Intellectual disability

Author(s):  
David Semple ◽  
Roger Smyth

This chapter covers intellectual disabilities. It provides a historical context and modern classification, before covering assessment, communication pathways, and management or treatment methods. Different types of intellectual disability, both genetic and non-genetic and pervasive developmental disorders, are covered in turn, and psychiatric comorbidities are also considered. The issues affecting transition periods are outlined, along with potential methods of alleviating stress.




2012 ◽  
Vol 200 (4) ◽  
pp. 282-289 ◽  
Author(s):  
Vera A. Morgan ◽  
Maxine L. Croft ◽  
Giulietta M. Valuri ◽  
Stephen R. Zubrick ◽  
Carol Bower ◽  
...  

BackgroundRecent evidence points to partially shared genetics of neuropsychiatric disorders.AimsWe examined risk of intellectual disability and other neuropsychiatric outcomes in 3174 children of mothers with schizophrenia, bipolar disorder or unipolar major depression compared with 3129 children of unaffected mothers.MethodWe used record linkage across Western Australian population-based registers. The contribution of obstetric factors to risk of intellectual disability was assessed.ResultsChildren were at significantly increased risk of intellectual disability with odds ratios (ORs) of 3.2 (95% CI 1.8–5.7), 3.1 (95% CI 1.9–4.9) and 2.9 (95% CI 1.8–4.7) in the maternal schizophrenia, bipolar disorder and unipolar depression groups respectively. Multivariate analysis suggests familial and obstetric factors may contribute independently to the risk. Although summated labour/delivery complications (OR = 1.4, 95% CI 1.0–2.0) just failed to reach significance, neonatal encephalopathy (OR = 7.7, 95% CI 3.0–20.2) and fetal distress (OR = 1.8, 95% CI 1.1–2.7) were independent significant predictors. Rates of rare syndromes in children of mothers with mental disorder were well above population rates. Risk of pervasive developmental disorders, including autism, was significantly elevated for children of mothers with bipolar disorder. Risk of epilepsy was doubled for children of mothers with unipolar depression.ConclusionsOur findings provide epidemiological support for clustering of neuropsychiatric disorders. Further larger epidemiological studies are warranted.



2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
N. Deriaz ◽  
G. Galli-Carminati ◽  
G. Bertschy

Background:Melatonin may be used to treat sleep disorders in both children and adults with intellectual disability. the evidence for its efficacy, potential adverse effects and drug interactions are reviewed in the context of prescribing to people with intellectual disability.Methods:This study presents the use of melatonin to treat severe circadian sleep-wake disturbances in 6 adults with pervasive developmental disorders. Melatonin was initiated at a daily dose of 3 mg at nocturnal bedtime. If this proved ineffective, the melatonin dose was titrated over the following 4 weeks at increments of 3mg/2weeks up to a maximum of 9 mg, unless it was tolerated. Assessments included the Clinical Global Impression-Severity (CGI-S) and CGI-Improvement (CGI-I).Results:Melatonin administered in the evening dramatically improved the sleep-wake pattern in all patients. Melatonin appears to be effective in reducing sleep onset latency and is probably effective in improving nocturnal awakenings and total sleep time in adults with pervasive developmental disorders. Its effectiveness remained stable for the 6-months period of administration. Melatonin was well-tolerated in all patients and no side effects were noted during the therapy.Conclusions:Melatonin appears to be promising as an efficient and seemingly safe alternative for treatment of severe circadian sleep disturbances in adults with intellectual disability. There may be heterogeneity of response depending on the nature of the sleep problem and cause of the intellectual disability or associated disabilities. Further studies are necessary before firm conclusions can be drawn and guidelines for the use of melatonin for people with ID formulated.



Author(s):  
Elena Vladimirovna Grebennikova ◽  
Igor Lvovich Shelekhov ◽  
Elena Anatolyevna Filimonova

It is customary to consider interpersonal relationships as a significant factor influencing the development of individual mental processes and personality. In recent years, studies that reveal the specifics of interpersonal relationships in persons with different types of dysontogenesis, including those with intellectual disabilities, have been of particular interest to specialists. This article presents the results of studying the interpersonal relationships of adolescents with intellectual disabilities (ID), complicated by visual impairment. When it comes to comparing the interpersonal relations in adolescents with intellectual disabilities, complicated by visual impairment and their peers with uncomplicated intellectual disabilities, the results of the study show that there are features which are general to both groups and features which are specific to only one group. In the surveyed groups, only one-third of adolescents consider their mother and father as a parental couple. More often than not, they communicate with their mother and refuse to communicate with their father. The adolescents of both groups are characterized by the following: low involvement in terms of interaction with peers; the presence of emotionally deficient or emotionally excessive reactions (with a predominance of the emotionally deficient type); poor decision-making, the desire to shift responsibility to others; lack of interest to become a leader; frequent conflicts with peers and inability to resolve them constructively. In addition, adolescents in the surveyed groups often demonstrate reactions to frustration in an active-aggressive or a passive-suffering manner. Moreover, in adolescents with uncomplicated ID, reactions of an active-aggressive type dominate, and in adolescents with ID complicated by visual impairment, reactions of a passive-suffering type are dominant. It is important to note that adolescents with ID complicated by visual impairment tend to be isolated from their peers and show high affection for home and their families.



2009 ◽  
Vol 5 (3) ◽  
pp. 196-200 ◽  
Author(s):  
Özlem Ünal ◽  
Özlem Özcan ◽  
Özgür Öner ◽  
Melda Akcakin ◽  
Ayla Aysev ◽  
...  




Author(s):  
José L. Ayuso-Mateos ◽  
Cary S. Kogan

It is now widely recognized that people with disorders of intellectual development should be integrated into society across their lifespan to the extent possible. Therefore, a central principle of care is normalization, that is, providing needed individualized supports to maximize the likelihood of achieving normal functioning. The presence of psychiatric comorbidities and behavioural disorders in persons with intellectual disabilities has a major impact in the functioning of those affected and therefore poses a challenge to the primary aim of normalization. This chapter reviews the current approaches to the conceptualization and diagnosis for intellectual disabilities, comorbidities, and evidence-based management strategies.



2006 ◽  
Vol 48 (11) ◽  
pp. 896 ◽  
Author(s):  
Pascale Guillem ◽  
Christine Cans ◽  
Vincent Guinchat ◽  
Marc Ratel ◽  
Pierre-Simon Jouk




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