Early-onset psychosis in youth with intellectual disability

Background Accurate diagnosis of psychotic disorders may be very difficult in youth with intellectual disabilities. Method The authors reviewed the assessment, treatment and follow‐up of 21 youths with ID referred because of early onset of psychotic symptoms. Results Just over one half of the patients had a diagnosis of schizophrenia or schizoaffective disorder. One third of the sample carried the diagnosis of psychosis NOS (not otherwise specified). After careful review, five out of seven of these psychotic‐like cases were assessed as non‐psychotic. Patients with Psychosis NOS associated with moderate or severe ID had the worst outcome. Conclusion This clinical review provides important information about the identification, diagnosis and outcome of psychotic symptoms in youth with low verbal abilities.     

Age-related fractures in people with intellectual disability and epilepsy

The present paper describes age-related fractures in 68 people with intellectual disability and epilepsy (39 females and 29 males). A higher incidence of fractures in epileptic subjects (269%) was noted when they were compared with non-epileptic patients (15%). In the sample of 263 epileptics (121 females and 142 males), a higher number of females (32%) sustained fractures than their male counterparts (20%). The peak period of all fractures is between 40 and 49 years of age. The highest incidence of fractures in females occurred during the periods from 10 to 19 and 40 to 49 years, while the peak was between 30 and 39 years for males. The causes of fractures and preventative measures are discussed, and further avenues for research are indicated.     

Socioeconomic status and children with intellectual disability in China

Background Intellectual disability (ID) accounts for 70% of all disabilities among children in China's Second National Sampling Survey on Disability. Although studies have shown a relationship between social class and ID in children, none have investigated the association of socioeconomic variables in Chinese children with mild or severe ID. Methods Data for children aged 0–6 years with and without ID were abstracted from the Second National Sampling Survey on Disability in China, conducted in 2006. Crude odds ratios showed the effect of sociodemographic factors on mild and severe ID. Adjusted odds ratios (OR_a) (95% confidence intervals) estimated the independent effects of these factors. Results For both mild and severe ID, risk of having ID increased with male sex, birth to a woman aged 35 years and older, lower maternal education, mother's older age at delivery, lower income and rural residence. After age, gender and parent disability were controlled, mothers aged 35 years and older were more likely to have a child with ID: mild ID, OR_a 1.47 (1.15–1.88); severe ID, OR_a 1.32 (1.00–1.73). There was an approximate increasing monotonic risk of severe ID with increasing socioeconomic disadvantage: lowest income, OR_a 3.00 (2.19–4.12); low income, OR_a 2.28 (1.63–3.19); lower middle income, OR_a 1.72 (1.27–2.33); middle income, OR_a 1.73 (1.28–2.36). Conclusions There is a significant relationship between sociodemographic factors and ID. Similar patterns were found for both mild and severe ID. Recommendations are given for preventing ID in Chinese children.     

Impulsiveness as a factor in sexual offending by people with mild intellectual disability

Background It has been suggested that sexual offending by people with intellectual disability (ID) results from a pattern of impulsive behaviour that is consistent with psychosocial disadvantage, rather than sexual deviancy. This study aimed to explore this hypothesis by assessing levels of impulsiveness in sexual offenders, non‐sexual offenders and non‐offenders with mild ID. Method Impulsiveness was assessed using a modified version of the Barratt Impulsiveness Scale (11th edition). Total impulsivity scores were compared between sexual offenders, non‐sexual offenders and non‐offenders, all with mild ID. Results There was a significant difference in the levels of impulsiveness between sexual offenders and non‐sexual offenders with ID (t = 2.83, P < 0.01). The sexual offenders were less impulsive than non‐sexual offenders. Conclusions This study did not support the hypothesis that sexual offending by people with ID is better explained by impulsive behaviour rather than sexual deviancy. It supports recent findings that among the general population, sexual offenders are less impulsive than controls and violent offenders.     

Motor performance of children with mild intellectual disability and borderline intellectual functioning

Background There is a relatively small body of research on the motor performance of children with mild intellectual disabilities (MID) and borderline intellectual functioning (BIF). Adequate levels of motor skills may contribute to lifelong enjoyment of physical activity, participation in sports and healthy lifestyles. The present study compares the motor skills of children with intellectual disability (ID) to the abilities observed in typically developing children. It also aimed to determine whether there is an association between degree of ID and motor performance. Methods A total of 170 children between 7 and 12 years old with MID or BIF, who attended schools for special education, were examined on the test component of the Movement Assessment Battery for Children (MABC) test. Both groups were compared with the norm scores of the total score, sub‐scale scores and individual items of the MABC test. Results Of the children, 81.8% with MID and 60.0% with BIF performed below the 16th percentile on the total score of the MABC. Both groups demonstrated a relative weakness in the area of manual dexterity. Comparisons between both groups showed small to moderate effect sizes on the total score of the MABC, as well as for all three sub‐scales, favouring the children with BIF. Conclusions Children with ID had significantly more borderline and definite motor problems than the normative sample and there was an association between degree of ID and performance of manual dexterity, ball skills and balance skills. This study highlights the importance of improving motor skill performance in both children with borderline and mild ID, and the results support the notion that the level of motor and cognitive functioning are related in children with ID.     

Old World—new territory: European perspectives on intellectual disability

People with intellectual disability share the mixed fortunes of the diverse countries in that they live, as well as the social and political changes that mark life in Europe at the close of the twentieth century. The European Union exerts its influence through common policies and centrally funded initiatives which promote the social and vocational integration of people with intellectual disabilities. At the same time, many countries in Central and Eastern Europe are building a new and as-yet untested social order. This paper outlines the distinctive features of European identity. Some of the gains already achieved on behalf of Europeans with intellectual disability are presented, as well as some of the problems which continue to threaten their well-being and inclusion. It is suggested that partnerships between countries and regions can help to chart new territory for citizens of the Old World.     

Homosexuality among people with a mild intellectual disability: an explorative study on the lived experiences of homosexual people in the Netherlands with a mild intellectual disability

Background Empirical research on homosexuality among people with an intellectual disability (ID) is limited and, to date, very little is known regarding the personal experiences of gay and lesbian people with an ID. This study set out to answer the question: What are the lived experiences of a specific cohort of homosexual people with an intellectual disability living in the Netherlands? Method To answer this question, a qualitative study was performed in which 21 people with a mild ID were interviewed via semi‐structured interviews. In this study, 19 participants were men and two were women (average age = 40.5 years). Results Participants reported positive and negative experiences, and talked about their gay or lesbian identity. Almost half of the participants (n = 10) reported that they had experienced sexual abuse including partner violence (n = 6). Additionally, they indicated that there was a lack of support for homosexual people with an ID. Conclusion Specific problems impact the lives of homosexual people with ID, namely the high prevalence of negative sexual experiences, the lack of support, training and sex education, and their search for a suitable partner.     

Numerical magnitude processing in children with mild intellectual disabilities

The present study investigated numerical magnitude processing in children with mild intellectual disabilities (MID) and examined whether these children have difficulties in the ability to represent numerical magnitudes and/or difficulties in the ability to access numerical magnitudes from formal symbols. We compared the performance of 26 children with MID on a symbolic (digits) and a non-symbolic (dot-arrays) comparison task with the performance of two control groups of typically developing children: one group matched on chronological age and one group matched on mathematical ability level. Findings revealed that children with MID performed more poorly than their typically developing chronological age-matched peers on both the symbolic and non-symbolic comparison tasks, while their performance did not substantially differ from the ability-matched control group. These findings suggest that the development of numerical magnitude representation in children with MID is marked by a delay. This performance pattern was observed for both symbolic and non-symbolic comparison tasks, although difficulties on the former task were more prominent. Interventions in children with MID should therefore foster both the development of magnitude representations and the connections between symbols and the magnitudes they represent.     

Cause-specific mortality of people with intellectual disability in a population-based, 35-year follow-up study

The aim of the present study was to investigate cause‐specific mortality in people with intellectual disability (ID). It was based on a 35‐year follow‐up study of a nation‐wide population of 2369 subjects aged between 2 and 97 years. The 1095 deceased people had accumulated 64 539 person‐years. The research took the form of a prospective cohort study with mortality follow‐up. Observed and expected deaths were calculated as standardized mortality ratios using the Finnish general population as the reference. Cause‐specific mortality ratios were calculated by the level of ID, sex and age. The three most common causes of death were cardiovascular diseases, respiratory diseases and neoplasms. Disease mortality was high up to 40 years of age, but did not increase thereafter. The difference between sexes in cause‐specific mortality was smaller than in the general population. Cause‐specific mortality differed significantly from the general population, with reduced mortality from neoplasms and external causes, but ageing individuals with mild ID had similar mortality patterns to the general population. The disparities in the cause‐specific mortality between younger people with ID and the general population fade with advancing age, producing similar health risks. In preventative work, special attention should focus on common diseases and accidents in the community.     

Eyewitness testimony and perceived credibility of youth with mild intellectual disability

Background Individuals with intellectual disability (ID) are more vulnerable to abuse compared to individuals without disabilities yet have limited access to the legal system. This study examined perceived credibility of youth with mild intellectual disability (MID) who provide courtroom testimony. Method Participants, 187 undergraduates, were asked general questions about credibility. They also read eyewitness testimony and answered questions about a particular witness's credibility. Half the participants were informed that the youth has MID [chronological age (CA) 15 years, mental age (MA) 10 years] and the others were informed that the youth is a typically developing 10‐year‐old. Results When participants were asked general questions about credibility they rated 15‐year‐olds with MID (MA 10 years) as less credible than typically developing 15‐year‐olds and as less credible than typically developing 10‐year‐olds. However, when participants read eyewitness testimony and answered questions about a particular witness's credibility, no statistically significant differences were found between participants who were informed that the witness was a 15‐year‐old with MID (MA 10 years) and those who were informed that the witness was a typically developing 10‐year‐old. Conclusions The present study provided a preliminary investigation of perceived credibility of witnesses with MID and suggests directions for future research in this area.     

Executive control in long-term abstinent alcoholics with mild to borderline intellectual disability: The relationship with IQ and severity of alcohol use-related problems

Deficits in executive control might be related to alcohol abuse in individuals with mild to borderline intellectual disability (MBID). The goal of the present study was to test the relationship between executive control (i.e., working memory capacity, inhibitory control and delay discounting), IQ and chronic alcohol use. Participants (N = 40) were divided into four groups based on IQ and severity of alcohol use-related problems (heavy and light drinkers with and without MBID). They were all admitted to a psychiatric treatment facility and long-term abstinent at the time of testing. Contrary to the expectations, executive control was not consistently impaired among individuals with MBID. Results showed that working memory capacity did seem to be impaired, whereas inhibitory control and delay discounting did not. Moreover, there were no differences between heavy and light drinkers on any of the parameters and having a dual diagnosis (heavy drinkers with MBID) did not result in additive negative effects on executive control. It is suggested that alcohol-related cognitive impairment is temporary and decreases over time after cessation of drinking.     

Prevalence of parents with intellectual disability in Australia

Background Parenting by people with intellectual disability is attracting increasing attention, and policymakers and service providers require empirical evidence to develop sound policy and service responses. The purpose of the study was to identify prevalence and demographic data on parents with ID in Australia compared with parents with other disabilities and the population of parents without disability.

Method The Survey of Disability, Ageing and Carers, 2009, was identified as the most suitable survey, and design-weighted analysis was performed.

Results An estimated 0.41% of Australian parents had intellectual disability, equating to 17,000 parents with ID. Parents with ID were more likely to have only 1 child and to reside outside a capital city compared with parents without disability.

Conclusions These findings provide benchmark data for monitoring, over time, the prevalence of parents with ID and point to policy and service responses for parents with only 1 child and for those in outer urban, regional, and rural areas of Australia.     

The effects of familial risk and parental resolution on parenting a child with mild intellectual disability

The current study investigated the manner by which family risk moderates the links between parental state of resolution with a child's diagnosis and both parent–child interaction and parental stress. The sample included 72 families with 4–7-year-old children (M = 5.53, SD = 0.73) diagnosed with mild intellectual disability. Parents reported on their resolution state and parental stress, and parent–child interactions were videotaped and analyzed. Results indicated that in families where mothers or fathers were unresolved rather than resolved, mother–child interactions were less positive only in the context of high family risk. The father–child interaction was not found to be affected by family risk and parental resolution. Interestingly, mothers in low family risk situations who were resolved reported the lowest level of parental stress, suggesting a “double buffer” effect, whereas fathers with high family risk who were unresolved experienced the highest levels of parental stress, suggesting a “double risk” effect.     

Modification of motivational interviewing for use with people with mild intellectual disability and challenging behaviour

Abstract

Background Motivational interviewing is a promising method to increase treatment motivation for people with mild intellectual disability and challenging behaviour. The purpose of the present study was to identify how professionals could adapt motivational interviewing techniques for use with clients.

Method We conducted semistructured qualitative interviews and focus groups with 26 clients, parents, and professionals. A general inductive approach led to the identification of multiple core themes.

Results The authors recommend several modifications to accommodate motivational interviewing for use with clients: adapt to language level, adjust to cognitive abilities, and control for social desirability of responding. In addition, certain characteristics of professionals were also found to be critical for effective motivational interviewing: trustworthiness, engagement, acceptance, empathy, and honesty.

Conclusions Concrete recommendations for the adaptation of the motivational interviewing techniques for use with people with mild intellectual disability and challenging behaviour are identified. Certain characteristics of professionals are also critical for maximising the treatment motivation of clients.     

Effectiveness of treatment programmes for depression among adults with mild/moderate intellectual disability

Background The current study describes the development and evaluation of group treatment programme for people with mild/moderate intellectual disability (ID). Methods A total of 34 participants (16 males, 18 females) completed the treatment programme and 15 participants (six males, nine females) comprised a control group. Results Compared to the control group, the intervention group showed an improvement in levels of depression, positive feelings about the self, and lower levels of automatic negative thoughts after the intervention. These changes were maintained at 3‐month follow‐up. Conclusions These results demonstrate that intervention programmes are effective for the treatment of depression among people with ID.