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Results for “Intellectual Disability”

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PubMed2006

The impact on mothers of bringing up a child with intellectual disabilities: a cross-cultural study.

BACKGROUND: Most research into the impact on mothers of having a child with an intellectual disability has been done in Western cultures. These mothers are at increased risk of stress, along with poorer health and weakened family relationships. Nurses are well placed to support these mothers. OBJECTIVES: (1) To describe across three different cultures-Irish, Taiwanese and Jordanian-the inter-relationships among three indicators of maternal well-being. (2) To identify the coping strategies of mothers and the professional and informal supports available to them. (3) To identify the variables that have a negative impact on maternal well-being and possible moderating influences on them. DESIGN: A survey approach with three groups of self-selected mothers. PARTICIPANTS: The characteristics of the child determined the inclusion criteria; namely aged 5-18 years with a diagnosis of intellectual disability of such severity that the children attended special schools or centres. In each country, the special services within particular geographical areas were approached and all families known to them were given the opportunity to participate. In all 206 mothers agreed to participate. METHODS: Mothers were interviewed individually at home or in the day centre attended by their child. They completed various rating scales of known reliability and validity. In addition they described in their own words, the impact the child had on their lives and how they coped. RESULTS: In all three countries, mothers experienced poor mental health, increased levels of child-related stress and poorer family functioning which the qualitative data further illuminated. Their child's behaviour problems were a major factor in this. The impacts on mothers' well-being were not alleviated by access to professional supports or use of coping strategies. CONCLUSIONS: Health professionals need to adopt family-centred approaches that embrace the support needs of mothers. Similar strategies would apply across all cultures although they must be responsive to individual need.

Adaptation, Psychological↗

PubMed2003

Refractive errors and visual impairment in 900 adults with intellectual disabilities in the Netherlands.

PURPOSE: To collect data on refractive errors and visual impairment in adults with an intellectual disability (ID) in the Netherlands. PATIENTS: A randomized sample of 2100 participants was drawn from a base population of 9000 adults with intellectual disabilities in the Netherlands. This article reports on the first 900 participants. METHODS: All participants underwent a protocol-based on-site ophthalmological assessment carried out by skilled investigators. RESULTS: Co-operation was classified according to the number of tests that could be carried out reliably and was good or excellent in 80% of subjects, average in 13% and poor in 7%. Refraction could be reliably assessed in 505/900 (56%) subjects. There was an increased risk of visual impairment in all subgroups compared to the general Dutch population. Visual acuity (VA) was related to the level of ID, but refractive errors were not. New spectacles were prescribed in 106 cases (12%). Of 374 people in whom both monocular VA and the refractive error of the right eye could be reliably assessed, 153 (41%) had a pretest prescription, 16 (10%) of which we found to be inadequate. Of the 221 participants without a pretest prescription, 41 (19%) benefited from correction. Only 38/84 (45%) subjects aged 50 years or older, who could benefit from correction for near vision, had near spectacles. New correction increased the mean distant VA significantly from 0.44 to 0.65 (p < 0.0005). CONCLUSIONS: With some adaptations, visual screening is feasible in a majority of adults with ID. Visual impairment and refractive errors are much more prevalent in adults with ID than in the normal population. Accurate spectacle correction resulted in significant improvement in distant VA.

Adult↗

PubMed1997

Prevalence and incidence of health problems in people with intellectual disability.

The objective of this study was to determine the prevalence and incidence of the most frequent chronic health problems in relation to age in people with intellectual disabilities living in residential facilities in the Netherlands. A prospective cohort study was done with four data collections, each with an interval of one year. Data were collected by means of questionnaires which were completed by each person's physician. Striking results included the reported high prevalence and incidence of visual and hearing impairment, which was even more pronounced in people with Down's syndrome than in people with intellectual disability resulting from other causes. Gastrointestinal problems also appeared to have high incidence rates. Dementia was frequently reported in people with Down's syndrome aged 40 years and older. The results reflect the need for a more predictive policy which can anticipate health problems in people with intellectual disability.

Adolescent↗

PubMed2004

Psychiatric inpatient care for adults with intellectual disabilities: generic or specialist units?

BACKGROUND: When adults with intellectual disabilities (ID) require a psychiatric admission, general adult mental health units are often used. Specialist units have emerged recently as a care option but there is only limited evidence of their effectiveness. Thus this study aims to describe and evaluate the effectiveness of a specialist inpatient unit and report on the utilization of generic and specialist inpatient services. METHOD: All patients admitted to a specialist ID psychiatric unit were evaluated on admission and immediately after discharge on a number of outcome measures. In addition, they were compared with those admitted to general adult mental health units covering the same catchment area. RESULTS: Significant improvements were demonstrated within the specialist unit cohort on measures including psychopathology, global level of functioning, behavioural impairment and severity of mental illness. The specialist unit patients had a longer length of inpatient stay but were less likely to be discharged to out-of-area residential placement. CONCLUSIONS: Specialist units are an effective care option for this group of people.

Adult↗

PubMedDate not supplied

Construction and psychometric properties of sexuality scales: sex knowledge, experience, and needs scales for people with intellectual disabilities (SexKen-ID), people with physical disabilities (SexKen-PD), and the general population (SexKen-GP).

This study reports on the development and assessment of the psychometric properties of three measures to assess sexual knowledge, experience, feelings, and needs. The first was designed to assess the Sexual Knowledge, Experience, Feelings, and Needs of people with mild intellectual disabilities (SexKen-ID). The two parallel measures were designed to assess the same areas of sexuality among people with physical disabilities (SexKen-PD) and among the general population (SexKen-GP). The areas of sexuality included in the scales were Friendship, Dating and Intimacy, Marriage, Body Part Identification, Sex and Sex Education, Menstruation, Sexual Interaction, Contraception, Pregnancy, Abortion and Child-birth, Sexually Transmitted Diseases, Masturbation, and Homosexuality. Generation of the items in these scales is described in Studies 1-3. Study 4 describes the evaluation of the psychometric properties of the scales. Sixty-six people with intellectual disabilities, 54 people with physical disabilities, and 100 people from the general population completed the scales. Test-retest reliabilities were also calculated with 30 people with intellectual disabilities, 30 people with physical disabilities, and 30 people from the general population. These data demonstrate the good psychometric properties of the scales and so their simitability for assessing the sexual knowledge, experience, feelings, and needs of people with disability.

Adult↗

PubMed2006

Color vision screening for individuals with intellectual disabilities: a comparison between the Neitz Test of Color Vision and Color Vision Testing Made Easy.

BACKGROUND: The Neitz Test of Color Vision (Neitz) and Color Vision Testing Made Easy(trade mark) (CVTME) were compared to determine which test was more effective in evaluating patients with intellectual disability (i.e., mental retardation) and developmental delay. METHODS: Two hundred eight Special Olympics floor hockey athletes were screened in San Diego, California, and 93 athletes were screened in Long Beach, California for a total of 301 athletes. Each athlete was administered the CVTME and the Neitz tests. RESULTS: The pass rate for the CVTME was 94.6% (n = 93) at Long Beach and 96.2% (n = 208) at San Diego. Every athlete was able to complete the CVTME. The pass rate for the Neitz was 38.7% at Long Beach and 56.7% at San Diego. Additionally, 10.8% of the Long Beach athletes and 12.5% of the San Diego athletes were unable to understand the Neitz. In addition, there was a low level of agreement between the results from the 2 tests with kappa = 0.081 for the San Diego data and 0.028 for the Long Beach data. CONCLUSIONS: This study suggests that the CVTME continues to be the screening test of choice in evaluating color vision in individuals with intellectual disability. The Neitz had more failing scores on the first attempt and more total failing scores leading to over-referrals, making it an inappropriate screening test for individuals with intellectual disability and developmental delay.

Adolescent↗

PubMed2006

Development of a measure to assess the impact of epilepsy on people with an intellectual disability: the Glasgow Epilepsy Outcome Scale - Client version (GEOS-C).

BACKGROUND: Epilepsy is common in people with intellectual disability, yet clinicians and researchers seldom obtain information directly from the client. The development and preliminary validation of a novel measure for use with people with mild to moderate intellectual disabilities is described. METHODS: Focus group methods (6 groups; 24 participants) identified issues of concern, and qualitative analysis (NUD*IST) was applied to derive items and themes for a draft scale. Psychometric scale development techniques were then used in a pilot study and subsequent field-testing to investigate validity and reliability (n = 46). RESULTS: A total of 148 issues of concern was reduced initially to 52 and then to 42 items using these methods. The derived scale comprised sub-scales reflecting (1) concerns about having seizures; (2) about injury; (3) about issues during; and (4) after seizures; (5) about medication; (6) about what people think; and (7) about daily life. Cronbach alpha for the Glasgow Epilepsy Outcome Scale - Client version (GEOS-C) was 0.92, and ranged from 0.64-0.81 for the sub-scales. Relatively weak associations (r <or= 0.40), between client and family carer, staff carer or clinician views, suggests that proxy reports are not good predictors of how people with epilepsy themselves are feeling. Preliminary validation suggests that the GEOS-C can discriminate on variables of clinical importance. CONCLUSIONS: The GEOS-C complements existing GEOS measures, can be completed in 5-15 min depending upon the level of support required, and may provide a valuable clinical and research tool. Further validational work and appraisal of sensitivity are required.

Activities of Daily Living↗

PubMed1994

A survey of aggressive behaviour among a population of persons with intellectual disability in Queensland.

A survey was conducted on aggressive behaviour within a population of 2412 persons with intellectual disability in Queensland, Australia. Two hundred and sixty-one individuals were identified who engaged in at least one form of aggressive behaviour, yielding an overall prevalence of 11%. The relative prevalence of aggressive behaviour was higher among institutionalized persons (35%) when compared to those living in group homes (17%) or other community-based facilities (3%). The aggressive behaviour sample included a higher percentage of males (64%). Most were described as functioning in the severe/profound (54%) or moderate (31%) range of intellectual disability with one-third having no intelligible speech. Two-thirds of the sample received medication for their challenging behaviour, while only one-third had behavioural programmes. Eighty per cent engaged in three or more forms of aggression. Many also displayed self-injury (34%) or property destruction (30%). Surveys of aggressive behaviour may prove useful for coordinating services.

Adolescent↗

PubMed2005

Use of electronic technologies by people with intellectual disabilities.

Today's electronic technologies, including computers, cell phones, Internet, and electronic organizers, hold great promise for individuals with intellectual disabilities, yet little research has been conducted to explore patterns of use among this population. Drawing upon a survey of 83 adults with intellectual disabilities, we examined factors affecting use for three key electronic technologies: computer, Internet, and electronic organizers. Forty-one percent of participants used a computer; 25%, the Internet; and 11%, electronic organizers. Age, work setting, and self-perceived ability to manually copy information affected likelihood of use. Primary barriers reported by participants included lack of access, training and support, and expense of technologies. Interest in using such technologies was high, and participants offered suggestions for improved accessibility.

Adolescent↗

PubMed1999

The prevalence of gastroesophageal reflux disease in institutionalized intellectually disabled individuals.

OBJECTIVE: The prevalence of gastroesophageal reflux disease (GERD) was randomly investigated among Dutch and Belgian intellectually disabled individuals. METHODS: In six institutes including 1607 residents, 435 persons with IQ <50 underwent 24-h esophageal pH-metry and were scored for possible predisposing factors and characteristic reflux symptoms. In 49 (11.2%) cases the test failed because of technical reasons. A pathological pH test was defined as a pH <4 for >4.5% of the measured time. Subjects with a pathological pH test (patients) were compared with those with a normal pH test (controls). RESULTS: Of the remaining individuals, 51.8% (200/386) showed a normal pH test, whereas 186 showed a pathological pH test (median duration pH <4: 14.2%, range: 4.5-78.4%). As possible predisposing factors scoliosis, cerebral palsy, use of anticonvulsant drugs or other benzodiazepines, and IQ <35 were found, whereas symptoms such as vomiting, hematemesis, rumination, and depressive symptoms were indicative for reflux. At endoscopy reflux esophagitis was diagnosed in 129 of the 186 patients (69.4%). In 61 (47.3%) of 129 patients, grade I, 43 (33.3%) grade II, 25 (19.4%) grade III/IV (Savary-Miller) were found. Barrett's esophagus was found in 18 (14.0%) and peptic strictures in five (3.9%) cases. CONCLUSIONS: An abnormal 24-h pH-metry and symptoms suggestive for GERD were documented frequently in a large cohort of institutionalized intellectually disabled individuals. Further endoscopical evaluation confirmed the diagnosis of reflux esophagitis in the majority of these individuals.

Adolescent↗

PubMed2000

Aging mothers and aging daughters: life-long caring and intellectual disability.

While aging and caring are well-discussed in academic literature, the association among aging, caring and intellectual disability is less well documented. This paper draws on a recently completed Australian study which focuses on such mother/daughter relationships and whose narratives form the framework for an argument for a re-imagining of the concept of care for aged people with intellectual disability. Specifically, using a genealogical approach, the paper describes how powerful discourses at the time of the daughter's birth (1940s and 1950s)--associated with eugenics, institutional care and motherhood--are framing the way in which aging mothers are now contemplating the future care for their adult (and also aging) daughters.

Aged↗

PubMed1999

Chronological age and crystallized intelligence of people with intellectual disability.

The influence of chronological age (CA) and fluid intelligence on the crystallized intelligence level of people with intellectual disability was studied in a group of 102 participants aged between 6 and 20 years. The results, which were based on their performance in 12 fluid and crystallized intelligence markers, indicate that the fluid intelligence factor and CA explain an important fraction of crystallized intelligence factor variance (43% and 21%, respectively). This finding provides support for the hypothesis that CA-related experience exerts a significant effect on the crystallized component of intelligence in people with intellectual disability.

Adolescent↗

PubMed2005

Factors affecting the likelihood that people with intellectual disabilities will gain employment.

The study aimed to identify factors that may affect the likelihood that people with intellectual disabilities will find employment through a supported employment agency. A retrospective analysis of the files of the last 200 individuals to use such an agency was carried out. Variables were identified that may influence outcome, such as demographic factors, job preferences and identified support needs. A specific rating of staff assessed client motivation was developed from written comments made by staff. Staff assessed motivation after two weeks on the scheme was found to be the only significant predictor of employment outcome. Motivation levels decreased for all groups of participants while at the agency, irrespective of work outcome. This study highlights that a greater emphasis on motivation within employment agencies may increase the chances of people with intellectual disability finding work.

Adult↗

PubMed1996

Quality of life in the families of young people with intellectual disabilities.

This paper reports on an investigation into quality of life in the families of young people with intellectual disabilities. Quality of life is an emerging area of research in nursing, therefore some of the theoretical issues in definition and measurement of quality of life are discussed. These issues include objective and subjective dimensions, and the neglected issue of the importance of these dimensions. Families with a member with an intellectual disability were found to have lower objective and subjective quality of life scores but were no different from the control group on the importance dimension. This finding implies that they have similar aspirations to other families but are unable to satisfy these aspirations. Implications of the findings of the study for policy makers and service delivery agencies are discussed.

Adolescent↗

PubMed2004

Distinctive MMN relative to sound types in adults with intellectual disability.

The effect of stimulus characteristics (vowel vs pure tone) upon mismatch negativity (MMN) was compared between adults with intellectual disability and healthy controls. Either vowels (synthesized vowels /e/ and /o/) or pure tones (1940 and 851 Hz corresponding to the F2 frequencies of /e/ and /o/, respectively) were presented using an oddball procedure. Both groups showed identical results in latency (vowel MMN>pure tone MMN) and less amplitudes for vowels. However, the disabled group demonstrated amplitude attenuation regardless of the stimulus type, although the vowel MMN amplitude showed a descending trend with age in both groups. These results suggest that auditory sensory memory in intellectual disability might have an insufficient capacity yet share a property common to controls.

Acoustic Stimulation↗

PubMed2005

Ageing and health issues in intellectual disabilities.

PURPOSE OF REVIEW: This review summarizes recent research and evidence-based practice and policy guidelines from 31 articles or books focused on the health of ageing individuals with intellectual disabilities. RECENT FINDINGS: Findings are presented under four headings that correspond to categories of health measures applied in recent EU evidence-based public health documents. Large group studies, notably longitudinal studies, have advanced knowledge of the health-related attributes of the population of older adults with intellectual disabilities and their distinctive health risks, including those linked to aetiologies. Empirical studies applying various research designs and literature reviews presented findings about weight and levels of physical activity, prevalent health problems (e.g. high levels of sensory impairment, risk factors for coronary artery disease) and other aspects of the health status of this population. Efforts to improve assessment methods for dementia continue. Evidence from small group studies in Israel and the USA suggests that interventions to increase physical activity and functioning of older adults may be beneficial. Pharmacological studies consider treatments for dementia as well as widespread prescription of medications to manage challenging behaviours. Health system issues include access to health care, training for health professionals, support for family care givers, end of life care and more cohesive national health policies. SUMMARY: Health-related research in older people with intellectual disabilities has extended our understanding of the characteristics of this population relative to other groups of older individuals and to national populations in terms of health status, determinants of health and priorities for policy and practice.

Journal Article↗

PubMed2002

Risk assessment in offenders with intellectual disability: the evidence base.

A review of the current literature on risk assessment and management in offenders with intellectual disability (ID) revealed little direct evidence for the specific population. Theoretical models and non-ID populations have been abstracted and adapted, but not validated, for those with ID. The varying conceptual frameworks of risk, and its assessment and management, must be considered in context. Difficulties remain with the consideration of offences versus offence-like behaviour, offender versus those with similar needs, and indeed, what is regarded as 'intellectual disability'. Mainstream forensic assessment has moved towards a more dynamic appreciation of risk and risk management, as opposed to risk elimination. This development is more in line with the normalization principles of 'risk-taking' in ID. Consideration is given to future research and development priorities.

Comorbidity↗

PubMed2004

[Japanese physicians'attitude for utilization of social support services for persons with intellectual disabilities].

We assessed physicians'attitude for the utilization of social (medical, educational, and financial) support services for persons with intellectual disabilities supplied by the Japanese government. A total of 113 physicians specializing in pediatric neurology answered our mail-in questionnaire. Medical care benefits for psychiatric outpatients and short-time stay were the most common services utilized. Whereas most physicians used various public support services regardless of their experience and affiliations, the selection of services by an individual physician correlated with the number and state of patients they usually cared. Physicians were less familiar with the services regarding residential or community care and advocacy. Knowledge of the specialists on each service will enrich assistance appropriate to the life styles of each patient with intellectual disabilities.

Child↗