Epilepsy is a common neurological condition in children and is often associated with intellectual impairment. However, there is limited information on the intellectual impairment among children with epilepsy in Uganda. This study assessed the prevalence and associated factors of intellectual impairment among children and adolescents with epilepsy attending two national referral hospitals in Uganda. This cross-sectional study included children and adolescents aged 5 to 17 years who had a diagnosis of epilepsy. Intellectual functioning was assessed using the Raven's Progressive Matrices. Logistic regression analysis was performed to determine demographic and clinical factors associated with intellectual impairment. Of 386 participants, 34.7% had intellectual impairment. Older age (adjusted odds ratio [aOR] = 6.94, P = 0.001), being in a special needs school (aOR = 14.50, P = 0.016), not being in school (aOR = 26.01, P < 0.001), delayed speech (aOR = 3.26, P = 0.030), and anti-seizure medication polypharmacy (aOR = 3.08, P = 0.020) were positively associated with intellectual impairment, while adolescent-onset epilepsy (aOR = 0.05, P = 0.030) was negatively associated. Intellectual impairment is common among Ugandan children and adolescents with epilepsy and is associated with older age, school non-attendance, special-needs school placement, delayed speech, and anti-seizure medication polypharmacy. These findings underscore the need for routine assessment of intellectual functioning and targeted interventions, including academic support, speech therapy, and optimization of treatment regimens.

Employment trajectories of individuals with intellectual and developmental disabilities: A 7-year longitudinal study.

Black people with intellectual and developmental disabilities (IDD) report poor health and lower service use compared with their White counterparts. Structural racism, neighborhood segregation in particular, has been identified as a potential barrier to equitable service use, but empirical investigations remain limited. To examine the association between race/ethnicity and neighborhood-level segregation on the use of outpatient occupational therapy and physical therapy and home health services among people with IDD. A secondary data analysis, using weighted two-level logistic regression models, of the Medical Expenditure Panel Survey (2013-2020) and census tract data from the American Community Survey. Sixteen percent of individuals with IDD reported use of outpatient occupational therapy and physical therapy, and 23% reported use of home health services. Race and neighborhood segregation were not significantly associated with service use; however, age and Medicaid coverage showed significant associations with both occupational therapy and physical therapy and home health care use. Individuals ages 0 to 3 yr were more likely to receive services than older cohorts, highlighting age-related disparities. The findings suggest that although racial disparities were not evident in this data set, structural and age-related factors still shape service utilization. Occupational therapy scholars need larger and more nuanced data sets of people with IDD to better map associations between race and neighborhood segregation and its impact on service use along the health care pipeline. Plain-Language Summary: In this article, we introduce a novel application of neighborhood-level racial segregation measures to assess structural racism in health care access among people with intellectual and developmental disabilities (IDD). By integrating data from the Medical Expenditure Panel Survey and American Community Survey, we provide preliminary evidence on service utilization patterns for outpatient occupational therapy and physical therapy and home health care, highlighting age-related disparities and the need for more nuanced data sets. The findings underscore the importance of contextualizing service use within structural determinants and offer direction for occupational therapy practitioners and health services researchers to refine equity-driven methodologies and advocacy strategies, ensuring that all people with IDD can access the home and community-based supports they need to participate in daily life. Positionality Statement: The research team was led by Khalilah R. Johnson, an occupational scientist and occupational therapy practitioner who identifies as Black and female and has an extensive history working with Black people with IDD in participatory action research and practice. Izabela Annis, the team's statistician and programmer, uses European ethnic classification and identifies as Slavic. In her work, she uses rigorous and comprehensive statistical methods to measure and analyze the complex effects of structural racism on health and social outcomes. Kathleen C. Thomas is a White woman whose family experience of serious mental illness shapes her understanding of stigma and its structural impacts. This lens informs her commitment to research and mentoring that focuses on reducing disparities experienced by people with mental illness and by communities marginalized by disability, poverty, rurality, and racism.

Understanding physical activity through the biopsychosocial model of health in young adults (19-30years of age) with intellectual and developmental disabilities: A mixed methods systematic review.

For children with an intellectual and developmental disability (IDD), meaningful inclusion in recreational sport can lead to many physical and psychosocial benefits. Investigators have begun to explore how recreational sport programs should be designed, implemented, and evaluated to promote these valued outcomes. Despite advancements in adapted sport research, sport program leaders are not always equipped with the strategies and tools to meet the participation needs and priorities of children with IDD. Our team partnered with management at Special Olympics Canada to encourage evidence-based sport program leadership and programming across Canada for young athletes with IDD. We employed a multiphased integrated knowledge translation approach to mobilize quality participation evidence through practical tools for sport program leaders. By elucidating our process, we aim to inspire future initiatives geared toward translating knowledge into action in the adapted sport context for young athletes with IDD across Canada and beyond.

Children and adolescents with developmental disabilities often encounter substantial barriers to physical activity. However, prior research has rarely provided a comprehensive understanding that integrates multiple perspectives. We conducted semi-structured interviews with nine parents and seven sports professionals in South Korea. Data were analysed thematically using Braun and Clarke's six-phase framework. Identified barriers included inaccessible or poorly maintained facilities, societal stigma, insufficient instructor qualifications, fragmented administrative systems, and uniform, short-term programmes. Parents also reported discomfort in inclusive settings and a preference for designated disability-friendly spaces. Facilitators included government-supported infrastructure, disability awareness training, family psychoeducation, structured instructor certification, and long-term, individualised programmes tailored to individual support needs. Participation in physical activity is shaped by interconnected physical, attitudinal, institutional, social, and programmatic factors. Addressing these challenges requires inclusive infrastructure, standardised qualification systems, emotional and informational support for families, and sustained, tailored programme development.

Comprehensive and accessible sexual health education (SHE) can improve knowledge and skills among youth with intellectual and developmental disabilities (I/DD). This case study highlights how a mid-sized school district adapted and delivered SHE in high school special education (SpEd) classrooms. Using feedback from students, teachers, and I/DD experts, school district staff adapted and piloted a SHE unit for youth with I/DD. Lessons incorporated universal design for learning principles while addressing sexual health topics and teaching strategies for youth with I/DD. Training and technical assistance improved educator comfort and delivery of SHE. Districts creating and piloting a SHE unit should consider providing training and coaching for SpEd teachers, working with SpEd leadership to gain support and access, engaging parents to increase buy-in and reduce opt-outs, and eliciting ongoing feedback from students and teachers. More practice-based research is needed to advance I/DD-inclusive SHE. Future studies examining how SHE curriculum for special education is developed, adapted, taught, and evaluated are needed while centering student voice.

Paid carers supporting men with Intellectual and Developmental Disability and Harmful Sexual Behaviour face complex challenges which can affect the carers well-being and quality of care for the person they support. This study explores carers' lived experiences of caring for this group of men. Six paid carers were interviewed regarding their experience of providing care. Semi-structured interviews were conducted online and analysed using Interpretative Phenomenological Analysis. Three superordinate themes were identified through the analysis: 'The balance of drive and burden', 'External influence on care provided' and 'Co-producing care and support'. Carers found the role emotionally demanding and needed support from others to cope. The importance of person-centred care and carer responsiveness was also emphasised. This study highlights the emotional demands and negative public perception faced by paid carers. Clinical implications include enhancing professional recognition, strengthening organisational support and promoting emotional processing.

Dental anxiety poses a major challenge in managing children with intellectual and developmental disabilities (IDD), often exacerbated by sensory sensitivities. Weighted blankets, through deep touch pressure (DTP) stimulation, are believed to reduce stress via parasympathetic activation. This study evaluated the effectiveness of weighted blankets in reducing dental anxiety in children with mild IDD. A randomized crossover trial was conducted on 42 children (aged 6-14 years) with mild IDD. Custom-made weighted blankets (10% of body weight, filled with kitchen grains) were used. Participants attended two appointments 1 month apart-Group 1 received the blanket first, while Group 2 served as control, with roles reversed in the second visit. Physiological (pulse rate, blood pressure, oxygen saturation) and behavioral (Venham's Anxiety Rating Scale) parameters were recorded at baseline and during Atraumatic Restorative Treatment (ART). Use of weighted blankets significantly reduced anxiety and physiological markers across both groups. Group 1 showed reductions in systolic/diastolic pressure (1.99/1 mmHg), pulse rate (4 bpm), improved oxygen saturation (+2.99%), and decreased anxiety scores (0.99). Group 2 showed similar trends when the blanket was introduced. Weighted blankets offer a safe, non-pharmacological option to manage dental anxiety in children with mild IDD. Clinical trial registration - Indian was done (CTRI/2023/06/054290) dated 26/06/2023.

Cognitive impairment in intensive care unit (ICU) survivors is multifactorial and can affect especially memory, attention, and executive functions. This study aimed to determine the cognitive functioning of patients with circulatory shock immediately after ICU discharge and 3 months later. This study, ASSESS-SHOCK 2, is a preplanned sub-study of the observational ASSESS-SHOCK study conducted at Helsinki University Hospital ICU. We included adults with circulatory shock, defined as hypotension requiring vasopressor infusion and concomitant signs of hypoperfusion. We excluded patients with severe neurological or psychiatric diagnoses, impairment of hearing or vision, developmental disability, and language barriers. Cognitive functioning of patients was assessed within 3 days of ICU discharge and 3 months thereafter with the Montreal Cognitive Assessment (MoCA) test. We defined cognitive impairment as MoCA score < 26 points. We also included data of 48 volunteer controls, tested once, to analyses. Fifty-five patients underwent an assessment within 3 days of ICU discharge, and 36 of them completed a follow-up assessment at 3 months. At discharge median MoCA-score was 22 (IQR 17-25). At the 3 months follow-up, the median MoCA-score was 26.5 points (IQR 24.25-28) showing improvement from discharge to follow-up (p < 0.001). The prevalence of cognitive impairment at discharge was 78.2%, and, at the 3-month follow-up 44.4%. In the control group, the median MoCA score was 27 points (IQR 25-28) and the prevalence of cognitive impairment 33%. We found cognitive impairment in more than three out of four ICU survivors immediately after ICU treatment for circulatory shock. We observed an improvement in cognitive functioning between ICU discharge and 3 months follow-up. These results have importance considering the optimal timing of information given to patients and when involving patients in decision-making. This study used the MoCA score to investigate the change in cognitive impairment in patients who survived circulatory shock, from the time of discharge from intensive care to 3 months after discharge. Scores indicated more severe cognitive dysfunction compared to controls at the time of discharge, but these improved to match control scores 3 months later. The findings have important implications for strategies to inform and support newly discharged ICU survivors who have experienced circulatory shock.

The parenting experience of parents of children with disabilities is unique, encompassing both positive and challenging aspects. Parental mentalization (PM), the ability of parents to interpret and understand their children's inner world, has been identified as a crucial factor benefiting both parents and their children. However, the literature on PM in parents of children with disabilities would benefit from greater organization. This scoping review aims to address this gap by examining the existing research on PM in this population. The study was conducted in accordance with the PRISMA-ScR guidelines. The review included studies retrieved from five databases: PsycNet, PubMed, MEDLINE, ProQuest, and EBSCO. Studies were eligible for inclusion if they were peer-reviewed, published in English, and examined the PM abilities of parents of children with developmental disabilities. A total of 27 studies were identified, coded, and analyzed to generate key themes, including: (1) comparison of PM between groups, (2) associations between PM and demographic characteristics, (3) PM-focused interventions, and (4) variables associated with PM. The discussion highlights gaps in the current literature, offers recommendations for future research, and provides practical implications for supporting the PM of parents of children with disabilities.

Few studies have documented executive functions (EFs) following treatment of childhood noncentral nervous systems (non-CNS) solid tumor although treatments administered for several months or even a year during active brain development could affect EF development. The aims of this study were to explore everyday life executive complaints and associated factors. EFs were assessed using parent form of the Behavior Rating Inventory of Executive Function in a large sample of participants diagnosed with a non-CNS solid tumor (n = 253). The study sample comprised 253 patients (139 boys [55%]; mean age at diagnosis 6.12 years [SD = 4.18] years, mean age at assessment 11.65 years [SD = 3.21], 17 [7%] with a history of developmental delay or learning disability before cancer). Parental education level was medium-low (i.e., <12 years of formal education) in 94 families (37%). Mean Behavior Rating Inventory of Executive Function T-scores were in the normative range, but significantly elevated compared to norms across all three composite indices and most clinical scales (all p < .001), with small effect sizes (Cohen's 0.20 < d ≤ 0.30). Thirty-eight (15%) participants evidenced global executive composite scores in the clinical range (T ≥ 65). Executive complaints were significantly more frequent in boys, in older participants at assessment, in those with longer time since diagnosis, and in those with a history of developmental delay/learning disabilities. Clinically significant global executive composite scores were also associated with greater need for school support and ongoing rehabilitation at the time of assessment. Our results suggest significant, albeit mild parent-reported EF impairments following treatment of childhood non-CNS tumor. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Unified Sports within Special Olympics aims to promote inclusion, where athletes with intellectual and developmental disabilities train and compete together with partners who do not have a disability. However, little is known about the health-related physical fitness (HrPF) of these athletes and partners. The primary objective of this study was to describe the HrPF of participants in the 2022 Unified Cup. Measures of HrPF were collected during Healthy Athletes Screenings from 201 soccer players, including 106 athletes and 95 partners. Notable differences were observed between athletes and partners in calf flexibility, timed sit-to-stand, and partial sit-up measures of HrPF (p < .001). In addition, hamstring flexibility and seated push-up showed notable differences between genders (p < .001). This study adds to the literature by utilizing the Healthy Athletes Screenings database. Results should be considered by coaches and programmers when working with Unified athletes in competitive settings.

Sex chromosome aberrations affect approximately 1.5 per 1000 individuals, although somatically inconspicuous phenotypes can remain undetected. Even when diagnosed, the elevated risk of neuropsychiatric manifestations needs to be specifically addressed in psychiatric care. This narrative review analyzes the current literature on neuropsychiatric manifestations of sex chromosome syndromes, focusing on the four most common forms (Klinefelter, Turner, XYY and triple‑X syndromes). Sex chromosome aberrations show characteristic neuropsychiatric manifestations. Frequent psychiatric manifestations include attention deficit hyperactivity disorder, autism spectrum disorders, anxiety disorders, affective and psychotic disorders. Cognitive impairments affect the majority of individuals and are manifested in speech developmental disorders, executive dysfunctions or visuospatial deficits. Severe intellectual impairments are rare (< 5-10%). Heightened clinical attention to neuropsychiatric manifestations of sex chromosome aberrations facilitates earlier diagnosis and access to developmental, psycho(pharmaco)logical and endocrinological treatment approaches to improve the quality of life and social participation of those affected.

Evaluate the outcomes of individuals with intellectual and developmental disabilities (IDD) admitted to an intensive behavior treatment program to reduce severe externalizing behavior (e.g., aggression; self-injury). The authors conducted a retrospective electronic health record review of 40 consecutive patients aged 6 to 19 years with severe externalizing behavior causing imminent risk of harm to self or others over a 4-year period (January 2020 to December 2023). The intensive outpatient model involved daily intervention (Monday-Friday; 5 hours per day across an approximate 5-month period) that was structured and individualized based on the tenants of applied behavior analysis. Systematic data extraction included participant characteristics, outcomes of behavioral assessments, components of the behavioral intervention, percent reduction of externalizing behavior, and percent of caregiver-directed goals met. All participants had a diagnosis of autism and 80% had a co-occurring intellectual disability. Participants presented with 3 primary types of externalizing behavior-aggression (87.5%), disruption (82.5%), and self-injury (67.5%). At discharge, participants had a 90.74% reduction in externalizing behavior and 82.5% of participants met their primary caregiver-directed goal. Findings provide provisional evidence regarding the benefits of intensive behavioral treatment for children with IDD and severe externalizing behavior.

Kleefstra syndrome (KLEFS1) results from EHMT1 haploinsufficiency and is characterized by variable neurodevelopmental delays and psychopathology. Developmental regression, marked by the sudden loss of previously acquired daily life skills during late puberty or early adulthood, has emerged as a severe complication in individuals with KLEFS1. To investigate the clinical and molecular mechanisms underlying developmental regression and assess the therapeutic potential of olanzapine, we conducted a sequential study in an international cohort of fifty-four individuals with KLEFS1. Among sixteen individuals treated with olanzapine, ten exhibited a beneficial response based upon improvement of their adaptive functioning, and four showed temporary improvement. These clinical findings informed preclinical studies using human induced pluripotent stem cell-derived and ex-vivo cortical slices from a mouse model of KLEFS1. We identified hyperactivity in EHMT1+/- neuronal networks co-cultured with EHMT1+/- astrocytes, a dysfunction reversible by olanzapine. Mechanistically, EHMT1+/- astrocytes displayed elevated levels of S100B, a neuroinflammatory marker contributing to neuronal network hyperactivity. Notably, olanzapine treatment reduced S100B levels, and pharmacological inhibition or genetic knockdown of S100B in EHMT1+/- astrocytes was sufficient to rescue the neuronal hyperactivity phenotype. These findings underscore a critical role for astrocytes in KLEFS1 pathophysiology and identify a potential cellular target for olanzapine in mitigating developmental regression.

Over the past decades, life expectancy in Germany has steadily increased. This trend also applies to people with physical, intellectual, and multiple disabilities, although their life expectancy remains at asignificantly lower level. Compared with the general population, differences are evident in health, social participation, and quality of life. Multimorbidity, chronic diseases, and frailty occur earlier and more frequently in people with intellectual disabilities and severe multiple disabilities, leading to limitations in daily life and increased care needs. For some individuals with intellectual and developmental disabilities (IDD), disability-specific risk factors also play arole, such as ahigher prevalence of epilepsy and mental health disorders, or, in the case of Down syndrome, the early onset of dementia.In addition to medical challenges, psychosocial factors become increasingly important in later life, including loneliness, inadequate social participation, and grief over the loss of previously mastered abilities. Despite improvements in care, the average life expectancy of people with severe intellectual and developmental disabilities and severe multiple disabilities remains substantially reduced. Like most people, they generally wish to grow old and die in familiar surroundings. However, due to inadequate support and care services, many are often forced to accept an unwanted move to aresidential nursing home for older adults.This review article discusses epidemiological data, the specific challenges faced by ageing people with intellectual and developmental disabilities, and the practical implications for improving care and social participation.

In this study, we explored the psychotherapeutic process for autistic adult clients without intellectual impairment with comorbid psychological disorders, drawing on the perspectives of highly specialized psychotherapists with extensive clinical experience in autism-focused practice. Within the context of the ongoing shift from deficit-based interventions toward neurodiversity-affirming approaches, we investigated how therapists conceptualize comorbidities in autism and how this conceptualization informs their therapeutic work. We employed a qualitative research design and collected data through semistructured interviews with 10 psychotherapists specialized in autism. We analyzed the data using a sequential combination of deductive and inductive thematic analysis. We identified five main themes (comprising a total of 22 subthemes): (a) development of comorbidity as an interactional vulnerability process; (b) change as a reorganization of self-understanding, regulation, and relational engagement; (c) helpful aspects of psychotherapy as needs-adapted, autism-informed relational practice; (d) therapeutic misfit as misattunement, overload, and contextual constraint; and (e) managing therapeutic misfit through adaptation, reattunement, and containment. Therapists viewed comorbid symptoms as arising from an interaction between autistic traits and environmental mismatches, rather than autism itself. Psychotherapy was conceived as prioritizing reducing comorbid symptoms, fostering self-acceptance, and mitigating social camouflaging. Therapists emphasized a flexible, integrative approach tailored to individual needs, supported by a strong therapeutic alliance. The accounts of specialized psychotherapists suggest a shift away from interventions targeting core autistic traits, with greater emphasis on promoting well-being and psychological health. The therapists aligned with neurodiversity principles, advocating for autism-specific expertise, individualized strategies, and systemic efforts to enhance social acceptance. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

One key question for current psychotherapy research is how limited resources should be used efficiently to optimise treatment pathways. We examined how primary care level (PCL) psychotherapy, a history of mental disorder, and sociodemographic factors are associated with the later probability of receiving long-term rehabilitative psychotherapy. This longitudinal observational cohort study based on a register data from the Gaps in Mental Health-Related Work Disability and Treatment Outcomes (GapMind) project, which combines data from national registers (Statistics Finland and the Social Insurance Institution of Finland) and the largest occupational health service (OHS) provider in Finland. The study population comprised Finnish occupationally active individuals aged 15-65 (N = 1,261,320). Data on the use of PCL psychotherapy in the OHS between 2019 and 2020 were combined with data on age, gender, socioeconomic status, education, history of mental disorders (including psychotropic medication purchases, sickness absences, pensions, and use of OHS due to mental disorders), and somatic disabling comorbidities and four-model logistic regression analyses were conducted. The primary outcome was the use of long-term psychotherapy during 2020-2022. Participation in PCL psychotherapy (OR 7.05-15.51) and a history of mental disorders (OR 1.67-4.25) were associated with a higher probability of receiving subsequently long-term rehabilitative psychotherapy. Higher age, female gender, and higher socioeconomic status were also associated with an elevated likelihood of engaging in long-term rehabilitative psychotherapy. Participation in PCL psychotherapy, and various clinical and sociodemographic factors were associated with an increased probability of receiving later long-term psychotherapy. These findings may support healthcare systems in leveraging this information to better anticipate the need for long-term psychotherapy.

This article examines the pressing issue of developing a secure, specialized online platform for distance learning for children with special educational needs. The digitalization of education has opened up new opportunities for inclusion, but mainstream solutions often fail to address the specific needs of this category of students, creating digital, cognitive, and social barriers. The goal of the study is to develop a conceptual model of a secure and adaptive educational environment that comprehensively addresses accessibility, personalization, and cybersecurity. The project took into account the usability of children with various developmental disabilities, including sensory impairments, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), and based on this, the key principles of user interface and user experience (UI/UX) design were formulated. The proposed platform architecture includes an intelligent content and interface adaptation system, personalized learning paths, and secure communication modules with pre-moderation functions. Particular attention is paid to a multi-layered security system that ensures the protection of personal data, the prevention of cyberbullying, and access control. The article is of practical value to educational technology developers, educators, and administrators of educational institutions seeking to create an inclusive digital learning environment.