PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Intellectual Disability”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,495 records · Page 83Linked to original sources

Language dysfunction in epileptic conditions.

Epilepsy may disrupt brain functions necessary for language development by its associated intellectual disabilities or directly as a consequence of the seizure disorder. Additionally, in recent years, there has been increasing recognition of the association of epileptiform electroencephalogram (EEG) abnormalities with language disorders and autism spectrum disorders. Any process that impairs language function has long-term consequences for academic, social, and occupational adjustments in children and adolescents with epilepsy. Furthermore, impairments in specific language abilities can impact memory and learning abilities. This article reviews interictal language function in children and adults with epilepsy; epilepsy surgery and language outcome; and language disorders associated with abnormal EEGs. The relationship between epilepsy and language function is complicated as the neuroanatomic circuits common to both overlap. We demonstrate how magnetoencephalography (MEG) offers the ability to analyze the relationship of language, EEG abnormalities, and epilepsy.

Adolescent↗

Levodopa responsive Parkinsonism in adults with Angelman Syndrome.

Two intellectually disabled adults with Angelman Syndrome are reported who developed intermittent episodes of a severe resting tremor, cogwheel rigidity and bradykinesia in their late teens. The Parkinsonism was not due to medications and there was a dramatic improvement with levodopa therapy. The association between Angelman Syndrome and Parkinsonism has not previously been described.

Adult↗

The characteristics of patients with encephaloceles.

Some of the intellectual, physical and family characteristics of 72 patients with encephaloceles were examined. Their numbers reached a peak in the 1960s and have declined dramatically since then. 70% of the patients were female. Many of the children had additional problems including hydrocephalus (34%), severe visual impairments (34%), inability to walk (21%), and urinary incontinence (13%). Their mean IQ was 65.2, and the males tended to be more physically and intellectually disabled than the females.

Child↗

Early diagnosis of Murray Valley encephalitis by reverse transcriptase-polymerase chain reaction.

A 4-year-old aboriginal boy developed encephalitis due to Murray Valley encephalitis virus (MVE) following an earlier infection with Kunjin virus (KUN). The illness was severe, resulting in cerebral atrophy and profound physical and intellectual disability. The earlier KUN infection complicated his serological profile and delayed antibody responses to MVE. By contrast, the reverse transcriptase-polymerase chain reaction (RT-PCR) assay detected MVE in serum 3 days after the onset of illness and 4 days before the appearance of MVE-specific IgM. We suggest that MVE-specific RT-PCR provides rapid and specific diagnosis of MVE and should be used more widely for the diagnosis of acute viral encephalitis in cases originating from flavivirus endemic areas.

Antibodies, Viral↗

Exploring visual-graphic symbol acquisition by pre-school age children with developmental and language delays.

The process of language acquisition requires an individual to organize the world through a system of symbols and referents. For children with severe intellectual disabilities and language delays, the ability to link a symbol to its referent may be a difficult task. In addition to the intervention strategy, issues such as the visual complexity and iconicity of a symbol arise when deciding what to select as a medium to teach language. This study explored the ability of four pre-school age children with developmental and language delays to acquire the meanings of Blissymbols and lexigrams using an observational experiential language intervention. In production, all four of the participants demonstrated symbol-referent relationships, while in comprehension, three of the four participants demonstrated at least emerging symbol-referent relationships. Although the number of symbols learned across participants varied, there were no differences between the learning of arbitrary and comparatively iconic symbols. The participants' comprehension skills appeared to influence their performance.

Child, Preschool↗

Having friends and Rett syndrome: how social relationships create meaningful contexts for limited skills.

PURPOSE: The experiences of a teenage girl with Rett syndrome who was being educated in an inclusive middle school are described to provide a better understanding of how social relationships create meaningful contexts for individuals with limited skills. The case example is used to illustrate the principle that contexts (including expectancies, acceptance, philosophical principles) can be designed to support meaningful social relationships, despite social and intellectual disabilities. METHOD: Naturalistic observations of social interactions over a two year period are reported to illustrate the possible types of social relationship between this young person and her adolescent friends and peers. RESULTS/CONCLUSIONS: While someone with this syndrome might be judged objectively to have minimal social skills, an accepting social environment willing to read minimal communicative cues provided the context for many typical social interactions. Since contexts require subjective judgement. the post-modern concept that disability represents a social construction can be viewed as a metaphor compatible with the reality that careful planning and structuring of the environment is in some instances the most appropriate intervention focus rather than the person with a disability. The sorts of positive friendship experiences described in this paper did not occur spontaneously, or by chance alone, nor were they the result of social skills instruction. Instead, they were associated with observable social behaviour by caregivers and peers who were extending their own repertoires to accommodate someone objectively determined to have a severe disability.

Activities of Daily Living↗

Towards a full life with Rett disorder.

In 1999, mutations in the gene methyl CpG2 (MECP2) were found to be the cause of the profoundly intellectually disabling Rett syndome. Through the combined efforts of laboratory and clinical scientists, therapists, educators and the families of affected people, many of its underlying anatomical, neurochemical, physiological and functional associations are now known, and some practical experience has been gained in therapeutic intervention. It is clear that there is considerable potential for reduced dependence and the provision of a happy and interesting life in this developmental disorder and there remains a need to identify the neural mechanisms which are available to people with Rett and to ensure that appropriate services are accessible.

Adolescent↗

Young people with Down syndrome: a preliminary investigation of health knowledge and associated behaviours.

BACKGROUND: Adults with intellectual disability have a range of significant health problems. If they are to live independently, they need to engage in behaviours that are health promoting, as well as avoiding behaviours that might directly lead to ill health. There is very little research about health-related knowledge and behaviour in this group. METHOD: A group of 38 adolescents with Down syndrome (DS) and their families participated in this study. A semi-structured interview and a series of tasks were used to collect data on individuals' health knowledge and behaviour relating to 4 aspects of health: hygiene, substance use, exercise and healthy eating. RESULTS: While the majority of young people demonstrated some awareness of basic hygiene, they were not yet at the level where these behaviours could be guaranteed to occur without parental support. Knowledge about substance use, exercise and healthy food was generally poor. CONCLUSION: Knowledge of most aspects of health assessed in this study was poor and pointed to a gap in the preparation of these young people for independent living.

Activities of Daily Living↗

Musculoskeletal pain in adults with cerebral palsy compared with the general population.

OBJECTIVE: To examine prevalence and localization of musculo-skeletal pain in adults with cerebral palsy compared with the general population and to investigate variables potentially associated with pain. DESIGN: A postal survey. SUBJECTS: Persons with cerebral palsy and no intellectual disabilities, 18 years or more, living in Norway. METHODS: A multidimensional questionnaire, including items on musculo-skeletal pain, was sent to 766 adults with cerebral palsy. RESULTS: In total 406 persons responded, 49% females and 51% males age range 18-72 years (mean 34 years). All categories of cerebral palsy were represented. Nearly one-third of the adults with cerebral palsy had chronic pain, vs 15% in the general population. Mean scores of domain of bodily pain on Short Form 36 were significantly lower from an earlier age in adults with cerebral palsy. Back pain was the most common in both groups. Pain in adults with cerebral palsy was significantly associated with gender, chronic fatigue, low life satisfaction and deteriorating physical function. CONCLUSION: Musculo-skeletal pain is a pronounced problem in adults with cerebral palsy from an early age, and should be addressed specifically in the follow-up programs, and in further clinical studies on potential causal pathways.

Adolescent↗

Mendelian disorders of the epigenetic machinery: a decade of insights into the molecular basis.

The Mendelian disorders of the Epigenetic Machinery (MDEMs), or Chromatinopathies, are now understood to be a collectively common cause of childhood neurodevelopmental delays and intellectual disability. In the past decade, the chromatin and gene expression consequences of heterozygous chromatin regulator disruption have been investigated in various disease models, yielding insights into the molecular pathogenesis of MDEMs. In this review, we highlight some of these results - drawing upon studies of representative MDEMs - together with potential unifying concepts. We propose that MDEMs are characterized by distributed, often subtle chromatin and gene expression perturbations, which impact diverse cellular pathways and processes and are frequently shared between distinct disorders. In this sense, they occupy an intermediate space between classical monogenic disorders and complex traits. We propose potential explanations for the variable expressivity in MDEMs and conclude by considering how technological advances can now enable a deeper and more precise mechanistic characterization of this important Mendelian disease group.

Humans↗

Responding to serious and complex mental health problems in youth: the role of an interagency forum.

OBJECTIVE: To review the origins, processes, clientele and outcomes of a child and youth interagency forum, a collaborative response to children and youth with severe and complex presentations. METHODS: After a description of the Forum origins, membership and processes, both qualitative and quantitative information is provided on the Forum clientele. The Forum's effectiveness is considered in terms of changes in services provided to this group, as well as changes in agency and interagency work practices. RESULTS: Forum clients were predominantly boys aged 12 years, with an overrepresentation of indigenous and intellectually disabled children. Few lived with biological parents, and on average had experienced five schools, 11 or more residential placements and were involved with six agencies. Disruptive behaviour symptoms were common, as were suicidal thoughts or actions (43%), history of physical (50%) or sexual abuse (21%), alcohol (29%) and drug use (14%). On average Forum clients were taking three psychotropic medications. Forum client impairment ranged from major impairment to gross impairment across several domains. CONCLUSIONS: While this is not a formal outcome study, evidence suggesting Forum usefulness included qualitative feedback from agencies, altered clinical and interagency practices, and decreased client impairment. Practical interventions for clients with chronic, complex multidomain impairments are discussed in the context of current Australian child and adolescent mental health services.

Achievement↗

Defining effective community support for long-term psychiatric patients according to behavioural principles.

OBJECTIVE: The purpose of this article is to define the characteristics of effective support in community mental health settings for patients with serious and persistent mental illness. METHOD: A broad literature providing empirical evidence on competent caregiver behaviours and styles is selectively reviewed. Relevant findings from family caregiver research and studies of social environments that enhance skill development in people with intellectual disabilities are incorporated, within a cognitive-behavioural framework. RESULTS: Six important domains are identified which represent positive caregiver styles: acceptance, creating a positive atmosphere, expectations of change, responsiveness, normalisation and educativeness. CONCLUSION: The characteristics hypothesised to be critical for caregivers and support workers are defined in a general way that can allow for individualisation according to the goals of the programs and the cultural priorities of staff and patients. Further empirical validation of these characteristics would enable community mental health services to provide more specialised clinical treatments.

Cognitive Behavioral Therapy↗

Comprehensive mutation analysis of TSC1 and TSC2-and phenotypic correlations in 150 families with tuberous sclerosis.

Tuberous sclerosis (TSC [MIM 191090 and MIM 191100]) is an autosomal dominant disorder characterized by hamartomas in many organs. Two thirds of cases are sporadic and are thought to represent new mutations. TSC is caused by mutations affecting either of the presumed tumor-suppressor genes, TSC1 and TSC2. Both appear to function as tumor suppressors, because somatic loss or intragenic mutation of the corresponding wild-type allele is seen in the associated hamartomas. Here we report the first comprehensive mutation analysis of TSC1 and TSC2 in a cohort of 150 unrelated TSC patients and their families, using heteroduplex and SSCP analysis of all coding exons and using pulsed-field gel electrophoresis and conventional Southern blot analysis and long PCR to screen for large rearrangements. Mutations were characterized in 120 (80%) of the 150 cases, affecting TSC1 in 22 cases and TSC2 in 98 cases. TSC1 mutations were significantly underrepresented in sporadic cases (P=. 000185). Twenty-two patients had TSC2 missense mutations that were found predominantly in the GAP-related domain (eight cases) and in a small region encoded in exons 16 and 17, between nucleotides 1849 and 1859 (eight cases), consistent with the presence of residues performing key functions at these sites. In contrast, all TSC1 mutations were predicted to be truncating, consistent with a structural or adapter role for the encoded protein. Intellectual disability was significantly more frequent in TSC2 sporadic cases than in TSC1 sporadic cases (P=.0145). These data provide the first representative picture of the distribution and spectrum of mutations across the TSC1 and TSC2 loci in clinically ascertained TSC and support a difference in severity of TSC1- and TSC2-associated disease.

Blotting, Southern↗

A locus for bilateral perisylvian polymicrogyria maps to Xq28.

Polymicrogyria (PMG) is one of a large group of human cortical malformations that collectively account for a significant percentage of patients with epilepsy, congenital neurological deficits, and intellectual disability. PMG is characterized by an excess of small gyri and abnormal cortical lamination. The most common distribution is bilateral, symmetrical, and maximal, in the region surrounding the sylvian fissures, and is known as "bilateral perisylvian polymicrogyria" (BPP). Most cases are sporadic, although several families have been observed with multiple affected members, usually following an X-linked inheritance pattern. Here we report the first genetic locus for BPP mapped by linkage analysis in five families. Linkage places the critical region for BPP at Xq28 (LOD score 3.08 in Xq28, distal to DXS8103 by multipoint analysis). We suggest that this region contains a gene that is necessary for correct neuronal organization and that the identification of this gene will both enhance our understanding of normal cortical development and accelerate the identification of other genes responsible for PMG.

Cerebral Cortex↗

ARX mutation-associated interneuron defects provide insights into mechanisms underlying developmental epilepsies.

Cortical interneuron (cIN) dysfunction is associated with various neurodevelopmental and neurological disorders, including developmental epilepsies, autism spectrum disorders and intellectual disabilities. Mutations in ARX (aristaless-related homeobox) are linked to these conditions, with or without accompanying structural brain anomalies. We previously demonstrated that the loss of Arx in the mouse ganglionic eminence, the birthplace of cINs, is associated with seizures, whereas its loss in cortical excitatory neuron progenitor cells results in structural anomalies but no seizures. To elucidate the pathophysiological role of ARX in cINs and its relationship to seizure phenotype, Arx conditional mutant mouse lines were investigated using Gad2- and Nkx2.1-Cre drivers to target distinct populations in the cIN lineage. Our data demonstrate that ARX abrogation results in defects in cIN density and distribution, as well as perinatal lethality. In these mice, we observed defects in cell cycle exit, a biased loss of the marginal zone migration stream of cINs, shifts in cell fate from caudal ganglionic eminence to medial ganglionic eminence identity, and a reduced number of parvalbumin⁺ and somatostatin⁺ cINs, with parvalbumin⁺ cINs being more severely affected. Single-cell RNA sequencing combined with chromatin immunoprecipitation and sequencing revealed that ARX regulates key processes involved in cell cycle progression, cIN subtype differentiation and cIN migration. Investigation of one downregulated target gene, Lmo1, uncovered a potential mechanism by which ARX regulates the number and distribution of cINs in the cortex. Cortical slice cultures demonstrate that LMO1 inhibits cIN migration by repressing Cxcr4 expression, which encodes a key receptor involved in cortical guidance. These data indicate that ARX positively regulates cIN migration by derepressing LMO1's repressive role. Consistent with our mouse model, we observed a significant loss of parvalbumin+ and somatostatin+ cINs in the brain of a patient carrying a pathogenic variant of ARX, who was diagnosed with developmental epileptic encephalopathy. Together, our data provide novel insights into how ARX and its target genes regulate cIN development and migration and into the pathogenic mechanisms underlying a spectrum of neurodevelopmental disorders linked to loss of ARX.

Animals↗

The four ages of Down syndrome.

BACKGROUND: Down syndrome (DS) affects approximately 1 per 650-1000 live births and is the most common known genetic cause of intellectual disability. A highly significant change in the survival of people with DS has occurred during the last two generations, with life expectancy estimates increasing from 12 to nearly 60 years of age. SUBJECTS AND METHODS: Detailed information on 1332 people in Western Australia with DS was abstracted from a specialist statewide database for the period 1953-2000 and electronically linked with three other state or national health and mortality data sources and the state Birth Defects Registry. RESULTS: Over the last 25 years the percentage of women over 35 years giving birth increased from 4.8 to 18.6%, accompanied by an increase in the overall prevalence of DS from 1.1 to 2.9 per 1000 births. Four life stages of DS were identified: prenatal, childhood and early adulthood, adulthood, and senescence. Although pneumonia, or other types of respiratory infections, was the most common cause of death across the entire lifespan, ranging from 23% of deaths in adulthood to 40% in senescence, each life stage exhibited a particular profile of comorbidities. Congenital heart defects were common causes in childhood (13%) and adulthood (23%), whereas in senescence coronary artery disease (10%) and cardiac, renal, and respiratory failure (9%) were leading causes of mortality. CONCLUSIONS: A major re-appraisal in attitudes towards DS is required to ensure that the medical and social needs of people with the disorder are adequately met across their entire lifespan. In particular, specific recognition of the comorbidities that can arise at different ages is needed, accompanied by the provision of appropriate levels of care and management.

Abortion, Induced↗

Duplication-based genetic dissection of the Down syndrome critical region reveals its complex functional organization.

Down syndrome (DS), associated with trisomy 21, is the most common genetic cause of developmental delay and intellectual disability, yet the specific dosage-sensitive genes and the associated genetic mechanisms underlying these phenotypes remain incompletely defined. Here, we applied an additive genetic strategy to dissect the Down syndrome critical region (DSCR) by generating 2 complementary mouse models using Cre/loxP-mediated chromosome engineering that together span the entire DSCR on mouse chromosome 16: Dp(16)5Yey, duplicating the Setd4-Kcnj6 interval, and Dp(16)6Yey, duplicating the Kcnj15-Mx2 interval. In addition, we engineered a third duplication model, Dp(16)7Yey, carrying a selective duplication of the Dyrk1a-Kcnj6 interval containing only these 2 genes. Building upon our previously reported results, cognitive behavioral analyses of these 3 models reveal a complex functional genetic architecture of the DSCR, including dosage-sensitive genetic elements, interactions among these elements, and their contributions to DS-associated cognitive deficits. Together, these findings highlight the complexity of dosage-dependent genetic interactions, which provide important insights into DSCR functional organization and have major implications for the development of effective therapeutic strategies for DS-associated cognitive deficits. In addition, these duplication mouse models represent valuable resources for further genetic dissection of DS phenotypes beyond cognition.

Animals↗

Adjustment of siblings of handicapped children: a comparison.

Compared 55 older siblings (ages 7 1/2 to 15 years) of young handicapped children (ages 1-7 years) with 55 matched siblings of nonhandicapped children. Results of standardized children's assessment scales show that siblings of handicapped children are comparable to siblings of nonhandicapped children in self-concept, behavior problems, and social competence. Differences, however, appear along certain psychological dimensions and great variations exist within each group of siblings. Further, demographic and personal attributes are differentially related to measures of adjustment in different groups of siblings. Implications for research and intervention are drawn.

Adaptation, Psychological↗