Moral Sensitivity of Young People with Intellectual Disability – Its Role in The Process of Their Education

According to Heller and Życiński (1980) the primary regulator of human behaviour is the system of values therefore its development should be in the centre of all educational and upbringing measures. Our focus here is on moral sensitivity understood as the ability of an individual to see social situations from the perspective of moral good and moral evil that represent values embodied in moral norms adopted by the world and internalised by humans as the principles of conduct. The main research question was the following: How morally sensitive are persons with ID and how is their sensitivity associated with the degree of intellectual disability and gender? A non-probability sample 267 of Polish residents aged 16-30 years with mild (58.42%) or moderate (41.58%) intellectual disability was assembled. Men and women were almost in equal proportion. The Moral Sensitivity Inventory (MSI; Otrębski, Sudoł, 2020) has been used to measure the moral sensitivity of people with ID. It consists of 10 illustrated stories presenting typical social situations containing moral dilemmas, and an evaluation form. The tested person’s task is to answer the following question “Who, in this story, did something right or wrong, and what was that?” and to indicate as many moral elements in the story and the picture as they can. The results imply that the study participants had different ability to discern moral good and moral evil. They were more sensitive to the manifestations of good and evil bad associated with Understanding one’s behaviour and its impact on others (more than one-fourth of them had high scores) and less perceptive of those relating to Respect for others’ property and Conformance to principles and norms. The results of the study expand the knowledge of the overall moral sensitivity of persons with intellectual disabilities.

X-linked intellectual disability mutations alter the conformational state of a histone demethylase's sensing of chromatin

The H3K4me3 chromatin modification, a hallmark of promoters of actively transcribed genes, is dynamically removed by the KDM5 family of histone demethylases. The KDM5 demethylases have a number of accessory domains, two of which, ARID and PHD1, lie within the catalytic domain. KDM5C, which has a unique role in neural development, harbors a number of mutations adjacent to its accessory domains that cause X-linked intellectual disability (XLID). The roles of these accessory domains remain unknown, limiting an understanding of how XLID mutations affect KDM5C activity. We find that while the ARID and PHD1 domains are required for efficient nucleosome demethylation, the PHD1 domain alone has an inhibitory role in KDM5C catalysis. We further find that binding of the H3 tail to PHD1 is coupled to the recognition of linker DNA by KDM5C. Our data suggests a model in which the PHD1 domain regulates DNA recognition by the ARID domain based on available substrate cues. In this model, recognition of distinct chromatin features is coupled to a conformational rearrangement of the ARID and PHD1 domains, which in turn modulates the positioning of the catalytic domain for efficient nucleosome demethylation. Importantly, we find that XLID mutations adjacent to the ARID and PHD1 domains alter the conformational state of these domains to enhance DNA binding. This results in the loss of specificity in chromatin recognition by KDM5C and renders catalytic activity sensitive to inhibition by linker DNA. Our findings suggest a unifying model by which XLID mutations alter chromatin recognition and enable euchromatin-specific dysregulation of demethylation by KDM5C.

A parent-led intervention to reduce anxiety in autistic children with a severe to profound intellectual disability: protocol for the LADDERS pilot feasibility trial

Background There is a need for evidence-based approaches to reduce anxiety experienced by autistic children with severe to profound intellectual disability (ID). Avoidance of anxiety triggers, as a response to pronounced anxiety, occurs irrespective of age, background and neurodiversity. When avoidance is unhelpful, evidence-based anxiety reduction approaches aim to reduce it gradually (graded exposure), subsequently reducing anxiety. Combining graded exposure with emotional regulation techniques may be effective and acceptable for autistic children with severe to profound ID, if sensitive to needs and characteristics of autistic children. We have developed a 16-week, parent-led intervention (LADDERS) to reduce anxiety in this population of autistic children. LADDERS consists of psychoeducation, graded exposure-based tasks, and skills building, delivered utilising a person-centred approach. This study aims to assess whether LADDERS 1) reduces anxiety and 2) whether autistic children and parents find it acceptable and feasible. Method A single-site, multiple baseline, single case experimental study will be conducted. Participants will be parents of autistic children aged between 4-15 years. A minimum of 8 participants will be recruited through a research participant database, the Autistica Discover Network and social media. Once eligibility is confirmed, participants will be assessed at baseline, during the intervention and at a 2-month follow-up (week 24). The primary outcome measure will be a daily diary that assesses child anxiety. Discussion The study will provide preliminary evidence of whether LADDERS reduces anxiety in autistic children with severe to profound ID. Qualitative data from parents and child engagement will provide data on acceptability and feasibility.

Management of psychotropic medications in adults with intellectual disability: a scoping review protocol

Introduction: Psychotropic medications are commonly prescribed among adults with intellectual disability (ID), often in the absence of a psychiatric diagnosis. As such, there is great disparity between the estimated prevalence of mental illness and the rates of psychotropic medication use amongst people with ID. ‘Off-label’ use of these medications may account for much of this discrepancy, in particular their use in the management of challenging behaviour. This has come under scrutiny due to the myriad of side effects and the deficiency of high-quality data supporting their use for this indication. Understanding the causes and justifications for such disparity is essential in discerning the efficacy of current prescription practice. Objective: To explore the existing evidence base regarding the prescription and management of psychotropic medications in adults with ID. The aim will be achieved through identifying the psychotropic medications commonly prescribed, the underlying rationale(s) for their prescription and the evidence available that demonstrates their appropriateness and effectiveness. Additionally, the paper will seek to evaluate the availability of any existing guidance that informs the management of these medications, and the evidence and outcomes of psychotropic medication dose reduction and/or cessation interventions. Inclusion criteria: This review will consider studies that focus on the use of psychotropic medications amongst patients with ID. Methods: Research studies (qualitative, quantitative and mixed design) and Grey Literature (English) will be included. The search will be conducted without time restrictions. Databases will include: Ovid MEDLINE, Embase, CINAHL, JBI Evidence Synthesis, Cochrane Central Register of Controlled Trials, Cochrane Databased of Systematic Reviews, PsycINFO and Scopus. A three-step search strategy will be followed, with results screened by two independent reviewers. Data will be extracted independently by two reviewers using a data extraction tool with results mapped and presented using a narrative form supported by tables and diagrams.