Parents Plus Programme 1: Evaluation of Its Effectiveness for Pre‐School Children with Developmental Disabilities and Behavioural Problems

Background This study aimed to evaluate the effectiveness of the Parents Plus programme with families of pre‐school children with developmental disabilities and significant behavioural problems in the Irish health service. The Parents Plus programme is a group‐based parent training package involving video modelling, which was designed to be effective for children with conduct problems, but without developmental disabilities. Materials and methods Pre‐ and post‐treatment assessments were conducted with 22 treated cases and 19 waiting‐list controls with a protocol that included the Strengths and Difficulties Questionnaire, the Child Behaviour Checklist, the General Health Questionnaire‐12, the Kansas Parental Satisfaction Scale, the Family Assessment Device, the Perceived Social Support Scale, the Family Inventory of Life Events and Changes, the Parenting Stress Index and the Questionnaire on Resources and Stress. Results Following the treatment, a comparison of treatment and control group means showed that the treated group showed better adjustment on the total difficulties scale of the Strengths and Difficulties Questionnaire. These gains were maintained at 10‐month follow‐up. Fifty per cent of treated cases showed clinically significant improvement and 14% showed reliable change on the Strengths and Difficulties Questionnaire. The treatment group reported a high level of satisfaction with the Parents Plus programme and showed significant goal attainment after treatment and at follow‐up. Conclusions For some families of pre‐school children with developmental disabilities and significant behavioural problems, the Parents Plus programme is an effective intervention and may be incorporated into routine early intervention clinics in the Irish health service.     

The Relationship Between Respite Care and Child Abuse Potential in Parents of Children with Developmental Disabilities: A Preliminary Report

This study longitudinally examined the impact of respite care services on child abuse potential and family relations in a sample of parents (N = 14) whose children were admitted for respite care to a center for developmental disability. A sample of parents (N = 18) whose children were admitted for short-term hospitalization (STH) was used as a contrast group. In addition, we examined the interrelationships between child abuse potential, family relations, and parenting stress at 3 time points. Parents completed measures of child abuse potential, family relations, and parenting stress at time of admission, discharge, and at a 2-month follow-up. Results indicated that neither respite care nor STH resulted in significant effects on child abuse potential or family relations although trends were found in the expected direction. Strong interrelationships were found between child abuse potential, family relations, and parenting stress at each of the 3 time points. These preliminary results suggest that respite care may be insufficient to directly impact child abuse potential; however, interventions that target variables related to abuse (e.g., quality of family relations, parenting stress) might be beneficial.     

Cognitive Functioning of Children with Severe Intellectual Disabilities and Children with Deafblindness: A Study of the Perceptions of Teachers and Parents in the USA and India

Background Teachers and parents play a very important role in providing valuable information for the assessment of children with severe disabilities. The needs of children, educational goals, and parental aspirations are similar irrespective of the part of the globe they live in. This study focused on the perceptions of teachers and parents of children with severe intellectual disability and children with deafblindness in the USA and India. Method A total of 125 teachers and parents from both countries formed the participants for the study. A questionnaire of 13 yes/no items with space for narrative comments was administered to participants. Results Analysis of the yes/no questions revealed that many of the perceptions of the participants were similar in both countries. Furthermore, the examples cited in the narrative were also similar across both countries. The teachers in this study tended to credit performance more readily than parents and teachers were more likely to report emerging skills and teaching strategies. The narratives highlighted the importance of functional assessment in the child’s natural environment over time to most fully capture the child’s present abilities and potential. Conclusions While detailed study with larger samples is necessary, the present study implies that it may be possible to develop assessment tools that can be used across countries for educational planning.     

Psychosocial Problems Among Siblings of Children with Disabilities in Japan: Psychosocial Association Between Mothers and Siblings

We conducted a questionnaire survey to evaluate the psychosocial condition of siblings of children with disabilities in Japan. The participants were 50 siblings (aged 5–12, male = 42.0%) of children with disabilities and their parents as well as a control group consisting of 128 elementary school pupils (aged 6–12, male = 57.4%) and their parents. The proportion of mothers of children with disabilities suffering from a minor psychiatric illness and the proportion of corresponding siblings with psychosocial problems were significantly higher in the test group than in the control group, and a multiple logistic regression analysis indicated that mothers suffering from a minor psychiatric illness were significantly associated with siblings with psychosocial problems among families of children with disabilities. We discuss the psychosocial problems of siblings of children with disabilities.     

Behavioural sleep problems in children and adults with intellectual disabilities: An integrative literature review

Background

People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well-being.

Methods

An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015.

Results

Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability.

Conclusion

A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep.     

Preference Assessment in Toddlers with Mild Developmental and Physical Disabilities: A Comparative Study

In this study, a preference assessment involving presentation of pairs of toys was conducted with 10 toddlers with mild developmental and physical disabilities and a matched control group of 10 nondisabled toddlers. An exploration phase preceded the preference assessment. Our main findings were that (a) the pair-wise presentation method yielded a significant rank ordering of preferences in developmentally disabled toddlers, but not in the nondisabled toddlers; (b) dynamic toys were more preferred than nondynamic toys in disabled toddlers; but not in the nondisabled toddlers; and (c) for both nondisabled and disabled toddlers, the rank order of preferences established by the pair-wise presentation method did not significantly correlate with the rank order of preferences reported by the toddlers' parents and teachers.     

Including Children with Intellectual Disabilities/Special Educational Needs into National Child Health Surveys: A Pilot Study

Background The language, format and length of typical national health survey questionnaires may make them inaccessible to many school‐aged children with an intellectual disability. Materials and Methods Using the standard delivery protocol, the WHO Health Behaviour in School‐aged Children (HBSC) Questionnaire, currently in use in 43 countries, was administered to 46 children (11–17 years) with intellectual disabilities of varying severity who were attending two special (i.e. non‐mainstream) schools. Two alternative administration procedures were subsequently piloted with a purposive subsample of 15 of these pupils. Results Using the standard protocol, just over half of the children were able to ‘complete’ the survey questionnaire, although a high proportion of their responses proved to be uncodable. Using modified procedures, both completion rates and codable response rates were markedly increased. Conclusions With relatively easy‐to‐achieve (albeit time‐consuming) procedural modifications, it is possible to collect data on a wide range of health‐related issues from a pupil group otherwise at risk of exclusion from school‐based national surveys. Confidentiality issues remain, however, as do concerns about accuracy of reporting in some areas, including perceived well‐being.     

Comparing Offenders against Women and Offenders against Children on Treatment Outcome in Offenders with Intellectual Disability

Background Several studies have shown the positive effects of sex offender treatment for men with intellectual disabilities who have perpetrated sex offences or inappropriate sexual behaviour. The present study investigates the process of treatment change and compares two groups of offenders against adults and offenders against children. Method Participants comprised of 15 men who had offended against adult women and 15 who offended against children. All were treated for 36 months. Groups were compared with repeated measures using the Questionnaire on Attitudes Consistent with Sexual Offending. Results At baseline, offenders against women had higher scores than offenders against children on the Rape scale while on the offences against children scale the opposite was the case. Both groups showed significant improvement with scores reducing to levels consistent with non‐offenders by 36 months. Significant improvements were still recorded from 18 to 36 months of treatment. Re‐offending across both groups was 23%. Conclusion Sex offender treatment can produce significant reductions in cognitive distortions in sex offenders with intellectual disabilities. The importance of continuing treatment for longer than 12 months was endorsed by the results.     

Parental mentalising among mothers with intellectual disability or ADHD: Links with experiences of abuse,neglect and psychosocial risk

Background

Parental mentalising difficulties are robustly linked to caregiving problems. Mothers with intellectual disability are at risk for caregiving problems, but knowledge on their parental mentalising abilities is lacking. The present study aimed to fill this gap.

Method

Thirty mothers with mild intellectual disability, and 61 comparison mothers with ADHD, were assessed for parental mentalising using the Parental Reflective Functioning Questionnaire. Contributions of intellectual disability, maternal exposure to childhood abuse/neglect and psychosocial risk to parental mentalising were examined through hierarchical regression analysis.

Results

Mothers with intellectual disability had a heightened risk for parental mentalising difficulties, in the form of elevated prementalising. Intellectual disability and cumulative childhood abuse/neglect uniquely predicted prementalising among the mothers, whereas cumulative psychosocial risk added to the risk for prementalising specifically among mothers with intellectual disability.

Conclusions

Our findings support contextual models of caregiving, and suggest a need for mentalisation-based support for parents with mild intellectual disability.     

Families of Children with Developmental Disabilities: Assessment and Comparison of Self-Reported Needs in Relation to Situational Variables

Parents of children with a developmental disability completed a survey that sampled self-reported needs (information, support, giving explanations to others, community services, finances, and family functioning) in relation to situational variables, such as age (child and parents), type of educational service received by the child, number of siblings, marital status of parents, family income, parents' level of education, and the family's participation in support services. Families of younger children were found to have the greatest overall needs. Increased number of hours per week of employment by fathers was associated with reduced needs. There also was less reported need by families who had a child enrolled in a residential-care setting. These findings extend the assessment of family needs to a population and age of children not addressed in previous research. Recommendations for the types of professional services that should be offered to families on the basis of an assessment of need are presented and discussed.     

Predicting Change in Emotional and Behavioural Problems during Inpatient Treatment in Clients with Mild Intellectual Disability

Background Little is known about client characteristics that are related to outcome during inpatient treatment of adults with mild intellectual disability (ID) and severe behavioural problems. Method We explored variables that were related to a change in behavioural problems in 87 individuals with mild ID during inpatient treatment in facilities for adults with mild ID and severe behavioural problems. Emotional and behavioural problems were measured using the Adult Behaviour Checklist (ABCL) and relationships between a change in ABCL total scores and other variables (e.g. age, adaptive skills, and presence of personality disorder) were explored. Results For the sample as a whole, we found a decrease in emotional and behavioural problems within a 1‐year period of inpatient treatment (following a 3‐month observation and diagnostic period). Male clients, clients without a personality disorder classification, and/or clients who showed more improvement in adaptive and social functioning, showed a larger decrease in emotional and behavioural problems than other clients. Gender and personality disorder classification appeared to be the most important predictive factors. Conclusion Clients with mild ID and severe behavioural problems may benefit from inpatient treatment. Those with a personality disorder and/or female clients may benefit less from such a program. Results of such studies may have consequences for service provision and management. Limitations of this study were the lack of data on the quantity and quality of the treatment package and unknown reliability and validity of Axis‐I and personality disorder diagnoses.