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Results for “Intellectual Disability”

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PubMed1997

Diagnosis of dementia in individuals with intellectual disability.

The foremost impediment to progress in the understanding and treatment of dementia in adults with intellectual disability is the lack of standardized criteria and diagnostic procedures. Standardized criteria for the diagnosis of dementia in individuals with intellectual disability are proposed, and their application is discussed. In addition, procedures for determining whether or not criteria are met in individual cases are outlined. It is the intention of the authors, who were participants of an International Colloquium on Alzheimer Disease and Mental Retardation, that these criteria be appropriate for use by both clinicians and researchers. Their use will improve communication among clinicians and researchers, and will allow researchers to test hypotheses concerning discrepancies in findings among research groups (e.g. dementia prevalence ranges and age of onset).

Age of Onset↗

PubMed2006

Supporting parents of youths with intellectual disabilities and psychopathology.

BACKGROUND: Parents of children and adolescents with both intellectual disabilities (ID) and psychopathology often experience high levels of parenting stress. To support these parents, information is required regarding the types of support they need and whether their needs are met. METHOD: In a sample of 745 youths (aged 10-24 years) with moderate to borderline ID, 289 parents perceived emotional and/or behavioural problems in their child. They were asked about their needs for support and whether these needs were met. Logistic regression analysis revealed the variables associated with both needing and receiving specific types of support. In addition, we asked those parents who had refrained from seeking support about their reasons. RESULTS: Most parents (88.2%) needed some supports, especially a friendly ear, respite care, child mental health care and information. Parents who perceived both emotional and behavioural problems in their child needed support the most. In addition, parents whose child had any of these problems before the past year, who worried most about their child and suffered from psychopathology themselves, more often needed support. Parents of children with moderate ID or physical problems especially needed 'relief care', that is, respite care, activities for the child and practical/material help. The need for a friendly ear was met most often (75.3%), whereas the need for parental counselling was met least often (35.5%). Not receiving support despite having a need for it was primarily related to the level of need. Parents who indicated to have a stronger need for support received support more often than parents who had a relatively low need for support. The parents' main reasons for not seeking support concerned their evaluation of their child's problems (not so serious or temporary), not knowing where to find support or wanting to solve the problems themselves first. CONCLUSIONS: Most parents had various support needs that were frequently unmet. Service providers should especially aim at providing information, activities, child mental health care and parental counselling. Furthermore, parents need to be informed about where and how they can obtain what kind of support. A case manager can be of help in this.

Adolescent↗

PubMed2002

Assessing emotional and behavioral problems in children with intellectual disability: revisiting the factor structure of the developmental behavior checklist.

The objective of the reported study was to reassess the factor structure of the Developmental Behaviour Checklist (DBC) in a large cross-cultural sample representing all levels of intellectual disability. Parent and teacher DBC ratings on a combined sample of 1536 Dutch and Australian children and adolescents (ages 3-22) with mild to profound intellectual disability were used. Principal components analyses produced five subscales: Disruptive/Antisocial, Self-Absorbed. Communication Disturbance, Anxiety, and Social Relating, explaining 43.7% of the total variance. Internal consistencies of these subscales ranged from .66 to .91. The revised factor structure of the DBC appears to be an improved and useful tool for assessing emotional and behavioral problems in children with intellectual disabilities.

Adolescent↗

PubMed1993

Use of hormonal contraceptives in an institutional setting: reasons for use, consent and safety in women with psychiatric and intellectual disabilities.

AIM: To describe the use of hormonal contraceptives in institutionalised women with psychiatric and/or intellectual disabilities. METHODS: Women who had been disability or mental health service inpatients for six months or more and were prescribed hormonal contraceptives were included. Data were collected from their clinical files and from structured interviews of the women and of their primary care givers. RESULTS: Forty two women were prescribed contraceptives, of whom 23 were intellectually disabled and 28 had mental illnesses. Most women had no children; four had had one child and two, two children. Thirteen were not sexually active. Depot medroxyprogesterone acetate (Depo Provera) was prescribed for 69%, combined oral contraceptive agents for 14% and progestin-only oral contraceptives for 17%. Contraceptives were initially prescribed by hospital staff for all but 1 woman, and were administered without consent for over half the group, including 11 women for whom this administration was not legally authorized. Less than half the group had blood pressure measured within the previous 12 months and only a third had a cervical smear within the previous 3 years. Of the women who were sexually active, less than half knew how to protect themselves from sexually transmitted diseases and less than 10% regularly used condoms. CONCLUSIONS: Improvements in reproductive health care for these women are needed, in particular attention to education and client participation in decisions about contraceptive treatment. It is suggested that gynaecological and family planning services be provided separately from psychiatric services.

Adult↗

PubMed1997

Medical aspects of ageing in a population with intellectual disability: III. Mobility, internal conditions and cancer.

The aim of this study was to assess mobility impairment and morbidity and mortality caused by internal conditions and cancer in an ageing population with mild to severe intellectual disability. Seventy subjects with a mean age of 70 years (range 60-92 years) at initial evaluation, were assessed during a 10-year prospective longitudinal study. As was to be expected, there was a high prevalence of mobility impairment (30% under and 58% over age 75), similar to reports from other ageing populations with intellectual disability, and of related conditions (chronic constipation, pulmonary function loss and urinary incontinence). Overall morbidity and mortality caused by internal disease and cancer might be comparable to that in the general ageing Dutch population, but questions concerning the specific contribution of risk factors will have to be addressed. The lack of or atypical presentation of subjective symptoms was striking. Nevertheless, autopsy outcomes showed that diagnosis in people with intellectual disability can be as accurate as in the general population, if performed actively.

Aged↗

PubMed1995

The psychiatric care of people with intellectual disabilities: the perceptions of trainee psychiatrists and psychiatric medical officers.

OBJECTIVE: The main aim of this study was to document the perceptions of trainee psychiatrists and psychiatric medical officers regarding the psychiatric care of people with intellectual disabilities. METHOD: A 28-item self-administered questionnaire was developed by the investigators and pretested on eight psychiatrists and psychiatric trainees. A revised version of the questionnaire was then sent to 128 psychiatric trainees and 27 medical officers working in the public psychiatric services in Victoria. 116 questionnaires were returned, and the responses analysed. RESULTS: The results indicate a high degree of interest in the psychiatry of intellectual disability, however this was tempered by a feeling that the respondents and their senior colleagues are inadequately trained. The respondents expressed major concerns regarding the care of people with dual disabilities in the hospital and community setting, and significant support for the development of specialised units and subspecialisation within psychiatry. The major concerns which were identified would in part explain why 30% of the respondents felt that they would prefer not to treat people with an intellectual disability and a psychiatric disorder. CONCLUSION: We can only support the assertion made by the Burdekin Report [12] that "there is an urgent need for academic research, increased clinical expertise and substantial increased resources in the much neglected area of dual disability.

Attitude of Health Personnel↗

PubMed2007

Mental ill-health in adults with intellectual disabilities: prevalence and associated factors.

BACKGROUND: Reported prevalence of mental ill-health among adults with intellectual disabilities ranges from 7 to 97%, owing to methodological limitations. Little is known about associations. AIMS: To determine the prevalence of mental ill-health in adults with intellectual disabilities and to investigate factors independently associated with it. METHOD: Population-based study (n=1023) with comprehensive individual assessments modelled using regression analyses. RESULTS: Point prevalence of mental ill-health was 40.9% (clinical diagnoses), 35.2% (DC-LD), 16.6% (ICD-10-DCR) and 15.7% (DSM-IV-TR). The most prevalent type was problem behaviours. Mental ill-health was associated with more life events, female gender, type of support, lower ability, more consultations, smoking, incontinence, not having severe physical disabilities and not having immobility; it was not associated with deprived areas, no occupation, communication impairment, epilepsy, hearing impairment or previous institutional residence. CONCLUSIONS: This investigation informs further longitudinal study, and development of appropriate interventions, public health strategy and policy. ICD-10-DCR and DSM-IV-TR undercount mental ill-health in this population compared with DC-LD.

Adolescent↗

PubMed2004

Elevated rates of schizophrenia in a familial sample with mental illness and intellectual disability.

BACKGROUND: It is unknown whether intellectual disability (ID) is more familially related to psychotic mood disorders or schizophrenia. L. S. Penrose's large sample of families with two or more members admitted to psychiatric hospitals provided a unique opportunity to investigate the familial relationship between mild ID, schizophrenia and psychotic affective disorders. METHOD: There were 183 affected relative pairs comprising probands with mild ID (95 male, 88 female) and their first or second degree relatives with schizophrenia or psychotic affective disorder. RESULTS: There were nearly twice as many relatives with a diagnosis of schizophrenia (n = 121) as relatives with affective disorders (n = 62) among the intellectually impaired probands. This excess of schizophrenia was statistically significant, even after accounting for the increased risk of hospitalization for schizophrenia (P = 0.005), and was fairly constant across the different relative types. First-degree relatives with either mental illness were more likely to be parents (n = 77) than siblings (n = 51) or children (n = 3), but there was no excess of mother-son pairs. CONCLUSIONS: These results suggest a stronger familial relationship of ID with schizophrenia than psychotic affective disorder, and lend some support to the neurodevelopmental hypothesis of schizophrenia.

Adult↗

PubMed2002

X-linked myoclonic epilepsy with spasticity and intellectual disability: mutation in the homeobox gene ARX.

OBJECTIVE: To describe a new syndrome of X-linked myoclonic epilepsy with generalized spasticity and intellectual disability (XMESID) and identify the gene defect underlying this disorder. METHODS: The authors studied a family in which six boys over two generations had intractable seizures using a validated seizure questionnaire, clinical examination, and EEG studies. Previous records and investigations were obtained. Information on seizure disorders was obtained on 271 members of the extended family. Molecular genetic analysis included linkage studies and mutational analysis using a positional candidate gene approach. RESULTS: All six affected boys had myoclonic seizures and TCS; two had infantile spasms, but only one had hypsarrhythmia. EEG studies show diffuse background slowing with slow generalized spike wave activity. All affected boys had moderate to profound intellectual disability. Hyperreflexia was observed in obligate carrier women. A late-onset progressive spastic ataxia in the matriarch raises the possibility of late clinical manifestations in obligate carriers. The disorder was mapped to Xp11.2-22.2 with a maximum lod score of 1.8. As recently reported, a missense mutation (1058C>T/P353L) was identified within the homeodomain of the novel human Aristaless related homeobox gene (ARX). CONCLUSIONS: XMESID is a rare X-linked recessive myoclonic epilepsy with spasticity and intellectual disability in boys. Hyperreflexia is found in carrier women. XMESID is associated with a missense mutation in ARX. This disorder is allelic with X-linked infantile spasms (ISSX; MIM 308350) where polyalanine tract expansions are the commonly observed molecular defect. Mutations of ARX are associated with a wide range of phenotypes; functional studies in the future may lend insights to the neurobiology of myoclonic seizures and infantile spasms.

Adult↗

PubMed2006

Mental health and intellectual disability: culture and diversity.

BACKGROUND: Compared with that in mental illness, cultural variation in popular conceptualisations of intellectual disability has been rarely addressed. METHODS: A survey of the relevant literature was conducted. RESULTS AND CONCLUSION: Preliminous conclusions are that local conceptualisation does not lead to invariant social response, but that intellectual disability is generally distinguished from mental illness.

Cross-Cultural Comparison↗

PubMed2003

Eyewitness memory, suggestibility, and repeated recall sessions in children with mild and moderate intellectual disabilities.

This study of eyewitness memory questioned children with mild and moderate intellectual disabilities (ID) about a live staged event 1 day later and, again, 2 weeks later. Children with mild ID performed as well as typically-developing children of the same age in response to free recall instructions, and they were just as able as same age peers to resist misleading questions. However, they performed more poorly on general questions, probing for further information after free recall. The children with mild ID also changed their responses to specific questions more often in the repeated interview. The group of children with moderate ID showed markedly lower performance than peers of the same age on nearly every type of eyewitness memory question. Comparisons of the children with ID to mental age-matched peers indicated that performance was similar, although children with ID gave more information in response to free recall instructions and changed their answers in the repeated interview more often. Standardized measures of verbal memory (TOMAL) and suggestibility (Gudjonsson Suggestibility Scale) were modest to moderate predictors of eyewitness memory performance.

Child↗

PubMed2003

The Human Genome Project: considerations for people with intellectual disabilities.

The paper discusses the impact which recent advances in gene technology may have for people with intellectual disabilities. It highlights a conflict between the apparent benefits of advances in genetics for the population in general and the negative effects on persons with intellectual disabilities in particular. This conflict is illustrated in the paper through the use of examples, including the implications of a person's lack of capacity to consent to investigations and treatment; the issue of individual responsibility for antisocial behaviour when this is considered to have a genetic component; and the issue of life and death decisions about treatment in the face of a progressive, genetically determined, disorder. The authors adopt a human rights perspective to discuss these examples because it provides a richness to articulate and justify moral concerns in this area which is lacking in much of the current debate as this is dominated by the primacy of autonomy.

Human Genome Project↗

PubMed2000

Use of the atypical antipsychotics Olanzapine and Risperidone in adults with intellectual disability.

The present study was designed to monitor the use of atypical antipsychotics in adults with intellectual disability and to evaluate the clinical effectiveness of these drugs. Twenty-one patients were commenced on an atypical antipsychotic: 12 on Olanzapine and nine on Risperidone. The ICD-10 diagnoses of the subjects were mild (13 cases) or moderate (8 cases) mental retardation, and psychiatric disorders (17 cases) with significant impairment of behaviour in 10 cases. Tolerability was good for 15 patients experiencing minimum or no side-effects, and medication was only stopped as a result of side-effects in one case. Clinical global outcome was rated as minimally improved or better for 16 cases. The present findings suggest that the atypical antipsychotics Olanzapine and Risperidone are well tolerated by patients with intellectual disability and psychiatric disorders, and are broadly effective against target symptoms.

Adult↗

PubMed1997

[The effect of "Ueda" method for the treatment of a severe motor and intellectual disabilities syndrome].

A case of severe motor and intellectual disabilities syndrome after being nearly drowned was reported. He could walk at the age of one year. But his condition became to a bedridden state by the hypoxic brain damage due to near drowning at one year and 5 months old. At one year and 8 months, he was treated by the "Ueda" method for physical therapy to cerebral palsy (CP). Before the treatment he showed decorticate posture and opisthotonic posture. Six weeks after the treatment, the severity of spasticity was remarkably decreased. He could take hip flexion posture and relaxed posture easily. His status remarkably improved. The effectiveness of the "Ueda" method to different spasticity from CP was also confirmed.

Cerebral Palsy↗

PubMed2006

Socioemotional understanding and frequent aggression in people with mild to moderate intellectual disabilities.

Aggression in a proportion of people with intellectual disabilities is often assumed to be due to social-cognitive deficits. We reported on two studies in which we compared the emotion recognition and perspective-taking abilities of 43 frequently aggressive individuals and 46 nonaggressive peers. No difference was found between the groups' ability to label facial affect. The perspective-taking task required participants to distinguish between reactions of angry versus calm characters. Although both groups had similar success with elements of the task, the aggressive group proved better at predicting characters' attributions. Results suggest that deficits in emotion recognition and perspective-taking cannot be assumed to be causal or maintaining factors of frequent aggression. This has implications for assessment and treatment.

Adult↗

PubMed2003

How do people with intellectual disabilities think about empowerment and information and communication technology (ICT)?

Several studies from the 1990s show that information and communication technology (ICT) can be important for people with intellectual disabilities, although later results have queried what importance technology can have in increasing the influence and participation of this group. This article presents the results from a study of people with moderate and mild intellectual disabilities and their view of issues related to empowerment and ICT. Data were collected through a study of original sources, participation observation, a group interview and four in-depth interviews with people with mild intellectual disabilities. Results show that respondents feel that it is important to be able have an influence on issues concerning work, housing, leisure time and social relationships. The way one views one's own ability to influence and control situations depends on individual self-esteem, social networks, previous experience and knowledge; the participants' coping skills also depend on these factors to a great extent. The ten participants who were interviewed had experience with ICT and felt that it was useful and enjoyable in a variety of ways concerning their studies, work and, for some, even their leisure time. Computers were used to gather information, to communicate with the surrounding world, to shop, for creative activities and for games. The respondents used media, such as television, radio, music systems and daily papers, for recreation and to gain information and knowledge.

Adult↗

PubMed2002

Evaluation of a group intervention for convicted arsonists with mild and borderline intellectual disabilities.

BACKGROUND: The extent to which people with intellectual disabilities (ID) set fires is difficult to ascertain. However, services working with people with ID and offending or quasi-offending histories are increasing the amount of attention that they give to this difficult and perplexing issue. This is due to the real and perceived threat that it presents to society and the seriousness with which it viewed by the criminal justice system. AIM: Against this background there is very little available in the research literature concerning treatment interventions for fire-setting behaviour in this client group, and even less regarding their effectiveness. METHOD: In the current study 14 men and women with mild and borderline ID, convictions for arson and detained in a hospital low secure service were offered and completed a broadly cognitive behavioural, approximately 40-session group-based intervention. The treatment was aimed primarily at reducing fire interest and attitudes associated with fire-setting behaviour. Participants were assessed pre- and post-treatment on a number of fire-specific, anger, self-esteem and depression measures. RESULTS: Following treatment, significant improvements were found in all areas assessed, excepting depression. Despite the limitations of the study design, the results provide encouragement and some guidance to practitioners who are required to develop interventions for this challenging, yet much neglected client group.

Adult↗

PubMed2006

The experience of health and wellness in mothers of young children with intellectual disabilities.

Today in Australian society the majority of families who have a child with a physical or intellectual disability will take care of that child across their lifespan. Mothers bear most of the burden associated with their child's care; however, little is known about the effect fulfilling this role has on the health of the mother. This interpretive research study was conducted with the aim of enhancing understanding of the health and wellness of mothers who have a child with an intellectual disability aged 0-5 years. Interview data were collected from five women living in a rural Australian city, and analysed using qualitative techniques. The research revealed that the mothers' health is backgrounded in time, space and the physical body, because their horizon of awareness is directed toward the needs of the child with a disability.

Australia↗