Sleep onset problems in two children with mild intellectual disability and epilepsy: Assessment and treatment in the home setting.

The role and future of assessment and treatment units for people with intellectual disabilities is once again the focus of debate and government policy. Reviewing the admissions to inpatient services can provide useful information about the characteristics, needs and clinical outcomes of clients. Data were collected retrospectively for all 36 referrals accepted to an inpatient assessment and treatment unit for people with intellectual disability, between January 2013 and April 2014. Clinical and demographic characteristics of service users were identified through descriptive analysis. Male service users, mild intellectual disability and diagnosis of autistic spectrum disorder were frequent, and a high proportion of admissions had complex and multiple needs. The Health of the Nation Outcome Scale–Intellectual Disabilities was used as a clinical outcome measure. We conclude with recommendations for service development following closure of our inpatient service.

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Intellectual disability (mental retardation)

Shorter Oxford Textbook of Psychiatry ◽

10.1093/med/9780198747437.003.0017 ◽

2017 ◽

pp. 485-512

Author(s):

Paul Harrison ◽

Philip Cowen ◽

Tom Burns ◽

Mina Fazel

Keyword(s):

Mental Health ◽

Mental Retardation ◽

Intellectual Disability ◽

Intellectual Disabilities ◽

Mental Health Problems ◽

Fragile X ◽

Mild Intellectual Disability ◽

Assessment And Treatment ◽

The Life Course ◽

Challenging Behaviours

‘Intellectual disabilities’ covers the life course, with a focus on the assessment and treatment of the intellectual disabilities at younger ages. This chapter outlines current understanding of the aetiology of the more common intellectual disabilities. The clinical features are discussed for severe/profound, moderate, and mild intellectual disability, and the more common psychiatric presentations for those with intellectual disabilities. Mood disorders, anxiety disorders, and dementia are discussed in greater detail, as are the more common presentations of intellectual disability, with sections on Down’s syndrome and fragile X. The importance of prevention of mental health problems and better understanding and management of more challenging behaviours are discussed alongside other treatments for psychiatric disorders.

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Client Safety and Telepractice in a Clinic or Home Setting

Perspectives on Telepractice ◽

10.1044/teles3.2.41 ◽

2013 ◽

Vol 3 (2) ◽

pp. 41-43

Author(s):

Lyn Tindall

Keyword(s):

Communication Disorders ◽

Speech Pathology ◽

Professional Issues ◽

Efficacy Data ◽

Home Setting ◽

Safe Environment ◽

Technological Advances ◽

Assessment And Treatment ◽

Available Technology ◽

And Gender

Telepractice is an exciting addition to the arsenal of speech-language pathologists for delivering services. Efficacy data continues to emerge proving the benefit of using available technology to provide assessment and treatment for persons with a variety of communication disorders, ages, and gender. In addition to providing assessment and treatment using telepractice technology, several professional issues have arisen which must be addressed before implementation of this service delivery system. Licensure and reimbursement have been at the forefront, as well they should. However, client safety is another issue that should also be addressed. Providing speech pathology services in a safe environment is a concept which may not have been considered before technological advances made it possible to provide services to someone while not being physically present.

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Assessment and treatment of pica within the home setting in Australia.

Behavioral Development ◽

10.1037/bdb0000094 ◽

2020 ◽

Vol 25 (1) ◽

pp. 40-51

Author(s):

Tessa Taylor

Keyword(s):

Home Setting ◽

Assessment And Treatment

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Comprehensive study of 28 individuals with SIN3A-related disorder underscoring the associated mild cognitive and distinctive facial phenotype

European Journal of Human Genetics ◽

10.1038/s41431-020-00769-7 ◽

2021 ◽

Author(s):

Meena Balasubramanian ◽

Alexander J. M. Dingemans ◽

Shadi Albaba ◽

Ruth Richardson ◽

Thabo M. Yates ◽

...

Keyword(s):

Intellectual Disability ◽

Protein Function ◽

Autism Spectrum ◽

Loss Of Function ◽

Mild Intellectual Disability ◽

Related Disorder ◽

Feeding Difficulties ◽

Facial Phenotype ◽

Novel Variants ◽

Common Behaviour

AbstractWitteveen-Kolk syndrome (OMIM 613406) is a recently defined neurodevelopmental syndrome caused by heterozygous loss-of-function variants in SIN3A. We define the clinical and neurodevelopmental phenotypes related to SIN3A-haploinsufficiency in 28 unreported patients. Patients with SIN3A variants adversely affecting protein function have mild intellectual disability, growth and feeding difficulties. Involvement of a multidisciplinary team including a geneticist, paediatrician and neurologist should be considered in managing these patients. Patients described here were identified through a combination of clinical evaluation and gene matching strategies (GeneMatcher and Decipher). All patients consented to participate in this study. Mean age of this cohort was 8.2 years (17 males, 11 females). Out of 16 patients ≥ 8 years old assessed, eight (50%) had mild intellectual disability (ID), four had moderate ID (22%), and one had severe ID (6%). Four (25%) did not have any cognitive impairment. Other neurological symptoms such as seizures (4/28) and hypotonia (12/28) were common. Behaviour problems were reported in a minority. In patients ≥2 years, three were diagnosed with Autism Spectrum Disorder (ASD) and four with Attention Deficit Hyperactivity Disorder (ADHD). We report 27 novel variants and one previously reported variant. 24 were truncating variants; three were missense variants and one large in-frame gain including exons 10–12.

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Searching for a dynamic equilibrium in decision making: the voices of adults with mild intellectual disability and their significant others in Hong Kong

Disability and Rehabilitation ◽

10.1080/09638288.2021.1925978 ◽

2021 ◽

pp. 1-11

Author(s):

Phyllis King Shui Wong

Keyword(s):

Decision Making ◽

Hong Kong ◽

Intellectual Disability ◽

Dynamic Equilibrium ◽

Significant Others ◽

Mild Intellectual Disability

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324 Naturalistic Characterization of Sleep in Chronic Insomnia Using a Non-Contact Sleep Measurement Device

SLEEP ◽

10.1093/sleep/zsab072.323 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A130-A130

Author(s):

Devon Hansen ◽

Mary Peterson ◽

Roy Raymann ◽

Hans Van Dongen ◽

Nathaniel Watson

Keyword(s):

Sleep Onset ◽

Contact Device ◽

Chronic Insomnia ◽

Poor Sleep ◽

Measurement Device ◽

Home Setting ◽

Time In Bed ◽

Sleep Measurement ◽

Measurement Devices

Abstract Introduction Individuals with insomnia report poor sleep quality and non-restorative sleep, and often exhibit irregular sleep patterns over days and weeks. First night effects and logistical challenges make it difficult to measure these sleep characteristics in the laboratory. Also, sensitivity to sleep disruption from obtrusive measurement devices confounds sleep measurements in people with insomnia in their naturalistic setting. Non-contact sleep measurement devices have the potential to address these issues and enable ecologically valid, longitudinal characterization of sleep in individuals with insomnia. Here we use a non-contact device – the SleepScore Max (SleepScore Labs) – to assess the sleep of individuals with chronic insomnia, compared to healthy sleeper controls, in their home setting. Methods As part of a larger study, 13 individuals with chronic insomnia (ages 25-60y, 7 males) and 8 healthy sleeper controls (ages 21-46y, 6 females) participated in an at-home sleep monitoring study. Enrollment criteria included an age range of 18-65y and, for the insomnia group, ICSD-3 criteria for chronic insomnia with no other clinically relevant illness. Participants used the non-contact sleep measurement device to record their sleep periods each night for 8 weeks. Sleep measurements were analyzed for group differences in both means (characterizing sleep overall) and within-subject standard deviations (characterizing sleep variability across nights), using mixed-effects regression controlling for systematic between-subject differences. Results Based on the non-contact sleep measurements, individuals with chronic insomnia exhibited greater variability in bedtime, time in bed, total sleep time, sleep latency, total wake time across time in bed, wakefulness after sleep onset, sleep interruptions, and estimated light sleep, compared to healthy sleeper controls (all F>5.7, P<0.05). No significant differences were found for group averages and for variability in estimated deep and REM sleep. Conclusion In this group of individuals with chronic insomnia, a non-contact device used to characterize sleep naturalistically captured enhanced variability across nights in multiple aspects of sleep stereotypical of sleep disturbances in chronic insomnia, differentiating the sample statistically significantly from healthy sleeper controls. Support (if any) NIH grant KL2TR002317; research devices provided by SleepScore Labs.

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