Disability Screening Questionnaire Research Articles

Exploring the short-term impact of using the Learning Disability Screening Questionnaire in a service for people experiencing homelessness

Exploring the short-term impact of using the Learning Disability Screening Questionnaire in a service for people experiencing homelessness

Facilitating the identification of intellectual disability in schools: A qualitative study of stakeholder views.

Many children experience delayed or missed identification of an intellectual disability diagnosis, meaning that key opportunities for early educational intervention may be lost. Semi-structured interviews were used to explore the views of teachers, parents, and clinicians (n = 22), about the use of the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) and what could improve screening and identification of intellectual disability in schools. Thematic analysis was used to identify relevant themes. Three themes were identified: the need for, and role of, screening in the context of limited knowledge about intellectual disability; the impact of screening and subsequent identification of intellectual disability; and the context within which participants felt screening should take place in order to maximise its benefits. The results confirmed the importance and benefits of timely identification of children with an intellectual disability and the positive role that screening might play in this.

Using the learning disability screening questionnaire to help identify people with an intellectual disability in homeless services.

We explored the accuracy of using the learning disability screening questionnaire (LDSQ) in services for people experiencing homelessness in the United Kingdom. We examined the concordance between the LDSQ outcomes and assessments of intellectual disability. Seventy adults experiencing homelessness completed the LDSQ. Staff completed the LDSQ and a measure of adaptive functioning for 38 of this group. Nine participants received an intellectual assessment. Sensitivity and specificity for the LDSQ when completed by staff was 83% and 96% respectively and 50% and 92% when completed by the individual. Seven people had intellectual and adaptive functioning in the intellectual disability range. The results suggest that the LDSQ would be an appropriate and beneficial screening tool to use within services for people experiencing homelessness. More accurate results would be likely if it were completed by staff.

Exploring the similarities and differences amongst service users with and without learning disabilities attending Saint Marys Sexual Assault Referral Centre.

People with learning disabilities are over-represented amongst Sexual Assault Referral Centre service users. This work aims to explore the similarities and differences between service users with and without learning disabilities. Medical notes of 52 service users likely to have a learning disability were compared with 52 service users not likely to have a learning disability (according to the Learning Disability Screening Questionnaire); all of whom attended Saint Marys SARC for a forensic medical examination during a 12-month period. Significant associations were found between the likelihood of learning disability and relationship to perpetrator; location of assault; alcohol use; time taken to present to SARC; domestic violence; self-harm; suicide attempts and mental health service involvement. People with learning disabilities in the sexually assaulted population are more likely to present with intersecting vulnerabilities emphasising the need for timely, accessible and appropriate patient-centred care for this group.

Prevalence of attention-deficit/hyperactivity disorder and intellectual disability among children with hydrocephalus.

Little is known about the prevalence of attention-deficit/hyperactivity disorder (ADHD) in children with hydrocephalus. In this study, the authors assessed the prevalence of ADHD and its association with clinical and demographic factors, including intellectual disability (ID), a potential factor that can confound the diagnosis of ADHD. The authors conducted a cross-sectional study of children 6-12 years of age with hydrocephalus using parent telephone surveys. The Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) and the National Institute for Children's Health Quality (NICHQ) Vanderbilt Assessment Scale were used to screen for ID and ADHD, respectively. Among children without ID, the authors identified those with ADHD and calculated a prevalence estimate and 95% confidence interval (Wald method). Logistic regression analysis was conducted to compare children with ADHD with those without ADHD based on demographics, family income, parental educational, etiology of hydrocephalus, and primary treatment. As a secondary analysis, the authors compared subjects with ID with those without using the same variables. Multivariable analysis was used to identify factors with independent association with ADHD and ID. A total of 147 primary caregivers responded to the telephone questionnaire. Seventy-two children (49%) met the cutoff score for ID (CAIDS-Q). The presence of ID was significantly associated with lower family income (p < 0.001). Hydrocephalus etiology (p = 0.051) and initial treatment (p = 0.06) approached significance. Of children without ID (n = 75), 25 demonstrated a likely diagnosis of ADHD on the NICHQ, yielding a prevalence estimate of 0.33 (95% CI 0.22-0.44). No clinical or demographic variable showed significant association with ADHD. These data indicate that the prevalence of ADHD among children with hydrocephalus (33%) is higher than among the general population (estimated prevalence in Alabama is 12.5%). ID is also common (49%). Routine screening for ADHD and ID in children with hydrocephalus may help to ensure that adequate resources are provided to optimize functional outcomes across development.

The use of an impact framework to evaluate the impact of research on policy and practice: Screening questionnaires for intellectual disability

Abstract There is an increasing emphasis on the importance of research having an impact on policy and practice. This can be more difficult to evidence in intellectual disability services because of the wide range of stakeholders involved. We evaluated whether an impact questionnaire covering: knowledge production, capacity building, informing policy and practice, social and economic benefits could successfully be used to evaluate the impact of research into and use of two screening questionnaires: the Learning Disability Screening Questionnaire (LDSQ) and Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q). We conducted an online search for published peer reviewed and grey literature, and Internet resources that referenced LDSQ and/or CAIDS-Q. The resultant literature and resources were assessed for relevance and organized according to the categories outlined in the impact questionnaire. Evidence was found for all the areas of impact, with the largest body of evidence being in relation to informing policy and practice and social benefits and the least for economic benefits. The impact questionnaire provided the basis for a comprehensive and useful evaluative framework to assess impact, although there was some overlap between the different categories. The process of using it highlighted some wider issues to consider when attempting to evaluate impact. The results indicated that the research underpinning the LDSQ and CAIDS-Q had resulted in significant, generally positive, and wide-reaching impact on policy and practice in intellectual disability and other services, resulting in a number of positive outcomes.

The disproportionately high prevalence of learning disabilities amongst adults attending Saint Marys Sexual Assault Referral Centre.

There is a dearth of reliable data on sexual assault prevalence amongst people with learning disabilities. This work aims to identify the prevalence of learning disabilities amongst adult clients attending Saint Marys Sexual Assault Referral Centre and ascertain the similarities/differences amongst clients with learning disabilities as compared to clients without. A short validated Learning Disability Screening Questionnaire was completed by adult clients attending Saint Marys for a forensic medical examination during a twelve-month period. Amongst 679 clients who attended for an FME and completed the LDSQ, 8.2% were likely to have a learning disability and the presence of self-reported: mental health issues (X2 =11.24, p=.001), self-harm (X2 =5.63, p=.017) and substance misuse (X2 =13.15906, p=.001). Consistent with the broader literature, people with learning disability were over-represented in the sexually assaulted population emphasizing the importance of timely, accessible and appropriate patient-centred care for this vulnerable group.

The impact of an adult intellectual disability screening questionnaire on service providers and users.

One contributor to the health inequalities that people with an intellectual disability face is failure to identify their intellectual disability. The Learning Disability Screening Questionnaire (LDSQ) can identify adults who are likely to have an intellectual disability, but little is known about its impact. A modified Delphi approach (literature search, interviews with staff and those using services [n=28], and completion of an online survey by professionals [n=29]) was used to develop a framework to evaluate the impact of the LDSQ. Items endorsed by 60% or more of respondents (9/18) were included in the final framework. These all related to benefits of the LDSQ, including identifying people not previously known to have an intellectual disability; helping prioritize diagnostic assessment; informing support needs; and helping increase wellbeing and life chances. The LDSQ may offer one way of helping address the health inequalities that people with an intellectual disability face.

Screening for intellectual disability with the Child and Adolescent Intellectual Screening Questionnaire: a modified Delphi approach.

To develop a consensus framework to evaluate the impact of screening for intellectual disability, using the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) in paediatric neurodevelopment clinics. A modified Delphi survey with four phases (literature review; initial development of framework [participants=11 parents, 8 professionals]; qualitative interviews [participants=4 parents, 15 professionals]; questionnaire development [participants=31 parents, 14 professionals] was used to develop the consensus framework. The framework was used to evaluate the impact of screening on six paediatricians and 31 parents of children who had participated in a previous paediatric screening project. Twelve of the original 20 items were retained based on levels of endorsement of 60 per cent or above. Direct benefits of using the CAIDS-Q were: indicating the child's level of functioning, increasing awareness of intellectual disability, helping to identify children with intellectual disability, and identifying potentially vulnerable children. Benefits related to subsequent diagnostic assessment were: promoting greater understanding of the child, identification of support needs, and receipt of support, particularly for the child at school. The use of the CAIDS-Q had a number of direct and indirect benefits for children, families, and services as reported by parents and paediatricians. A 12-item framework was developed to evaluate the impact of screening for intellectual disability. Direct benefits of the Child and Adolescent Intellectual Disability Screening Questionnaire include increasing awareness and identification of intellectual disability. Indirect benefits included increased identification of support needs and receipt of support.

Child and Adolescent Intellectual Disability Screening Questionnaire to identify children with intellectual disability.

To evaluate the psychometric properties of the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) in paediatric neurodevelopment clinics. Participants were 181 children (aged 6-18y) attending paediatric services in Scotland, divided into three age groups according to previous CAIDS-Q standardization cut-off scores. Fifty-four children (37 males, 17 females; mean age 117mo [SD 29.9mo]) met the criteria for intellectual disability and 127 did not (88 males, 39 females; mean age 120.1mo [SD 32.7mo]). A number of psychometric properties of the CAIDS-Q were evaluated, including test-retest and interrater reliability, convergent validity, sensitivity, specificity, and positive and negative predictive values based on existing cut-off scores. Significant positive relationships were found for all three age groups between CAIDS-Q scores and measures of intellectual and adaptive functioning. Test-retest reliability ranged from 'moderate' to 'almost perfect', whereas interrater reliability ranged from 'fair' to 'almost perfect'. Sensitivity and positive predictive value were 100% for all groups and specificity was between 83% and 94%, depending on age. Negative predictive values ranged from 75% to 91%. The CAIDS-Q appears to show psychometric properties that support its use as a screen for intellectual disability in paediatric neurodevelopmental settings. The Child and Adolescent Intellectual Disability Screening Questionnaire showed good psychometric properties. It identified all participating children who met the criteria for intellectual disability. Between 83% and 94% of children without intellectual disability were also correctly identified.

Neurodevelopmental disorders in prison inmates: comorbidity and combined associations with psychiatric symptoms and behavioural disturbance

The identification and management of inmates with neurodevelopmental disorders (ND) has been insufficiently addressed in the literature. We estimated the proportion of cases with Attention deficit/hyperactivity disorder (ADHD), Autism spectrum disorder (ASD) and Intellectual disability (ID) in prison, their comorbidity, and associations with disruptive behaviours and with psychiatric symptoms. Further, we examined the role of coexisting ND on psychiatric symptoms and attitudes toward violence. All 390 male inmates underwent an assessment that included the Diagnostic Interview for ADHD in Adults 2.0, the Autism Quotient, the Learning Disability Screening Questionnaire, the Brief Symptom Inventory (BSI), and measures of disruptive behaviours and attitudes towards violence. The percentage of cases with ADHD, ASD and ID were 25%, 9% and 9%. Inmates with ADHD and those with ID had significantly higher levels of disruptive behaviours. The combined ADHD/ASD group had significantly higher scores on global severity symptoms than either ADHD or ASD only. Meanwhile, the combined ADHD/ID group had significantly higher scores of behavioural disturbance than the ADHD-only group. Our findings show the extent of ND in prison, their inter-relations and associations with further mental health problems. Vulnerabilities conferred by ND within the criminal justice system should be addressed via interventions and preventative strategies.

Understanding the nurse's role in identifying children with intellectual disability.

The early diagnosis of children who have intellectual disability (ID) is crucial to ensuring the varied and complex needs of these people and their families are met in a timely and appropriate way. The ability to easily identify all children who should be assessed for ID would increase the chances of children with ID being diagnosed early on in life. This article describes ID, the kind of support children with ID need, and how nursing staff might use the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) to help identify children who should be formally assessed for ID. Nurses who would benefit from a greater ability to identify ID include health visitors, school nurses, practice nurses, and nurses working in paediatric clinics.

An Independent Investigation of the Utility of the Learning Disability Screening Questionnaire (LDSQ) within a Community Learning Disability Team.

The Learning Disability Screening Questionnaire (LDSQ) has been shown to have high sensitivity and specificity to identify those who are likely to meet intellectual disability diagnostic criteria (McKenzie, et al. ). However, there is no independent research to date to support these findings. An archival research design was used, utilizing data from diagnostic tools including the LDSQ, Wechsler Adult Intelligence assessments and Adaptive Behavior Assessment System Second Edition (ABAS-II) scores. Sensitivity and specificity values derived here were lower than those reported by (McKenzie, et al. ). Only IQ, not adaptive/social functioning, was found to be an accurate predictor of the LDSQ score. Results indicate limited validity in using(McKenzie, et al. ) proposed cut-off scores. The authors have expressed caution around using the LDSQ in isolation to identify those with an intellectual disability.

Selective Samples and the Accuracy of Screening for Intellectual Disabilities: Learning Disability Screening Questionnaire

The Learning Disability Screening Questionnaire (LDSQ) was developed primarily to provide a short and effective screening instrument to indicate possible intellectual disability amongst per-sons who come in contact with the service system. This study examined the validity of the Norwegian version of LDSQ in a sample of 35 subjects. All participants were outpatients referred for neuropsychological examinations. WAIS-III full-scale score was used for criterion validity. At a stated cut-off score of 46.6%, LDSQ showed several false negatives and false positives but no true positives. This raises the question of whether this test represents a valid screening instrument for learning disabilities in a clinical sample.

Validating the Learning Disability Screening Questionnaire Against the Weschler Adult Intelligence Scale, Fourth Edition.

The Learning Disability Screening Questionnaire (LDSQ), a brief screening tool for intellectual disability, was originally validated against the Weschler Adult Intelligence Scale, Third Edition (WAIS-III), which was superseded by the Weschler Adult Intelligence Scale, Fourth Edition (WAIS-IV) in the United Kingdom in 2010. This study examines the performance of the LDSQ using the WAIS-IV as the diagnostic intellectual assessment. Based on the original optimal cut-off score, the LDSQ sensitivity value was equivalent (91%) to that obtained in the original validation study, and the specificity value was higher at 92%. This suggests that the LDSQ remains valid when using the WAIS-IV as the comparative intellectual assessment.

Screening and diagnostic assessment of neurodevelopmental disorders in a male prison

Purpose – The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID). Design/methodology/approach – The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test. Findings – Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study. Originality/value – The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD.

Screening for learning disabilities in the criminal justice system: a review of existing measures for use within liaison and diversion services

Purpose – At present, there are significant limitations to the criminal justice system’s (CJS) ability to respond appropriately to detainees or defendant with learning disabilities (LD). The development of Liaison and Diversion Services has provided the opportunity to more easily identify people with LD in the CJS through the use of screening assessments. Therefore, the purpose of this paper is to consider why there is a need for screening assessments and review the literature on existing measures, in order to consider the next steps to develop a more effective pathway from the CJS to LD services. Design/methodology/approach – This paper takes the form of a literature review. Findings – The review found that there is a significant body of research defending the need for LD screening in the CJS across the UK. The aim of a screening process would be to identify individuals who possibly have LD and ensure that the correct measures are in place to assess and manage these individuals, including appropriate diversion to specialist LD services. The learning disability screening questionnaire (LDSQ) is an instrument that could be utilised in these instances and could be carried out by Liaison and Diversion Services. Research limitations/implications – Neither of the tools reviewed in this paper have been vigorously field tested within forensic settings in the UK. It is recommended that there should be trials of the LDSQ as a screening tool within Liaison and Diversion Services with comparison against outcomes of full diagnostic assessments for LD. Originality/value – Screening for LD is being discussed across the UK as part of Liaison and Diversion Services. This paper highlights the need for a reliable and valid screening tool and provides support for the use of the LDSQ.

An analysis of differential item functioning by gender in the Learning Disability Screening Questionnaire (LDSQ)

The Learning Disability Screening Questionnaire (LDSQ; McKenzie & Paxton, 2006) was developed as a brief screen for intellectual disability. Although several previous studies have evaluated the LDSQ with respect to its utility as a clinical and research tool, no studies have considered the fairness of the test across males and females. In the current study we, therefore, used a multi-group item response theory approach to assess differential item functioning across gender in a sample of 211 males and 132 females assessed in clinical and forensic settings. Although the test did not show evidence of differential item functioning by gender, it was necessary to exclude one item due to estimation problems and to combine two very highly related items (concerning reading and writing ability) into a single literacy item Thus, in addition to being generally supportive of the utility of the LDSQ, our results also highlight possible areas of weakness in the tool and suggest possible amendments that could be made to test content to improve the test in future revisions.

Evaluating the use of the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) to estimate IQ in children with low intellectual ability.

In situations where completing a full intellectual assessment is not possible or desirable the clinician or researcher may require an alternative means of accurately estimating intellectual functioning. There has been limited research in the use of proxy IQ measures in children with an intellectual disability or low IQ. The present study aimed to provide a means of converting total scores from a screening tool (the Child and Adolescent Intellectual Disability Screening Questionnaire: CAIDS-Q) to an estimated IQ. A series of linear regression analyses were conducted on data from 428 children and young people referred to clinical services, where FSIQ was predicted from CAIDS-Q total scores. Analyses were conducted for three age groups between ages 6 and 18 years. The study presents a conversion table for converting CAIDS-Q total scores to estimates of FSIQ, with corresponding 95% prediction intervals to allow the clinician or researcher to estimate FSIQ scores from CAIDS-Q total scores. It is emphasised that, while this conversion may offer a quick means of estimating intellectual functioning in children with a below average IQ, it should be used with caution, especially in children aged between 6 and 8 years old.

The accuracy of the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) in classifying severity of impairment: a brief report

Severity of intellectual disability (ID) is associated with a range of outcomes for the individual and having an indication of severity can help inform support needs. Previous research has not evaluated whether screening tools can accurately ascertain severity category in addition to providing a red flag for the presence of ID. We used multi-category receiver operating characteristic (ROC) analysis to assess whether the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) could be used clinically to classify individuals (n = 191) aged between 12 and 18 according to British Psychological Society (BPS) categories of severity of impairment. The volume under the surface statistic (VUS) was 0.59. The optimal cut-points estimated based on the ROC surface and Youden Index provided correct classification probabilities for the severe, significant and non-ID groups of 0.44, 0.63 and 0.86 and 0.79, 0.29 and 0.88 respectively. While the CAIDS-Q can accurately discriminate between those with and without ID, and provides a heuristic for severity of ID, the results indicate that it does not reliably identify whether an individual falls into the severe or significant category of intellectual impairment.