Diagnosis Of Disability Research Articles

Transitioning from paediatric to adult care in epilepsy: A qualitative study of adolescent experiences

ObjectiveTransition into adulthood and adult medical care is an important step in the life of young people with epilepsy. We aimed to gain a better insight into the lived experience of the transition to adulthood and adult medical care in epilepsy in Sweden, to improve future transitional care. MethodsA cross-sectional observational study with digital focus-group meetings and interviews with young people with epilepsy (16–22 years, n = 37) prior to, or after the transfer to adult care, or their primary caregivers if they had intellectual disability. We used reflexive thematic analysis to analyse the experiences and expectations on the transition to adulthood and adult medical care. ResultsThe results of the thematic analysis included four key areas during transition to adulthood and adult care for young persons with epilepsy: (I) worries on coming changes and future, (II) transfers are not smooth and adult care is less integrated, (III) epilepsy is part of a bigger picture, and (IV) parental roles change. In those with intellectual disability, parents experienced a stressful process and had to increase their efforts to coordinate all care contacts in adult care. Here, epilepsy was often experienced as a minor part of a more complex disease picture, where neurodevelopmental issues were often the primary concern. SignificanceTransition in epilepsy is often complex due to the large burden of co-occurring disease, specifically intellectual disability and neuropsychiatric diagnoses. Transfer to adult care is experienced as unplanned and participants experience uncertainty, indicating a need for an improved transition process. As effective interventions are known in other chronic diseases, future studies should focus on the evaluation of how these approaches can be feasible and effective in young people with epilepsy.

Psychological distress and mental health diagnoses in adults by disability and functional difficulty status: Findings from the 2021 national health interview survey

BackgroundEvidence suggests that disabled people have worse mental health than non-disabled people, but the degree to which disability contributes to mental health is unclear. ObjectiveThis paper uses 2021 National Health Interview Survey (NHIS) data to estimate the association between disability and depression and anxiety diagnoses as well as psychological distress among adults. MethodsWe calculated disability population prevalence and mental health diagnoses and associated symptoms among 28,534 NHIS respondents. Logistic regressions estimated the odds of depression or anxiety diagnoses and recent psychological distress, controlling for disability and mental health diagnoses. We measured disability using binary and continuum measures of functional disability with the Washington Group Short Set on Functioning. ResultsDisabled people have significantly greater odds of both depression and anxiety diagnoses compared to non-disabled people. Those with high functional disability have 552 % greater odds of an anxiety diagnosis (95 % CI: 5.61–7.58; p < 0.01) and 697 % greater odds of a depression diagnosis (95 % CI: 6.97–9.12; p < 0.01) compared to those with no functional disability. Similarly, those with any level of functional disability are more likely to have elevated psychological distress in the past 30 days compared to those with no functional disability. ConclusionsFindings support the idea that mental health is worse for disabled people compared to non-disabled people, with increasing functional disability associated with worse mental health. This suggests that mental health is not being adequately addressed for those with the greatest functional disability. Future work should seek to better understand the systemic causes of disparities.

Laser-printed paper ELISA and hydroxyapatite immobilization for colorimetric congenital anomalies screening in saliva

BackgroundAlpha-fetoprotein (AFP) is a fetal protein that can indicate congenital anomalies such as Down syndrome and spinal canal blockage when detected at abnormal levels in pregnant women. Current AFP detection methods rely on invasive blood or serum samples, which require sophisticated equipment. From the many solutions proposed, colorimetric paper-based assays excel in point-of-care settings. The concept of paper-based ELISA (p-ELISA) enhances traditional methods, aligning with the ASSURED criteria for diagnostics in resource-limited regions. Despite success in microfluidic paper-based assay devices, laser printing remains underexplored for p-ELISA. Additionally, modifying the paper surface provides an additional layer of sensitivity enhancement. ResultsIn this study, we developed a novel laser-printed paper-based ELISA (LP-pELISA) for rapid, sensitive, and noninvasive detection of AFP in saliva samples. The LP-pELISA platform was fabricated by printing hydrophobic barriers on filter paper using a laser printer, followed by depositing hydroxyapatite (HAp) as an immobilization material for the antibodies. The colorimetric detection was achieved using AuNPs functionalized with anti-AFP antibodies and silver nitrate enhancement. The LP-pELISA exhibited a linear response for AFP detection in both buffer and saliva samples over a range of 1.0–800 ng mL−1, with a limit of detection (LOD) reaching 1.0 ng mL−1. The assay also demonstrated good selectivity, repeatability, reproducibility, and stability. The LP-pELISA was further validated by testing spiked human saliva samples, showing its potential for point-of-care diagnosis of congenital disabilities. SignificanceThe LP-pELISA is a noninvasive platform showcasing simplicity, cost-effectiveness, and user-friendliness, utilizing laser printing, hydroxyapatite modification, and saliva samples to efficiently detect AFP. Beyond its application for AFP, this method's versatility extends to other biomarkers, positioning it as a catalyst for the evolution of paper-based biosensors. The LP-pELISA holds promise as a transformative tool for point-of-care diagnostics, fostering advancements in healthcare with its innovative technology.

Fidelity of family centered care model to early disability diagnosis and rehabilitation in the United Arab Emirates.

The role of parents in supporting early intervention for young children with disabilities is critical. Indeed, models of family centered care (FCC), which emphasis strong partnerships between health professionals and families in disability health services delivery are now widely associated with best practice. While FCC is consistently argued to be an appropriate model for disability service delivery, its utilization is limited primarily to Western countries such as Australia and the United States. Countries such as the United Arab Emirates (UAE) have prioritized early childhood development and are thus in search of best practices for delivery of early intervention for children and their families. The aim of this study was to explore the appropriateness of the FCC model in disability service delivery in the UAE. This study was conducted from the perspectives of health professionals who are involved in disability diagnosis, referral and ongoing support for families and children with disabilities. A total of 150 health professionals were recruited from health facilities, rehabilitation centers and schools in the Emirates of Abu Dhabi. The 27-item Measure of Process of Care for Service Providers (MPOC-SP) was used for data collection. The data were subjected to confirmatory factor analysis to confirm applicability of the model to this context. Multivariate analysis of variance and moderation analysis were also conducted, to ascertain the relationship between participants' satisfaction levels with their ability to diagnose, refer and provide on-going support and their likelihood of practicing key components of FCC. Computation of confirmatory factor analysis provided support for applicability of the MPOC-SP in the UAE context. Further inspection showed moderate to large correlations between the four components of FCC measured by MPOC-SP, providing further support for utilization of FCC in disability health service delivery in the UAE. The study concludes with a call to policymakers in the UAE to consider developing disability health policy based on key components of FCC. This could be supplemented by development of training modules on FCC to upskill health professionals involved in disability diagnosis and rehabilitation.

Experiences of learning disability nurses within community nursing teams, working in collaboration with primary care

Background: The approach and understanding of healthcare systems and societies regarding people who have a diagnosis of learning disability (LD) varies across countries; however, it is widely reported that those with LDs report feeling disempowerment and devalued by those working in healthcare. When an individual is devalued, they are more likely to have poorer health outcomes. International human rights laws, such as the Convention on the Rights of Persons with Disabilities, set out an international responsibility to address LD-related inequalities and mistreatment. In England, LD nurses predominantly work within community teams to improve patients living with LDs' holistic access to healthcare and reduce the health inequalities they experience. Exploration of the literature failed to identify any relevant research on the specific role and experiences of the LD nurse within a community team. Aim: This study aimed to explore the lived experiences of a LD nurse working with LD patients within a community setting. The research was conducted by an advanced clinical practitioner (ACP). Method: Semi-structured interviews were used to gather data from four participants. These interviews were recorded and analysed for themes and repeat experiences. Data were analysed using Braun and Clark's (2006) six step model. Findings: LD nurses reported that their patients benefited when they worked collaboratively with primary care. Discussion: The LD nurse was shown to improve access to healthcare for people living with a formal diagnosis of LD or intellectual disability. However, the LD community nurse role is not well known or understood. The LD nurse, when working collaboratively with primary care, often becomes a ‘token’ role that is not utilised. Investment in the role is required to ensure it reaches its full potential. The ACP is best placed to lead on these recommendations and contribute to building the research base in this area of expertise. The role is essential in reducing health inequalities and improving holistic healthcare outcomes for adults with a LD living within the community in the UK. Recommendations: It is recommended that a LD nurse, primary care pathway and an outcome measure tool for workforce planning are implemented within the LD nurse community setting. Future research within and outside the UK is needed to explore the experiences of LD nurses in other geographical locations.

Smith-Magenis Syndrome associated with Autism Spectrum Disorder with delayed diagnosis due to B12 deficiency: a case report

IntroductionSmith-Magenis syndrome (SMS) is a complex genetic disorder characterised by distinctive physical features, developmental delay, cognitive impairment and a typical behavioural phenotype. SMS is caused by interstitial 17p11.2 deletions (90%) involving multiple genes, including the retinoic acid-induced 1 gene (RAI1), or by pathogenic variants in RAI1 itself (10%).ObjectivesIn this case report, we present a case of Smith-Magenis syndrome with Autism Spectrum Disorder with karyotype 46,XX, 17p 11.2 gene deletion confirmed by Autism Spectrum Disorder, who was followed up in a paediatric neurology outpatient clinic with neuromotor developmental delay and whose diagnosis was delayed due to B12 deficiency. We also update scientific developments in Smith-Magenis syndrome.MethodsWe describe an 18-month-old male with Smith-Magenis syndrome and Autism Spectrum Disorder who was seen in our paediatric psychiatric outpatient clinic and who received B12 replacement with developmental delay.ResultsThe patient was followed up in the paediatric neurology outpatient clinic with delay in neuromotor developmental milestones and this delay was thought to be due to B12 deficiency (B12&lt;100 ng/L). The initial examination revealed delay in neuromotor and behavioural milestones, speech delay, wide and high nasal bridge and hypertelorism. Further physical examination revealed syndactyly of the second and third toes bilaterally and crossed lower teeth. Clinical and psychometric testing (Ankara Developmental Screening Inventory) by 2 consultants and 1 research assistant resulted in a diagnosis of intellectual disability and an additional diagnosis of Autism Spectrum Disorder due to social deficits that could not be explained by intellectual disability.ConclusionsSmith-Magenis syndrome is a well-known disorder involving the deletion of chromosome 17p11.2, which contains the RAI1 gene. This condition is associated with neuromotor and behavioural delay, as well as distinctive dysmorphic features. Clinicians should consider Smith-Magenis syndrome in the differential diagnosis for patients with delayed neuromotor and behavioural milestones, even in the presence of documented blood parameters (such as B12 deficiency) that may account for the delay.Disclosure of InterestNone Declared

Is There Uniformity in the Diagnosis of Learning Disability Globally?

Learning disabilities (LDs) are a group of neurodevelopmental deficits that negatively affect the acquisition, organization, retention, comprehension, or application of age appropriate knowledge. Persons with LD lead a subsidized quality of life, especially in academic/vocational and psychosocial domains. A certificate issued by the medical boards at a state or district level is required to avail benefits such as scribes or relaxations. This may be done through a series of assessments by psychologists, special educators, or other health-care professionals. The authors aim to understand if uniformity exists in the assessment methods used for the diagnosis of LD globally and to prepare a gap analysis for the same. A systematic review was performed on English literature articles published from January 2005 to August 2023. Full-text studies reporting assessment and diagnostic methods of LD were included. A total of 1246 records were identified through a manual search of an electronic database. Seven duplicates were removed and 1174 studies were excluded based on the relevance by screening titles, abstracts, and full texts. Sixty-five studies were included and analyzed. The authors found a lack of uniformity in this diagnostic protocol, leading to uncertainty in disability certification, doctor shopping, and additional stress for the patients, as well as added burden on the government. Identification of LD requires a multistep assessment process with culturally relevant tools and norms and the participation of a multidisciplinary team of experts.

The Effect of Understand-Answer Strategy Instruction on Reading Comprehension of Students with Ld

The purpose of this research is to determine the effect of the Understand-Answer Strategy on the reading comprehension skills of students with learning disabilities. The research was carried out on students with a diagnosis of learning disability studying in secondary schools in Pendik, Istanbul, affiliated with the Ministry of National Education. The selected students are between the ages of 12 and 13, with two girls and one boy. The research was carried out with a single-subject design, a "Multiple probe design between subjects". The dependent variable of the study is the number of correct answers given to the reading comprehension questions in a written reading comprehension text. The independent variable of the research is the Understand-Answer Strategy. The experimental process consisted of the stages of determining the starting level, teaching the Understand-Answer Strategy, end-of-teaching evaluation, monitoring, and generalization. At the end of the study, the opinions of the students and their families were also considered. The Understand-Answer Strategy consist of activating prior knowledge, discussing the strategy, being a model, guiding practices and independent practices. At the end of the research, the opinions of students and their families were examined as social validity data. In all evaluation conditions, students were asked to read a narrative text and then answer eight reading comprehension questions. The scoring of the data was determined by the correct answers given by the students to the questions. The research findings have shown that the Understand-Answer Strategy is effective in improving the reading comprehension skills of students with learning difficulties. Furthermore, students who learned this strategy were able to provide correct answers to reading comprehension questions 1, 3, and 5 weeks after the end of the application, and it was observed that students who learned the strategy with different participants generalized their reading comprehension performance. According to the social validity findings, students and their families expressed positive views about the Understand-Answer Strategy.

Mr. Gilbert's World Tour: Rethinking Disabled Veterans Across British Imperial Spaces.

This article provides a comparative analysis of the treatment of disabled First World War veterans in 1920s Britain and the simultaneous care of Imperial Pensioners residing in Australia and South Africa via the detailed administrative reports of a British civil servant, G.F. Gilbert. Imperial Pensioners were disabled veteran migrants of the British Army residing overseas. A study of these veteran populations in Australia and South Africa provides two primary insights into the broader historiography of disabled veterans. Firstly, a comparative case study helps to show the way in which cultural notions of disability were part of broader ideas of nation-building overseas. Secondly, the specific disability diagnosis category chosen as a more in-depth case study can further complicate and contradict broader assessments of national responses. This article attempts to build upon recent transnational histories of veterans by transcending national boundaries and homogenous veteran profiles with an extension in methodological scope by providing an intra-national case study via the Imperial Pensioner.

The Impact of metacognitive strategies on the development of language competence for secondary cycle learners with Hearing impairment

This study, which is part of doctoral research into applied Arabic linguistics and comparison, aimed to identify the impact of teaching using metacognitive learning strategies on developing linguistic competence for the Arabic language for deaf learners in LALLA ASMAE foundation for deaf children in Rabat-Morocco. To achieve the research objectives, theresearcher used the descriptive and the quasi-experimental methodologies approaches, and the research sample comprised two groups; experimental have been learned by the 5E-Learning cycle strategy and Self-Questioning, and the control group by an ordinary method.Study tools:- Mykle Bust test for diagnosis of learning disabilities.- Linguistic competence test (examined its psychometric stabilities).The results showed that there were significant differences at (α 0.05) between the average scores of the learners of the experimental and control group in the post-test of the linguistic competence in the Arabic language in favor of the experimental group used the 5E-Learning cycle and self-questioning strategy in teaching. There were also no statistically significant differences at (α 0.05) in the mean of student's scores on the post-test of the linguistic competence and language Fields due to the gender variable. Results confirm the positive effect of metacognitive strategies, specifically the 5E-Learning cycle and Self-Questioning. So, it is recommended to increase the use of metacognitive strategies in the educational learning process, especially for Hearing impairment learners and encouraging research to apply metacognitive strategies in teaching various fields of Arabic language skills in addition to generalizing the study of these strategies at different educational levels

Comparing fine motor performance among young children with autism spectrum disorder, intellectual disability, attention-deficit/hyperactivity disorder, and specific developmental disorder of motor function.

The acquisition of fine motor skills is considered to be a crucial developmental milestone throughout early childhood. This study aimed to investigate the fine motor performance of young children with different disability diagnoses. We enrolled a sample of 1,897 young children under the age of 6 years who were at risk of developmental delays and were identified by a transdisciplinary team. A series of standardized developmental assessments included the Bayley Scales of Infant Development-Third Edition, Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, Peabody Developmental Motor Scale-Second Edition, and Movement Assessment Battery for Children-Second Edition were used. Retrospective chart reviews were conducted on all children to identify specific developmental disorders. The number of autism spectrum disorder (ASD), intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), comorbidity, motor dysfunction, and unspecified developmental delays (DD) were 363 (19.1%), 223 (11.8%), 234 (12.3%), 285 (15.0%), 128 (6.7%), and 590 (31.1%), respectively. Young children with ID, comorbidity, and motor dysfunction demonstrated significant difficulty in performing manual dexterity and visual motor integration tasks and scored significantly lower in these areas than children with ASD, ADHD, and unspecified DD. In addition, fine motor performance was associated with cognitive ability in children with different disability diagnoses, indicating that young children showed better fine motor performance when they demonstrated better cognitive ability. Our findings support that differences in fine motor performance differ by disability type. Close links between fine motor performance and cognitive ability in children under the age of 6 years were seen in all disability types.

Academic performance in moderately and late preterm children in the United States: are they catching up?

ObjectiveTo determine whether preterm birth of 32–36 6/7 weeks gestation affected school performance from kindergarten through fifth grade.Study designWe assessed 14350 term infants and 1195 32–36 6/7 weeks gestation infants followed in the Early Childhood Longitudinal Study Kindergarten 2011 cohort for classroom performance in kindergarten-fifth grade. Multivariable regression was performed for comparisons, and data were weighted to be representative of the US population.ResultsChildren born 35–36 6/7 weeks gestation had no significant difference in their academic scores or performance, while 32–34 6/7 weeks’ children had lower academic scores and teacher performance scores when compared to term children. Children born between 32 and 36 6/7 weeks gestation had higher odds of individualized education plan needs and had learning disability diagnoses compared to term children.ConclusionsChildren born between 32 and 34 6/7 weeks gestation have poor school performance compared to term children. Children born between 32 and 36 6/7 weeks gestation are at risk for learning disabilities and likely benefit from continued support and services to improve achievement throughout school.

Factors Related to Regular Dental Check-Ups in Adults With Intellectual Disabilities in Japan

BackgroundWe investigated the factors associated with regular dental check-ups among adults with intellectual disabilities in Japan, with the aim of increasing the attendance rate of regular dental check-ups, which are important for maintaining the oral health of persons with intellectual disabilities. MethodsA questionnaire survey focused on oral health was conducted with 971 adults with intellectual disabilities in Japan. The survey included questions related to disability diagnosis, severity of intellectual disability, residence type, and several oral-health factors, including proxy-reported number of teeth, presence of a family dentist, frequency of regular dental check-ups, tooth-brushing habits, and availability of a dental hygienist at a facility. Logistic regression analysis was used to determine the association between regular dental check-ups (dependent variable) and independent variables. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. ResultsIn a multivariate analysis, sex, diagnosis of disability, severity of intellectual disability, residence type, and the presence of a family dentist were significantly associated with regular dental check-ups. The ORs for nonregular dental check-ups were significantly higher for adults with Down syndrome, those with mild disability, and those living at home with family; the respective mean ORs (95% CIs) were 2.3 (1.2-4.4), 3.3 (1.3-8.4), and 1.8 (1.1-3.0). The absence of a family dentist had a particularly strong association with a lack of regular dental check-ups, with a mean OR (95% CI) of 15.0 (8.7-26.0). ConclusionsRegular dental check-ups among adults with intellectual disabilities in Japan were associated with sex, diagnosis of disability, severity of disability, type of residence, and the presence of a family dentist.

Clinical effectiveness of the psychological therapy Mental Health Intervention for Children with Epilepsy in addition to usual care compared with assessment-enhanced usual care alone: a multicentre, randomised controlled clinical trial in the UK

Mental health difficulties are common in children and young people with chronic health conditions, but many of those in need do not access evidence-based psychological treatments. The study aim was to evaluate the clinical effectiveness of integrated mental health treatment for children and young people with epilepsy, a common chronic health condition known to be associated with a particularly high rate of co-occurring mental health difficulties. We conducted a parallel group, multicentre, open-label, randomised controlled trial of participants aged 3-18 years, attending epilepsy clinics across England and Northern Ireland who met diagnostic criteria for a common mental health disorder. Participants were randomised (1:1; using an independent web-based system) to receive the Mental Health Intervention for Children with Epilepsy (MICE) in addition to usual care, or assessment-enhanced usual care alone (control). Children and young people in both groups received a full diagnostic mental health assessment. MICE was a modular psychological intervention designed to treat common mental health conditions in children and young people using evidence-based approaches such as cognitive behaviour therapy and behavioural parenting strategies. Usual care for mental health disorders varied by site but typically included referral to appropriate services. Participants, along with their caregivers, and clinicians were not masked to treatment allocation but statisticians were masked until the point of analysis. The primary outcome, analysed by modified intention-to-treat, was the parent-report Strengths and Difficulties Questionnaire (SDQ) at 6 months post-randomisation. The study is complete and registered with ISRCTN (57823197). 1401 young people were potentially deemed eligible for study inclusion. Following the exclusion of 531 young people, 870 participants were assessed for eligibility and completed the SDQ, and 480 caregivers provided consent for study inclusion between May 20, 2019, and Jan 31, 2022. Between Aug 28, 2019, and Feb 21, 2022, 334 participants (mean ages 10·5 years [SD 3·6] in the MICE group vs 10·3 [4·0] in control group at baseline) were randomly assigned to an intervention using minimisation balanced by age, primary mental health disorder, diagnosis of intellectual disability, and autistic spectrum disorder at baseline. 168 (50%) of the participants were female and 166 (50%) were male. 166 participants were randomly assigned to the MICE group and 168 were randomly assigned to the control group. At 6 months, the mean SDQ difficulties for the 148 participants in the MICE group was 17·6 (SD 6·3) and 19·6 (6·1) for the 148 participants in the control group. The adjusted effect of MICE was -1·7 (95% CI -2·8 to -0·5; p=0·0040; Cohen's d, 0·3). 14 (8%) patients in the MICE group experienced at least one serious adverse event compared with 24 (14%) in the control group. 68% percent of serious adverse events (50 events) were admission due to seizures. MICE was superior to assessment-enhanced usual care in improving symptoms of emotional and behavioural difficulties in young people with epilepsy and common mental health disorders. The trial therefore shows that mental health comorbidities can be effectively and safely treated by a variety of clinicians, utilising an integrated intervention across ages and in the context of intellectual disability and autism. The evidence from this trial suggests that such a model should be fully embedded in epilepsy services and serves as a model for other chronic health conditions in young people. UK National Institute for Health Research Programme Grants for Applied Research programme and Epilepsy Research UK Endeavour Project Grant.

Is there a correlation between prepartum anaemia and an increased likelihood of developing postpartum depression? A prospective observational study

PurposePostpartum depression (PPD) represents a significant challenge to maternal and child health. Early screening for PPD is essential to ensure appropriate treatment and support. The present study aimed to assess whether maternal prepartum anaemia influences the likelihood of developing PPD within 3 days after delivery.MethodsIn collaboration with the Department of Psychiatry, a prospective observational study was carried out at the Gynaecology and Obstetrics Department of the University of Campania “Luigi Vanvitelli” in Naples. A total of 211 full-term pregnant women were enrolled, and their predelivery haemoglobin value was recorded. Women with gestational diabetes, hypertension, pre-eclampsia, intrauterine growth restriction, intellectual disability, or pre-existing diagnosis of psychotic spectrum disorder were excluded. Participants provided written informed consent to fill out the Edinburgh Postnatal Depression Scale (EPDS) 3 days after delivery. EPDS cut-off score of ≥ 10 was used to identify women at risk of developing PPD. Statistical analysis was performed using Student's t test, the Wilcoxon Rank Sum test, and linear regression.ResultsThe participants were categorized into 2 groups based on EPDS scores: EPDS < 10 (176 patients) or EPDS ≥ 10 (35 patients). The two groups showed homogeneity in terms of socio-demographic and clinical characteristics. The mean haemoglobin values of anaemic pregnant women in the EPDS ≤ 10 group (11.78 ± 1.39 g/dl) and the EPDS > 10 group (11.62 ± 1.27 g/dl) were not significantly different (p = 0.52). There was no significant correlation between the predelivery haemoglobin value and the EPDS postpartum score of < 10 or ≥ 10. The Wilcoxon Rank Sum test and the estimated coefficients of the linear regression model did not show any statistical relationship between continuous and binary haemoglobin values.ConclusionsOur study found that maternal prepartum anaemia did not negatively impact the likelihood of developing postpartum depressive symptoms, in the first 3 days after delivery.

Testing an algorithm to identify disabilities using current health and social healthcare database: the experience of the Agency for Health Protection of the Metropolitan Area of Milan

to describe prevalence of disability in the population of the Agency for Health Protection of Milan (ATS Milan), integrating current administrative healthcare, socio-healthcare, and social data; to classify disability with a diagnosis into a predominant structural and functional category according to the International Classification of Functioning, Disability and Health (ICF), supplementing it with additional levels of detail. retrospective observational study. subjects residing in the territory of ATS Milan in the years from 2018 to 2022. Main outcomes measures: prevalence of disability in the population of ATS Milan from 2018 to 2022; average annual costs since disability diagnosis of the entire population and stratified by the most common ICF classifications. the prevalence of disability ranges from 5.8% in 2018 to 8.4% in 2022. In general, women have a higher prevalence than men. However, there are significant differences in the gender distribution depending on the considered age group. The main disabilities (32.2%) affect the structures of the nervous system and mental functions, followed by disabilities identified solely by major prosthetic devices (9.4%) and sensory disabilities with alterations in sensory functions with the presence of a major device (5.2%). Analysis of average total annual per capita costs shows an upward trend with increasing years since the diagnosis. the definition of standardized tools, such as the selection from several available healthcare data provided by service suppliers, can be helpful in obtaining reliable data on the prevalence of disability in the population. This evidence can be useful in planning public health interventions to address the needs of this population. The work developed by ATS Milan has been carried out in alignment with the activities outlined in Mission 5 of the National Recovery and Resilience Plan (PNRR), in particular for the reform of disability legislation, which foresees the definition of standardized tools for the in-depth study of the epidemiological aspects of the phenomenon.

Interrogative Suggestibility and Ability to Give Resistant Responses in Children with Mild Intellectual Disabilities and Borderline Intellectual Functioning

Children with intellectual disabilities can be victims of crimes but are generally deemed less reliable in the forensic context than children without disabilities. Their deficits may cause inaccurate recall, greater memory errors, and greater suggestive vulnerability. The aim of the present study is to verify the effects of intellectual abilities on recall tasks, levels of suggestibility, vulnerability to negative social pressure, and Resistant Behavioural Responses (RBR). The study involved 120 children aged 7–16 years who were administered the GSS2 (1997) and Raven Matrices. Forty children had a diagnosis of mild intellectual disability (MID), 40 had borderline intellectual functioning (BIF), and 40 were typically developing peers. Children with MID and BIF showed more errors in distortions, inventions, and confabulations at the recall task and higher levels of suggestibility.Low IQs reduced the ability of source monitoring and led to less resistant responses to misleading questions. IQ affected resistant responses both at the first and second suggestive interview, reducing both source monitoring capabilities and the ability to manage social pressure. Age may impact the ability to provide resistant responses but only in the first suggestive interview (Yield 1), which depends more on the maturity of cognitive processes involved in interrogative suggestibility.

1969 Assessing the acute hospital care of patients with a diagnosis of a learning disability and hip fracture

Abstract Introduction Patients with learning disabilities (LD) often have complex medical needs resulting in onset of frailty at younger ages. This increases risk of morbidity and mortality following emergency admissions, such as acute fractured neck of femur (FNOF). This risk is further increased by communication difficulties experienced in this group. There is little information about how LD affects the quality of care of patients with FNOF as defined by the national hip fracture standards (NHFS). Methods This retrospective audit reviewed notes of patients with LD admitted to a teaching hospital with FNOF over 5 years. The audit examined whether the care of patients with LD complied with the NHFS and best practice tariff guidelines, regardless of age. The audit sought to explore potential disparities between patients with LD and the general population. It assessed whether steps were taken to optimise care as defined by the Royal College of Physicians toolkit for LD. Results 46 patients were included; 22% were under the age of 60. Operative management was in line with recommendations. However, 37% did not receive appropriate bone strengthening treatment and 37% were not mobilised within the first 24 hours. This correlated with fewer patients remaining freely mobile following the admission (8.7% post-operatively vs 41.3% pre-operatively). Documentation of LD severity LD and usual behaviours was unreliable, as was documentation of key conversations, such as those regarding capacity or resuscitation. Conclusions This highlights the importance of addressing the increased needs of patients with LD regardless of age, to better facilitate holistic assessment and treatment of this vulnerable population. Locally we plan to minimise variation by utilising LD nurses and providing comprehensive geriatric review of all patients with LD admitted with FNOF. We recommend that data collection, including 120-day follow-up, be incorporated into routine practice for all patients with LD admitted with FNOF.

The overrepresentation of parents with disabilities in child protection

BackgroundRacial disproportionality and disparity have long plagued the United States child protection system (CPS). Determining whether disproportionality exists for parents with various disability diagnoses, and the points at which it may occur within CPS, is important to the provision of appropriate assessment and service delivery to children and families. ObjectiveThis study describes the characteristics of parents with different types of disabilities and estimates their representation at various CPS decision-making points. Participants and settingThe sample consists of a longitudinal, population-level cohort of individuals aged 15–21 identified from statewide educational records, whose disability status could be determined. Statewide CPS records were integrated to determine subsequent CPS involvement (as alleged offenders/parents involved in a child maltreatment investigation, and/or as parents of children placed in out-of-home care [OHC], and/or as parents whose parental rights were terminated [TPR]), or lack thereof. MethodsDescriptive statistics, chi-square analysis, disparity indices with decision-point enumeration, and logistic regression analyses were used to answer study questions. ResultsFindings reveal consistent and significant overrepresentation of parents with disabilities at CPS investigation as compared to parents without disabilities. Additionally there is a fairly similar trend across disability diagnoses in the reduction of overrepresentation at OHC, followed by a diagnosis-specific change in representation as parents with disability move into a situation of TPR, with some parents with disabilities being over-represented and others not. ConclusionAttention to practice, policy, and research are necessary to provide fair and equitable services to parents with disabilities and their children in CPS.

Ab. No. 93 Prevalence of Learning Disability in School-Going Kids of Government School in District Patiala, Punjab

Introduction: The purpose of the study is to determine the prevalence of learning disability in school-going children from the IIIrd –Vth class of government schools by using the Learning Disability Diagnostic Inventory (LDDI). The study contributes to expanding the role of physiotherapy in multidisciplinary teams by fostering effective therapeutic approaches to promote balanced development of children with learning disability. Methods: A total of 80 students belonging to the class III-V between the 8-11 years of age group from different government schools were selected as participants in the present study. Methods: The study was conducted using convenience sampling method. A detailed questionnaire was used to document each student’s academic performance. The students were then subjected to a series of assessments, including visual auditory perception tests and an IQ based (Colored Progressive Matrices) CPM test followed by LDDI filled by the teacher of each student. The data was analysed through descriptive statistics and inferences. Results: The findings of the study were that out of total 80 students the prevalence of Learning Disability in Writing domain constitutes (10%), Reading (7.5%), Speaking (21.25%),Reasoning (6.25%),Listening (25%), Arithmetic disability (8.75%). Students of primary class IIIrd-Vth were at higher risk of learning disability in government schools. Conclusion: The study concluded that the learning disability is more prevalent in early aged students between age of 8-11. Institutional based educational strategies are required for appropriate modifications in education and teaching techniques. Implications: The present study helps in making early diagnosis of learning disability at school level and further widens the spectrum for planned effective therapeutic interventions to enhance the academic performance of students with learning disability and enhance the overall quality of life.