Maternal distress and expressed emotion: cross-sectional and longitudinal relationships with behavior problems of children with intellectual disabilities

Mothers of children with intellectual disability were assessed at two time points, 2 years apart (n = 75 at Time 1, n = 56 at Time 2). Data were gathered on maternal distress, mental health, expressed emotion, and the child's internalizing and externalizing behavior problems. Consistent with previous research with families of children who have intellectual disability, maternal distress and children's behavior problems entered into a bidirectional relationship over time. This relationship was found to be specific to externalizing problems. Exploratory analyses also suggest that maternal distress and depression had a bidirectional longitudinal relationship. In terms of maternal expressed emotion, criticism and not emotional over-involvement was cross-sectionally but not longitudinally related to children's externalizing behavior problems and to maternal distress.     

Working memory performance in children with and without intellectual disabilities

Performance on working memory span tasks by children with intellectual disabilities ages 11 to 12 was compared to that of CA- and MA-matched controls. Limited evidence was available to support a "difference" position, whereby the intellectual disabilities group obtained lower scores than both the CA and MA groups. Some evidence was found for the "developmental" position, whereby the intellectual disabilities group performed at the same level as the MA group but more poorly than the CA-matched group. Finally, some evidence supported an unconventional "difference" account; children in the intellectual disabilities group performed better than the MA group, although still not as well as the CA-matched group. Results were interpreted with reference to the role of strategies in working memory performance.     

Social skills in children with intellectual disabilities with and without autism

Background Social skills were studied in 363 children with mild intellectual disabilities (ID) and 147 with moderate ID with and without autism (age 4 through 18). The objective was to investigate the value of the Children's Social Behaviour Questionnaire (CSBQ), as a measure of subtle social skills, added to a measure of basic social skills with the Vineland Adaptive Behaviour Scales (VABS), in identifying children with ID with or without autism. Method Children with mild and moderate ID, with and without autistic symptomatology were compared on basic social skills, measured with the Communication and Socialization domains of the VABS, and subtle social skills, measured with the CSBQ. Results Measuring basic social skills is not sufficient in differentiating between levels of ID. Communicative skills and subtle social skills, that concern overlooking activities or situations and fear of changes in the existing situation, seem to play a far greater role. Additionally, with respect to identifying autistic symptomatology, basic social skills do not contribute, as opposed to communicative skills and the tendency to withdraw from others. Conclusions The results implicate that the CSBQ not only has specific value as a measure of subtle social skills to identify pervasive developmental disorders, but that the instrument also has a specific contribution to differentiating between the two levels of ID. Furthermore, our outcomes imply a slight difference between limitations in subtle social skills as mentioned by the AAMR (American Association on Mental Retardation 2002 ) and limitations in subtle social skills as seen in milder forms of pervasive developmental disorders. Clinical and theoretical implications will be discussed.     

Understanding of facial expressions of emotion by children with intellectual disabilities of differing aetiology

Background Interpreting emotional expressions is a socio‐cognitive skill central to interpersonal interaction. Poor emotion recognition has been reported in autism but is less well understood in other kinds of intellectual disabilities (ID), with procedural differences making comparisons across studies and syndromes difficult. This study aimed to compare directly facial emotion recognition skills in children with fragile X syndrome (FXS), Down's syndrome (DS) and non‐specific intellectual disability (NSID), contrasting ability and error profiles with those of typically developing (TD) children of equivalent cognitive and linguistic status. Methods Sixty children participated in the study: 15 FXS, 15 DS, 15 NSID and 15 TD children. Standardised measures of cognitive, language and socialisation skills were collected for all children, along with measures of performance on two photo‐matching tasks: an ‘identity‐matching’ task (to control for basic face‐processing ability) and an ‘emotion‐matching’ task (happiness, sadness, anger, surprise, fear or disgust). Results Identity‐matching ability did not differ across the four child groups. Only the DS group performed significantly more poorly on the emotion‐matching task and only in comparison to the TD group, with fear recognition an area of particular difficulty. Conclusion Findings support previous evidence of emotion recognition abilities commensurate with overall developmental level in children with FXS or NSID, but not DS. They also suggest, however, that syndrome‐specific difficulties may be subtle and detectable, at least in smaller‐scale studies, only in comparison with TD matches, and not always across syndromes. Implications for behavioural phenotype theory, educational interventions and future research are discussed.     

Sensory processing dysfunctions as expressed among children with different severities of intellectual developmental disabilities

High frequency of sensory processing dysfunctions (SPD) is prevalent among children with intellectual developmental disabilities and contributes to their maladaptive behaviors. However, the knowledge about the expressions of SPD in different levels of IDD severity is limited. As SPD may reduce adaptive responses and limit participation, this knowledge should be elaborated. The purpose of the present study was to examine the specific expressions of sensory processing among children with different severity levels of IDD. Participants were 91 children aged 4-9 years with mild, moderate severe-profound and IDD. Their parents completed the short sensory profile (SSP). According the results, SPD were manifested across all levels of IDD. Groups differed in specific behaviors related to sensory stimuli. The highest percentage of children with severe sensory processing difficulties was found among children with mild and sever IDD level. SPD may characterize children with all severity levels of IDD. Nevertheless, the probability that children with a specific IDD level will be more vulnerable to specific aspects of SPD emphasizes the need for early evaluation and intervention to address the specific sensory needs of children with different IDD levels. This may enhance their development, performance and participation in daily living.     

Behavior problems in children with mild intellectual disabilities: An initial step towards prevention

To develop prevention activities, an analysis is conducted of child and parent characteristics that occur significantly more often among children with a mild intellectual disability and behavior problems than among children with a mild intellectual disability and no behavior problems and their families. The sample consisted of 45 children attenting schools for special education. Data were collected from the children, their parents, and their teachers. The instruments used are the Dutch version of the Parenting Stress Index, the Nijmegen Child-Rearing Situation Questionnaire and the Strenghts and Difficulties Questionnaire for parents, teachers and children. On the basis of the results of parents on the Strenghts and Difficulties Questionnaire, the research sample was divided into one group of children with behavior problems and one group without behavior problems. Parents of the children with behavior problems were found to feel less competent, more socially isolated, less satisfied about their relationship with their partner, and indicate more negative life occurrences than the parents of the children without behavior problems. Characteristics in the area of adaptability, mood, distractibility/hyperactivity, demandingness, reinforcement of parents, and acceptability were found to contribute to the total stress in the child–parent relationship for those children with behavior problems and their parents. On the basis of these results prevention activities will be developed and tested on their effectiveness.     

Reciprocity in autistic and typically developing children and adolescents with and without mild intellectual disabilities

The assessment of autism in individuals with mild intellectual disabilities (MID) is complicated because of the overlap between autistic traits and intellectual limitations. Impaired social emotional reciprocity is a core diagnostic criterion for autism. However, it is unknown whether reciprocal behaviour differs between MID individuals with or without an autism spectrum disorder (ASD). This study explored differences in reciprocal behaviour of 35 children and adolescents with MID (intelligence quotient 50–85): 15 with ASD (ASD‐MID) and 20 with typical development (TD‐MID) using the Interactive Drawing Test (IDT). ASD‐MID participants showed a lower quality of reciprocal behaviour compared with TD‐MID participants. The difference in quality of reciprocal behaviour between ASD‐MID and TD‐MID participants was not significantly related with Peabody Picture Vocabulary Test scores and thus not attributable to verbal capacity. The IDT is likely to reflect the child's inclination to display reciprocal behaviour in everyday situations, as its scale scores were meaningfully associated with the level of social cognition assessed with the Social Responsiveness Scale. Thus, the IDT seems well suited for measuring impairments in reciprocal behaviour in children and adolescents with MID.     

Self-injurious-behavior in children and adolescents with intellectual disabilities

10% of the children and teenagers with intellectual disability develop self-injurious behavior during lifespan. The causes for this are investigated, often various and reach from learn-theoretical up to neurobiological conditions. The available work gives overview of the current state of research to the etiology, further factors of influence as well as the process of self-injurious behavior by intellectual disability. Beyond that current diagnostics procedures, standard of treatment of the last thirty years and their effectiveness are presented and discussed finally.     

Theory of Mind "emotion", developmental characteristics and social understanding in children and adolescents with intellectual disabilities

Patterns of development of ToM-emotion abilities in intellectually disabled (ID) children and typically developing (TD) children matched on their developmental age were investigated. The links between cognition, language, social understanding and ToM-emotion abilities were examined. EDEI-R (Perron-Borelli, M. (1996). Echelles Différentielles d’Efficiences Intellectuelles. Forme Révisée (EDEI-R). Paris: Editions et Applications Psychologiques) was used to match participants and to assess social understanding. ECOSSE (Lecocq, P. (1996). L’E.CO.S.SE. Une épreuve de compréhension syntaxico-sémantique. Paris: Presses Universitaires du Septentrion) assessed the level of syntactic and semantic comprehension of French speaking, to ensure a good comprehension of the questions in ToM-emotion tasks. Adapted tasks of the understanding of causes and consequences of emotions (Quintal, G. (2001). La compréhension des émotions chez les enfants d’âge préscolaire dans le cadre d’une théorie de l’esprit. Un-published master's thesis, University of Montreal, Québec) assessed ToM-emotion abilities (Nader-Grosbois, N., Thirion-Marissiaux, A.-F., & Grosbois, M. (2003). Adapted tests for assessment of the Theory of Mind of causes and consequences of emotions (unpublished documents). Louvain-la-Neuve, Belgium). Similarities in the development of ToM-emotion abilities and social understanding were found, respectively, in both groups (delay hypothesis in ID participants). Some differences between groups were observed in the links between social understanding and ToM-emotion abilities. Significant correlations between developmental characteristics (verbal and non-verbal cognition) and ToM-emotion abilities were obtained for both groups. Verbal cognition explained an important part of the variance of ToM results (understanding of causes and consequences of emotions). The impact of chronological age on ToM-emotion abilities was also examined and is discussed.     

The siblings relationship of adolescents with and without intellectual disabilities

The sibling relationship of adolescents with and without intellectual disabilities was examined. Participants were 70 sibling dyads - each dyad was comprised of one 12-year old adolescent with (N = 23) or without intellectual disabilities (N = 47). Sibling relationships, behavior problems, and social skills were assessed using mother reports. Results revealed three findings. First, for typically developing adolescents, mothers reported more warmth in the sibling relationship for opposite sex dyads. For adolescents with intellectual disabilities, mothers reported more warmth in the sibling relationship for same-sex dyads. Second, for typically developing adolescents, mothers reported more status/power differences when the sibling was younger than when the sibling was older. For adolescents with intellectual disabilities, birth order did not affect status/power in the sibling relationship. Third, for typically developing adolescents, conflict was related to internalizing behavior problems. For adolescents with intellectual disabilities, conflict was related to externalizing behavior problems. Implications, limitations, and future directions are discussed.     

Short-term memory coding in children with intellectual disabilities

To examine visual and verbal coding strategies, I asked children with intellectual disabilities and peers matched for MA and CA to perform picture memory span tasks with phonologically similar, visually similar, long, or nonsimilar named items. The CA group showed effects consistent with advanced verbal memory coding (phonological similarity and word length effects). Neither the intellectual disabilities nor MA groups showed evidence for memory coding strategies. However, children in these groups with MAs above 6 years showed significant visual similarity and word length effects, broadly consistent with an intermediate stage of dual visual and verbal coding. These results suggest that developmental progressions in memory coding strategies are independent of intellectual disabilities status and consistent with MA.     

Self-assessment of facility-based supports for persons with intellectual disabilities and children with motional disabilities

To improve the support provided at facilities for persons with intellectual disabilities and children with motional disabilities, the author designed a questionnaire to be used for self-appraisal by the personnel of the relevant facilities. Twenty-one facilities participated; these facilities indicated that they needed to improve grievance procedures, the protection of privacy, staff training and collaborations with physicians, though they judged themselves to be able to respond appropriately to requests from individual users. Facilities for children answered that they supplied satisfactory supports, though other facilities such as workshops and community homes did not put regulations on staffs' abuse in statutory form. Grievance procedures and discussion with users are necessary to supply support based on needs of individual users.     

Psychiatric disorders and characteristics of abuse in sexually abused children and adolescents with and without intellectual disabilities

The purpose of this study was to compare sexually abused children and adolescents, with and without intellectual disabilities (ID), in terms of post-abuse psychiatric disorders, features of the sexual abuse, and sociodemographic characteristics. The study included sexually abused children aged 6–16 years, who were sent to three different child mental health units for forensic evaluation; there were 102 cases (69 girls and 33 boys) with ID and 154 cases (126 girls and 28 boys) without ID. Researchers retrospectively examined the files, social examination reports, and the judicial reports of the cases. It was determined that in the group with ID, sexual abuse types including penetration and contact had higher rates, they were exposed to more frequent repeated abuses, the abuses were revealed with their own reports at a later period and lower rates, and post-abuse pregnancies were more frequent. It was also determined that the abuser was a familiar person and a family member at lower rates and more than one abuser was encountered more frequently, compared to the group without ID. While no difference was determined between the two groups in terms of the frequency of post-abuse post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), conduct disorder (CD) was observed more frequently in the group with ID. This study emphasizes that sexual abuse, which is an important problem in individuals with ID, has different features and effects.     

Moral judgment of young sex offenders with and without intellectual disabilities

This study examined differences in moral judgment between juvenile sex offenders with and without intellectual disabilities. The Sociomoral Reflection Measure-Short Form (SRM-SF) was used to assess moral judgment, and was extended with questions referring to general sexual situations and to the offenders’ abuse victim(s). Juvenile sex offenders with and without ID significantly differed in moral judgment stage regarding general life, sexual and own abuse victim situations. Juvenile sex offenders with ID generally showed stage 2 moral reasoning, which indicated that their justifications for moral decisions were dominated by instrumental and pragmatic reciprocity, whereas juvenile sex offenders without ID used reasons and justifications representing transitional moral stage 2/3 moral judgment, indicating that the maintenance of interpersonal relationships was considered to a certain extent in their justifications for moral decisions. Future research should examine to what extent moral judgment of offenders with ID should be targeted in treatment.