs in schools and the community to fulfill this need. Three aspects of health education programming are considered: physical activity, general health knowledge, and social supports for health. Continuity of information is viewed as important in policy development as well as in interprofessional coordination and cooperation to assure that these individuals are not further handicapped by poor health.

Cooking↗

PubMed2004

General psychiatric services for adults with intellectual disability and mental illness.

BACKGROUND: Adults with intellectual disability (ID) and mental illness may use general or specialist psychiatric services. This review aims to assess if there is evidence for a difference in outcome between them. METHODS: A literature review was conducted using a variety of electronic databases and hand-search strategies to identify all studies evaluating the outcome of people with ID and mental illness using general psychiatric services. RESULTS: There is no conclusive evidence to favour the use of general or specialist psychiatric services. People with ID stay less time on general psychiatric than specialist inpatient units. People with severe ID appear not to be well served in general services. Older studies of inpatient samples suggest a worse outcome for people with ID. Novel specialist services generally improve upon pre-existing general services. Assertive outreach in general services may preferentially benefit those with ID. Recent studies suggest similar lengths of stay in general psychiatric beds for people with and without ID. CONCLUSIONS: Although 27 studies were located, only two were randomized controlled trials. The evidence is poor quality therefore further evaluation of services employing a variety of designs need to be employed to give more robust evidence as to which services are preferred.

Adult↗

PubMed2002

A review of the assessment and treatment of anger and aggression in offenders with intellectual disability.

Rates of aggression amongst people with intellectual disability (ID) have been found to be high in studies conducted on several continents across a number of service settings. Aggression is the primary reason for people with ID to be admitted or re-admitted to institutional settings, and it is also the main reason for individuals in this client group to be prescribed behaviour-control drugs. Anger is a significant activator of aggression, but little is known about the emotional aspects of the lives of people with ID. There are many reasons for this, but a lack of reliable and validated assessment measures is chief among them. The present review found that very little work has been conducted to date concerning the development of robust tools for assessing anger and aggression in this population. A narrative review of interventions for reducing aggression and anger in people with ID showed that there is virtually no evidence to support the use of psychotropic medications. Research has shown that behavioural interventions can be effective; however, they are intrusive and have not been tested in naturalistic settings with higher-functioning clients and low-frequency aggression. More recently, cognitive-behavioural interventions have shown promise, but the mechanisms for effective change have yet to be delineated. Priority research questions relating to assessment, treatment and therapeutic skills in working with anger and aggression problems are offered by the present review.

Aggression↗

PubMed2006

[Relationships between spinal deformities and respiratory function in patients with severe motor and intellectual disabilities syndrome].

The term severe motor and intellectual disabilities syndrome (SMIDS) refers to describe a heterogeneous group of disorders with severe physical disabilities and profound mental retardation. Many patients with SMIDS have spinal deformities such as spinal rotation and scoliosis. On the other hand, they often have respiratory dysfunction, resulting in high mortality from respiratory failure. Therefore, we hypothesized that spinal abnormalities might affect respiratory dysfunction, and analyzed the correlation between spinal abnormalities (Cobb angles (CA) and spinal rotation scores (SRS)) and respiratory parameters (observed during tidal breathing at static supine posture) in 10 patients with SMIDS (M: F 2:8, age 29.0 +/- 7.3 years). The patients inability to make effort in spirometry prevented us from evaluating vital capacity and forced expiratory volume. We measured respiratory rate, tidal volume, and expiratory gas during tidal breathing for 10 minutes. There was no patient with the athethotic type of CP. CA and SRS were found to be correlated with each other (r = 0.81, p < 0.01). CA was inversely correlated with tidal volume (both Vt and Vt/Height;r = -0.69, p < 0.05). Both CA and SRS correlated with respiratory rate (r = 0.67 and 0.69, respectively). Moreover, the slope of the regression lines of the VO2-VCO2 plots (V-slope) was correlated with CA (r = 0.86, p < 0.01). Contrary to our expectation, none of the respiratory parameters showed significant correlations with BMI. Moreover, we found no relationship between the spinal deformity (CA or SRS) and BMI. These observations suggest that the spinal abnormalities affect respiratory patterns in a restrictive manner and increase the respiratory change rate during tidal breathing in patients with SMIDS.

Adult↗

PubMed2005

Applying the developmental perspective in the psychiatric assessment and diagnosis of persons with intellectual disability: part II--diagnosis.

BACKGROUND: The descriptive phenomenological categorical psychiatric diagnostic systems that are currently being used in the field of intellectual disability do not adequately provide for the special needs of persons with intellectual disability. Many relevant diagnostic questions are left unanswered or are only partially accounted for. This is particularly true for persons with low developmental levels. METHOD: A solution to these stumbling blocks is sought in enhancing the contemporary categorical diagnostic systems by also applying methods derived from the developmental perspective. RESULT: By taking the levels of emotional and personality development, in addition to other developmental aspects into account, the clinical picture becomes more comprehensible and explainable. CONCLUSION: The integrative diagnosis that results from this combined approach provides an insight into the processes that have led to the disorder and enriches one's understanding of the presentation form of the disorder. This diagnosis is process- rather than symptom-oriented and is particularly useful with persons who have a low level of psychosocial development.

Adolescent↗

PubMed2000

The dual diagnosis facility: a renewed engagement with the psychiatry of intellectual disability?

A case study of a pilot residential facility for intellectually disabled adults who also suffer the effects of mental illness I presented in the context of the emergent debate surrounding the issue of dual diagnosis and co-morbidity. The innovative role of nurses in the establishment if this new service is discussed in terms of the beginning of a renewed engagement with the psychiatry of intellectual disability and it's implications for nursing practice and practice arrangements.

Child↗

PubMed2006

Decision-making about risk in people with epilepsy and intellectual disability.

AIM: This paper reports a study of the process of risk-evaluation and subsequent decision-making in the care for people with epilepsy and intellectual disability. BACKGROUND: People with intellectual disability and severe epilepsy are at risk of suffering accidents during seizure, and often need protection. Whether to implement protective measures or to accept risk is a complex decision, burdened with uncertainty. Taking risks can lead to dangerous, sometimes life-threatening situations, while protective measures are restrictive and may raise ethical concerns. METHODS: In 2003 a multiple embedded case study was conducted with 15 clients. In each case, the client, their representative, care-manager and nurse were interviewed. FINDINGS: The decision about whether to accept risks or implement protective measures was always taken in relation to specific events, and varied from medication and supervision to total restriction of the client's mobility. Decision-making was influenced by frequency, type, predictability and consequences of seizures; the effectiveness and practicability of protective measures; additional disabilities; characteristics of the client and their representative; and characteristics of nurses and organization. The predominant factor was the attitude of the representatives. They determined the relative weight of the other factors involved. CONCLUSION: A systematic approach to risk management could considerably improve the balance between risk and quality of life. Continuous evaluation would make it possible to tune the application of protective measures to the severity of the seizures at any time, and to avoid protective measures being maintained only because care providers have become accustomed to them. A systematic assessment of clients' capabilities to participate in this complex decision-making process is equally indicated.

Accident Prevention↗

PubMed2006

Sensory impairments and health concerns related to the degree of intellectual disability in people with Down syndrome.

The relationship between poor health and cognitive impairment is not fully understood yet. People with Down syndrome are prone to a number of health problems, including congenital heart defect, visual impairment, hearing loss, autoimmune diseases, epilepsy, early-onset Alzheimer's disease and intellectual disability. Our aim was to assess the impact of impaired health on cognitive performance in people with Down syndrome. A series of people with Down syndrome (n=129) were studied for their intellectual disability, sensory impairments and health concerns. The medical and psychological records of all persons with Down syndrome in the Intellectual Disability Service Register of Kainuu from 1970 to 2004 were analysed. The detected health issues were related to the individuals' cognitive levels. Visual impairment, poor dental health and acute neurological disease were associated with the severity of intellectual disability and ageing.

Aged↗

PubMed1994

A stimulus control procedure to increase requesting with individuals who are severely/profoundly intellectually disabled.

Various procedures have been used to establish and increase manual signed and spoken requesting with individuals who are intellectually disabled. A few studies have used the so-called blockable response conditioned establishing operation (BR-CEO) as a stimulus control procedure to increase requesting. A variation on the BR-CEO is the interrupted chain procedure, in which requesting for the activity that had been interrupted is reinforced by continuation of the activity. Rather than interrupting an ongoing activity, six individuals who are severely/profoundly intellectually disabled were studied with respect to the differential effectiveness of presenting them incomplete versus complete referents (i.e. activity and objects) as a consequence of their requesting on their rate of requesting. Data were collected within a reversal design. The results show that five out of six individuals more than doubled their rate of requesting. Incomplete presentation of referents may be a practical procedure to increase requesting.

Adolescent↗

PubMed1999

Psychopharmacotherapy in children and adults with intellectual disability.

The prevalence of psychiatric disorders is increased in children and adults with intellectual disability. Brain damage or dysfunction interact with social and family factors to increase susceptibility to mental illness. Psychiatric disorders in the context of genetic syndromes are commonly overlooked, and there is substantial underdiagnosis of mental disorders because of the atypical and non-specific clinical presentations, and the frequent assumption that psychiatric symptoms are an inherent part of the underlying intellectual disability. There is a strong need for evidence-based practice in the prescribing and monitoring of drugs in this population, especially since many of the drugs are unlicensed for use in children. There is an urgent need to understand and establish the pharmacokinetics, pharmacodynamics, and side-effect profiles of psychotropic medication in this population. Positive trends in pharmacotherapy include the use of atypical antipsychotics instead of the classic antipsychotics, serotonin-specific reuptake inhibitors (SSRIs) rather than tricyclic antidepressants, and newer antiepileptic drugs. Another welcome trend is the use of SSRIs instead of antipsychotics in the long-term management of challenging behaviour in this population.

Adult↗

PubMed2003

Ageing and intellectual disability in Israel: a study to compare community residence with living at home.

The present study was conducted to compare ageing phenomena in people with intellectual disabilities aged 40 years and above living in community residences (n = 29) with those living with their families (n = 31). The goals were to compare the health status between the two types of settings, to compare the health status between the study sample and the general Israeli population of the same age group, and to investigate whether deterioration occurs among the participants in activities of daily living (ADLs), cognitive ability and leisure activity. Health problems had already appeared by 40 years of age among the participants. The most frequent problems were visual impairment (33%), hearing impairments (20%) and heart problems (20%). Dental problems were found in 30%. The community-based residence group displayed more medical problems than people living at home, whereas individuals living at home had more dental problems. The functioning of the participants in the ADL areas was high, with no evident decline reported during the previous 5 years. Concerning leisure time, a decline in functioning in both residential groups was observed, and interestingly, the scores for social life and leisure activities were better for the community-based residential group. There is a need for better dental service provision for people with intellectual disabilities living at home. The data provided in the current study can serve as a preliminary base for the development of geriatric services for older adults with intellectual disabilities in the community and also provide a basis for further comparison with peers in the general population.

Activities of Daily Living↗

PubMed1996

The effects of behavioural relaxation on cognitive performance in adults with severe intellectual disabilities.

Behavioural relaxation training has been found to be effective in the treatment of generalized anxiety in people with intellectual disability. The present study is designed to assess whether or not these techniques can help individuals in more generalized aspects of their life. Two groups of 10 adults with a severe intellectual disability formed a relaxation group and a control group. The relaxation group were given a course in behavioural relaxation training and the control group were given a quiet reading period for the same amount of time. Each subject was given a digit span test, a test of long-term memory and an incidental learning test after each session. Results suggest behavioural relaxation training has a beneficial effect on performance on tests of short-term memory and incidental learning, but no effect upon long-term memory.

Adult↗

PubMed1997

The importance of smoking education and preventative health strategies for people with intellectual disability.

Tobacco smoking is a major health problem within our community. To date, little attention has been focused on determining the prevalence of smoking in people with disabilities or in developing appropriate strategies to assist them to stop smoking. Funding from the Victorian Health Promotion Foundation enabled the Developmental Disability Unit at Monash University, Box Hill, Victoria, Australia, to undertake a project investigating smoking in a population of people with intellectual disability. In the first part of the project, the smoking rate among a geographically defined group of people with mild intellectual disability was investigated. A smoking prevalence of 36% was found within the sample group, as compared to a prevalence of 26% within the general Victorian adult population. An association was found between the motivation to quite and the recall of advice to stop smoking. The second part of the project comprised the development and piloting of a smoking education course for people with intellectual disability. The pilot sample was small, but the results were encouraging. Fifty-five per cent of the group either quit smoking or cut down their intake significantly. Seventy-three per cent expressed a desire to stop smoking at the completion of the course, and all participants expressed an increased concern and knowledge about the effects of smoking on their health after completing the course.

Adult↗

PubMed1999

Mediator analysis: an overview of recent research on carers supporting people with intellectual disability and challenging behavior.

Families and front-line care staff are often key agents in helping deliver behavioural interventions to people with intellectual disability and challenging behaviour. The present paper reviews factors which may impact on the effectiveness of such interventions. Both PsychLit and MedLine were used to conduct an automated literature search which included the terms 'learning disability', 'mental handicap', 'mental retardation', 'intellectual disability', 'challenging behaviour', 'families' and 'staff. This search was substantially augmented by additional citations obtained from books and journal articles. The impact of attitudes, beliefs and emotional states as setting conditions for interventions was highlighted. A variety of more general setting conditions related to intervention effectiveness were also identified. Implications for both clinical practice and future research were discussed.

Adaptation, Psychological↗

PubMed1998

Mental health and intellectual disability: an international perspective.

The present paper reports on the inaugural meeting of the Mental Health Special Interest Research Group (SIRG) of the International Association for the Scientific Study of Intellectual disability which was held at Fitzwilliam College, Cambridge, UK, in March 1998. The meeting was organized in conjunction with the Ninth Annual SIRG on ageing and intellectual disability. Representatives from North America, several European and Scandinavian countries, Australia, and Israel attended. Two broad themes had been determined prior to the meeting: 'Improving the detection of mental health problems' and 'Research strategies for identifying risk factors for mental health problems'. In the presentations and subsequent discussions, it was apparent that there were extremely diverse perspectives both across and within the different countries represented. Not only were individuals' experiences very different, but most strikingly, the theoretical frameworks were very diverse. This was partly a function of there being understandable differences in perspectives across disciplines, but at its most marked, there were fundamental differences in the way both intellectual disability and mental health were conceptualized.

Humans↗

PubMedDate not supplied

Validation of the Lifestress Inventory for people with a mild intellectual disability.

The Subjective Stress Scale (SSS; Bramston & Bostock, 1994) was developed to measure stress in people with a mild intellectual disability. In previous research, the SSS was found to measure two broad dimensions of stress (a) a General Worry factor and (b) a factor that tapped concerns about Negative Interpersonal Relations (Bramston & Fogarty, 1995). The present study sought to continue this line of research by introducing a slightly modified form of the SSS, to be known as the Lifestress Inventory (LI) and examining the psychometric properties of the scale when administered to a new sample of 221 people with mild intellectual disabilities. Confirmatory factor analysis indicated that three underlying factors corresponding to General Worry, Negative Interpersonal Relations, and Coping were sufficient to account for the correlations among the items in the LI. Rasch analysis indicated some improvements to the scoring format for the LI and also showed that the most easily experienced stressors were associated with the Negative Interpersonal Relations dimension. The refinements introduced by the LI and the further demonstration that some of the broad stress dimensions identified in the general population can also be found in people with an intellectual disability represent important milestones for researchers interested in exploring reactions to stress among this population.

Adaptation, Psychological↗

PubMed2005

The place of people with intellectual disabilities in Bandung, Indonesia.

This report is an attempt to 'make visible' people with intellectual disabilities in Bandung, Indonesia, who have been rendered invisible due the stigmatization of disabled bodies in Indonesian society. The Western concept of deinstitutionalization is not appropriate to the contemporary culture of Indonesia. Returning to the 'special schools' following completion of secondary education resolves some of the problems of social exclusion, while reinforcing other exclusionary aspects of Indonesian society. Institutionalization is seen as a privilege in the Indonesian context, as only the better off can afford the cost of placing people with intellectual disabilities in institutions.

Cultural Characteristics↗