Level Of Intellectual Disability Research Articles

Helicobacter pylori Infection in Children With Cerebral Palsy: A Cross-Sectional Study

BackgroundChildren with cerebral palsy (CP) frequently have associated disorders and complications, including gastrointestinal problems. Helicobacter pylori is a common infection worldwide, frequently associated with gastrointestinal manifestations. MethodsTo estimate the prevalence of H. pylori infection in children with CP, a cross-sectional study over an eight-month period was performed in the pediatric neurology outpatient clinic of Tanta University Hospital. The study included 100 patients with CP aged two to 17 years. All patients were tested for H. pylori antigen in stool by enzyme-linked immunosorbent assay. ResultsThe mean age of studied children with CP was 7.03 ± 4.1 years; there were 57 males and 43 females. Spastic quadriplegic CP was the most common type of CP (34%). Forty-five children with CP were positive for H. pylori antigen in stool. Intellectual disability (ID), low sociodemographic scoring system, semisolid diet, and Eating and Drinking Ability Classification System (EDACS) levels 4 and 5 were significant predictors of H. pylori infection (odds ratio of 1.86, 2.63, 12, and 1.77, respectively, P < 0.05). Vomiting, abdominal pain, and gastrointestinal tract bleeding were significantly more frequent in H. pylori-infected children with CP than noninfected children with CP (P value < 0.05) ConclusionH. pylori is a relatively common infection among children with CP. The main risk factors for H. pylori infection were low socioeconomic level, ID, semisolid diet, and EDACS levels 4 and 5.

Differentiation of the body build and posture in the population of people with intellectual disabilities and Down Syndrome: a systematic review

BackgroundThe aim of the study was to identify the variables of the internal compensatory mechanisms that differentiate the body build and posture of people with Down syndrome (DS) from the intellectual disability (ID) population. It was assumed that gaining knowledge in the abovementioned aspect will allow for a better understanding of the limitation of the kinesthetic abilities of people with ID and DS and simultaneously enable to optimize the process of planning and interventions to improve physical activity in this population with the adequate use of theirs strengths in the biomechanical and morphofunctional systems.MethodsThe methodology of this systematic review was developed according to the PRISMA guidelines. A search of PubMed, EBSCO, Scopus databases was conducted to identify all studies on DS/ID and the body build and posture from 2003 to 2023.Results395 articles were assessed to determine eligibility, while 22 studies met the inclusion criteria and were subjected to detailed analysis and assessment of their methodological quality. The differentiation of the body build and posture in DS population can be induced by both internal and external compensatory mechanisms. It is difficult to confirm the direct effect of the intrinsic variables that impact the body build and posture in the ID population, excluding people with DS.ConclusionsCompared to other ID, the intrinsic differences in the body build and posture in DS individuals were induced by gender, age, and level of ID. The tendency for diversity between DS and other ID populations in body build and posture may be determined by the presence of the third copy of chromosome 21 in DS group. Internal compensatory processes may be induced mainly by abnormalities in the structure of the cervical vertebrae and feet. IQ should not be used as the only variable that identifies the population of people with ID.

Cognitive reserve in Down syndrome: a new opportunity to understand resilience in Alzheimer’s disease

AbstractBackgroundTraditionally, cognitive reserve (CR) and other related concepts underlying resilience, have been studied in the context of aging and Alzheimer’s disease (AD; Stern et al., 2020). Despite the increasing interest in elucidating how CR measures influence brain and cognitive development through a lifespan perspective (Kremen et al., 2019), its study in developmental diseases such as Down syndrome (DS) remains unexplored. Understanding the role of CR and its neurobiological mechanisms in DS is critical, since this population is genetically determined to develop AD (Fortea et al., 2021). During the last decades, people with DS have experienced an improvement in the number and quality of stimulating activities due to the higher inversions in disability services and community support resources. In this regard, our goal was to test whether this enriched environment would result in a generational effect showing a lower intellectual disability (ID) level and a higher intellectual profile as function of the birth year in DS.MethodWe selected a cross‐sectional subsample from the cohort study of adults with DS recruited at the Alzheimer‐Down Unit from the Catalan Down Syndrome Foundation and Hospital of Sant Pau. We included 528 participants with DS without clinical symptoms of AD born between 1955‐1995 (age: 39.25±9.27 years; 46.02% females). Participants with profound ID (as these individuals perform at floor scores) were excluded for Kaufman Brief Intelligence Test (K‐BIT) analyses (N = 379; age: 39.03±9.10 years; 48.02% females).ResultResults evidenced a generational increase in the proportion of individuals with mild or moderate ID and a decrease in those with profound or severe ID level (Fig1). Similarly, a higher proportion of individuals acquired intellectual milestones (i.e., language, literacy, calculation; Fig2). Furthermore, our analyses revealed an increase in mean K‐BIT scores as function of the birth year (P&lt;.001; Fig3).ConclusionThere have been major changes in CR proxies in individuals with DS. Given the near full penetrance of AD in this population, characterizing the effect of these factors on AD presentation and pathophysiology could signify an important advance in the design of primary prevention plans in this particularly vulnerable population, which could probably be transferred to the general population.

Does the Timing of Alzheimer’s Disease vary by Severity of Intellectual Disability in Down Syndrome?

AbstractBackgroundTrisomy 21 causes Down syndrome (DS) and is a recognized cause of Alzheimer’s disease (AD). The triplication of the amyloid precursor protein gene leads to an overexpression of amyloid‐beta (Aβ), which accumulates into extracellular plaques, followed by intracellular neurofibrillary tau tangles (Lott &amp; Head, 2019). However, variability in the age of AD onset in DS spans 25+ years (Iulita et al., 2022). As the DS field moves to AD clinical trials, it is important to identify factors related to this variability, such as premorbid severity of intellectual disability (ID). We compared the age‐trajectory of the AD biomarkers Aβ and tau and cognitive decline across premorbid ID levels (mild, moderate, and severe/profound), in models controlling trisomy type (full, mosaic, translocation) and APOE statusMethodAnalyses involved 361 adults with DS (M = 45.22 years, SD = 9.92) from the Alzheimer’s Biomarkers Consortium‐Down Syndrome. Participants completed measures of memory, mental status, and visuospatial ability. Premorbid ID level was recorded. PET was acquired using [11C] PiB for Aβ, and [18F] AV‐1451 for tau in 162 participants. Aβ was quantified using the centiloid method and tau was quantified as SUVR (reference: cerebellar cortex) in a composite region determined as the volume‐weighted average of select FreeSurfer 5.3, T1 MR‐based components.ResultsGeneral linear models controlling for site, age, trisomy type and APOE status indicated no significant effect of premorbid ID level by age on the cognitive outcomes (Figure 1a‐e). There was not a significant effect of premorbid ID by age on PET Aβ or on tau PET (Figure 2a‐b). There was not a significant difference in age of those with mild cognitive impairment‐DS (MCI‐DS) or dementia by premorbid ID level (Figure 3).ConclusionThis study adds to the characterization of the time course of AD pathology and clinical symptomology in DS. Findings provide robust evidence of a similar time course in AD trajectory across severity of ID, laying the groundwork for the inclusion of individuals with DS with a variety of IQ levels in clinical AD trials. Premorbid IQ may have little effect on AD biomarkers in DS in contrast to findings in neurotypical populations.

Evaluation of postural stability under single and dual task conditions in individuals with and without intellectual disability

Background: The aim was to investigate how varying levels of intellectual disability (ID) impact postural stability parameters and response reaction time (RRT). Method: Fifty-nine individuals with low and moderate levels of ID and 55 sex- and age-matched peers without ID performed a bipedal standing postural control task while having their (I) eyes open [OE], (II) eyes closed [CE], and (III) while performing a secondary cognitive task- pressing a trigger button while maintaining still stance (dual task, DT). Seven postural control parameters (total, mediolateral and anteroposterior displacement, sway area, sway mean velocity, mediolateral dispersion, and anteroposterior dispersion) during each experimental condition as well as the RRT during the DT were recorded. Results: The results revealed that (I) CE and DT partially affected postural control parameters when compared to OE condition (in 13 and in 3 out of 21 pairwise comparisons, respectively), (II) individuals with ID had poorer postural control than peers without ID during the OE and DT conditions (p ≤ 0.05), but not during the CE condition (except for the larger total displacement observed in participants with moderate disability compared to participants without ID, p ≤ 0.05), (III) RRT was longer in individuals with ID compared to the group without ID (p ≤ 0.001), and (IV) no postural control parameter (p ≥ 0.05) nor RRT (p = 0.138) revealed differences between the participants with low and moderate levels of ID. Conclusions: These findings suggest that individuals with ID present reduced performance in the postural control parameters especially when they need to respond to DT compared to individuals without ID.

Cardiometabolic Effects of Antipsychotics in Challenging Behavior and Neuropsychiatric Symptoms in Patients With Intellectual Disability.

Introduction Despite the well-established association between antipsychotics and metabolic adverse effects in psychiatric disorders, the variable influence of long-term and off-label antipsychotic medication on behavioral disorders has not been investigated in detail. Objective To clarify the impact of antipsychotic use on challenging behavior (CB) and neuropsychiatric symptoms (NPS), we evaluated the clinical findings and cardiometabolic effects in individuals with intellectual disability (ID) hospitalized in our residential facility for profoundly disabled patients. Patients and methods A total of 130 individuals hospitalized in our residential facility were retrospectively investigated and divided into two groups - individuals with and without CB and NPS. Antipsychotics (first- and second-generation antipsychotics) are prescribed to all individuals in the CB and NPS-positive ID group. Conversely, antipsychotics were not prescribed to any individuals in the CB- and NPS-negative ID groups. To investigate the cardiometabolic effects of antipsychotics, the following metabolic parameters were measured: body weight (BW), total calorie intake per day, body mass index (BMI), blood pressure, serum lipid levels (total cholesterol, high-density lipoprotein cholesterol, and triglyceride), and corrected QT interval (QTc) of electrocardiogram (ECG). The etiology of disabilities, level of ID, severity of motor disability, and presence or absence of epilepsy were also examined. Results Two main results were derived: (1) Autism spectrum disorder was the most predominant etiology in individuals with CB and NPS who were prescribed antipsychotics, and (2) the mean values of metabolic parameters were all normal in both medicated and nonmedicated individuals, but the total calorie intake was significantly higher in individuals who were prescribed antipsychotics. Conclusions Our investigation demonstrated that in individuals with an adequate energy intake, most metabolic parameters can be maintained within normal limits. We suggest that body weight control is the primary step in avoiding the cardiometabolic adverse effects of antipsychotics in intellectually disabled individuals with CB and NPS.

24 Individual Differences in CAMCOG-DS Performance in Children and Adults with Down's Syndrome and Relationship to Language and Reasoning

Objective:The Cambridge Cognitive Examination for Down's Syndrome (CAMCOG-DS) was developed to assess cognitive functioning and dementia-related cognitive decline in people with Down's Syndrome (DS). It has been translated into different languages and is often used in international studies. Although adapted for people with intellectual disabilities (ID), many tasks involve verbal responses and instructions are presented orally. Therefore, the administration for people with severe language deficits can be challenging. The aim of this retrospective data analysis is to examine the influence of language ability and reasoning on CAMCOG-DS performance. Study 1 examined the relationship between CAMCOG-DS, picture naming, single word comprehension and reasoning in adults with DS. Study 2 replicates and broadens the findings in a sample of children and adults with DS.Participants and Methods:Study 1 included 40 adults with DS between 18 and 51 years (M = 28.6, SD = 8.4). 25 had a mild and 15 a moderate ID. CAMCOG-DS, the short form of the Boston Naming test (BNT), a test for single word comprehension from the Werdenfelser Testbatterie (WTB) and the Colored Progressive Matrices (CPM) were administered. Study 2 included 38 participants between 8 and 59 years (23 children, M = 11.4; 15 adults; M = 31.3). 3 had a borderline, 23 a mild, and 12 a moderate ID. The same tasks as in Study 1 were applied, but the CPM was replaced by its successor, the Raven's 2.Results:In Study 1, participants with mild ID performed better in all tasks than those with moderate ID (p &lt; .05). Moderate relationships were found between CAMCOG-DS total score and the language tasks (r = .56 and r = .46), which remained significant when level of ID was controlled for. There was also a moderate relationship between CAMCOG-DS and reasoning (r = .46). Regression analysis showed that BNT performance predicted CAMCOG-DS performance (R2 = .31). In Study 2, those with mild ID, compared to those with moderate ID, performed better in all tasks (p &lt; .05), however, regarding the CAMCOG-DS and language tasks, this effect was larger in adults than in children. Adults performed better than children in the CAMCOG-DS and BNT (p &lt; .05), but not in single word comprehension or reasoning. As in Study 1, moderate to large correlations were revealed between CAMCOG-DS and language tasks and between CAMCOG-DS and reasoning (r &gt; .52), remaining significant when age and ID level were controlled for. Regression analysis showed that both naming and reasoning but not single word comprehension or age predicted CAMCOG-DS performance (R2 = .69), however, performance was best predicted by naming (R2 = .65).Conclusions:Our results suggest that language ability and reasoning relate to CAMCOG-DS performance, which is best predicted by BNT picture naming. This should be considered in CAMCOG-DS interpretation, as the capabilities of patients with lesser language ability might be underestimated. Future developments of dementia assessments for people with ID should include more nonverbal tasks.

School Experiences and Anxiety Trajectories Among Youth with Intellectual Disabilities.

This study investigated how the school experiences and personal characteristics of youth with Intellectual Disabilities (ID) contribute to their longitudinal trajectories of anxiety. To this end, we relied on a sample of 390 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged from 11 to 22 (M = 15.70), and recruited in Canada (n = 140) and Australia (n = 250). Across three yearly time points, all participants completed self-report measures of anxiety, school climate, and victimization. Our results revealed a slight normative decrease in anxiety over time and showed that experiences of school victimization were associated with higher levels of anxiety (initially and momentarily) and increases in victimization were accompanied by increases in anxiety over time. Perceptions of attending a school that fosters security and promotes learning also tended to be accompanied by lower levels of anxiety (initially and momentarily). Momentary increases in perceptions of attending a school that fosters positive peer interactions were associated with momentary decreases in anxiety, whereas momentary increases in perceptions of attending a school characterized by positive teacher-student relationships and an equitable treatment of all students both led to small momentary increases in anxiety once all other components of student school experiences were considered. The theoretical and practical implications of these results are discussed.

Sarcopenia predicts 5-year mortality in older adults with intellectual disabilities.

People with intellectual disabilities (ID) have a lower life expectancy than their peers without ID. A contributing factor to the lower life expectancy and early mortality could be sarcopenia: low muscle mass and low muscle function. In the general population, sarcopenia strongly predicts early mortality, but this association is unknown in people with ID. Therefore, this study aims to explore the association between sarcopenia and 5-year mortality in older adults with ID. In the Healthy Ageing and Intellectual Disabilities (HA-ID) study, the prevalence of sarcopenia was measured at baseline among 884 older adults (≥50years) with ID. All-cause mortality was measured over a 5-year follow-up period. Univariable and multivariable Cox proportional hazard models were applied to determine the association between sarcopenia (no sarcopenia, pre-sarcopenia, sarcopenia, severe sarcopenia) and early mortality, adjusted for age, sex, level of ID, presence of Down syndrome, and co-morbidity (chronic obstructive pulmonary disease, diabetes type 2 and metabolic syndrome). The unadjusted hazard ratio (HR) for sarcopenia was 2.28 [95% confidence interval (CI) 1.48-3.42], P<0.001), and 2.40 (95% CI 1.40-4.10, P=0.001) for severe sarcopenia. When adjusted for age, sex, level of ID, and Down syndrome, sarcopenia (HR=1.72, 95% CI 1.08-2.75, P=0.022) and severe sarcopenia (HR=1.86, 95% CI 1.07-3.23, P=0.028) were significantly associated with early mortality. When additionally adjusted for co-morbidity, the adjusted HR decreased to 1.62 (95% CI 1.02-2.59, P=0.043) and 1.81 (95% CI 1.04-3.15, P=0.035) for sarcopenia and severe sarcopenia, respectively. Sarcopenia is an independent risk factor for early mortality in older adults with ID over a 5-year follow-up period. Our results stress the need to delay the incidence and development of sarcopenia in older adults with ID.

Sports Games and Motor Skills in Children, Adolescents and Youth with Intellectual Disabilities.

(1) Background: Sports games are one of the best ways of engaging in physical activity for individuals with intellectual disabilities (ID) and Down syndrome (DS). This systematic review of the current literature aims to identify and sum relevant data on motor skills and clarify whether there are positive effects of sports programs in motor skills games in children, adolescents, and youth with ID and DS. (2) Methods: The systematic review of the papers was carried out following the methodological guidelines and by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) consensus. The following electronic databases were researched: PubMed, MEDLINE, Google Scholar, ScienceDirect, and ERIC from 2001 to 2023. (3) Results: The basketball test battery can be used to improve and monitor basketball training. Basketball players with lower levels of ID achieved better results, especially those with disabilities of the II and III degrees. Futsal has a positive impact on the coordination, and the differences between the test results of the vertical jump with and without an arm swing, that can be seen indirectly as a coordination factor, were statistically significant. (4) Conclusions: Basketball is recommended as an effective and practical rehabilitation program for children, adolescents, and youth with ID and DS. Futsal is an interesting and helpful activity for individuals with ID as well.

Differences in Self and Proxy Assessments of Self-Determination in Young People with Intellectual Disability: The Role of Personal and Contextual Variables.

Assessing self-determination in students with intellectual disabilities (IDs) is a primary step in facilitating progress monitoring. Researchers have developed both self and proxy assessments to favor a more in-depth evaluation of self-determination expression. However, to date, limited research has explored the congruence between both assessments. To address this need, the present study analyzes the differences between 219 adolescents with ID; 63% being males with an age range from 13 to 21 years (M = 16.8; SD = 1.72); and their teachers in their assessment of self-determination and explores which factors (students' age, sex, level of ID and opportunities at school) might explain those differences. The participants were recruited intentionally. Students with IDs completed two questionnaires: the AIR Self-Determination Scale and the Spanish version of the Self-Determination Inventory, which was also completed by their teachers. Significant differences were found in the self-determination assessment, with teachers rating it lower. Further, students' sex and the opportunities they were provided at school to engage in self-determined actions were found to explain the differences in self-determination assessment. Research and practice initiatives to assess self-determination in young people with IDs must consider that informants' points of view might be influenced by students' sex and by contextual opportunities to engage in self-determined actions. Implications for further research and practice are discussed.

Caring for Adults With Significant Levels of Intellectual Disability in Outpatient Settings: Results of a National Survey of Physicians.

Between 1% and 2% of the U.S. population has an intellectual disability (ID) and often experience disparities in health care. Communication patterns and sedation use for routine medical procedures are important aspects of care for this population. We explored physicians' communication patterns and sedation use in caring for patients with significant levels of ID through a mailed survey of 1,400 physicians among seven specialties in outpatient settings (response rate = 61.0%). Among physicians who saw at least one patient with significant levels of ID in an average month, 74.8% reported usually/always communicating primarily with someone other than the patient. Among specialists, 85.5% (95% CI: 80.5%-90.5%) reported doing so, compared to 69.9% (95% CI: 64.4%-75.4%) for primary care physicians (p < 0.001). Also, 11.4% reported sedating at least one patient with significant levels of ID for a routine procedure. Three quarters of physicians reported communicating primarily with persons other than the patient usually or always-an approach that, in some instances, may not align with best medical practice. The percentage of physicians who report sedating at least one individual is associated with significant ID and the physician's volume of patients with significant ID.

Classroom influence—Do students with high autistic traits benefit from their classmates’ social skills?

IntroductionChildren and adolescents with intellectual disability (ID) and high levels of autistic traits often attend special needs classrooms where they spend a lot of time with other students who demonstrate diverse impairments and competencies. Research in typical development shows that classmates and the classroom composition in terms of specific classmate competencies can have a strong impact on individual social development. In this context, classmates’ social skills are of particular interest, as they are associated with successful social interaction and the ability to establish and maintain social relationships. Based on these associations, the present study investigated whether the levels of autistic traits and social skills in children and adolescents with ID and high levels of autistic traits are influenced by their classmates’ levels of social skills.MethodsA longitudinal design was used, with the first measurement point at the beginning of the school year and the second at the end of the school year. School staff members provided information on 330 students with ID and high levels of autistic traits (20.6% girls; mean age 10.17 years, SD = 3.74) who were schooled in 142 classrooms across 16 Swiss special needs schools.ResultsResults showed that students’ individual levels of autistic traits and social skills at T2 were not predicted by the classroom level of social skills at T1 when controlling for individual levels of autistic traits, individual levels of social skills, gender, age, and general levels of functioning at T1.DiscussionConsidering the present findings, perspectives for further research and support of children and adolescents with ID and high levels of autistic traits within the classroom context are discussed.

A New Screening Tool for Rapid Diagnosis of Functional and Environmental Factors Influencing Adults with Intellectual Disabilities.

The dynamic nature of intellectual disability (ID) and its many comorbidities necessitate repeated screening and functional diagnosis. However, the existing scales are lengthy and expensive and cannot be implemented at all levels of ID. During phase one of this study (September 2019-September 2020), the functional screening tool (FST-ID) was validated for adults with ID and then used as a clinical tool to collect data for 76 participants from their direct service providers (DSP). Their age ranged from 21 to 71 years (mean = 37.63, SD ± 14.61), and they were diagnosed with severe/profound (N = 16) and moderate (N = 29), and mild (N = 31) levels of ID. The scale was found to hold high psychometric values. During phase two (September 2020-June 2022), the scale was found to be reliable as a continuous, clinical on-going screening tool, enabling the screening of functional and environmental changes experienced by adults with ID during acute times of the pandemic and regular times alike. All 76 adults experienced changes at the senior's daycare center mostly. The new scale may also help in the future to determine whether those changes only relate to post COVID-19 symptoms or other comorbidities as well.

Social Interaction Profiles Among Youth with Intellectual Disabilities: Associations with Indicators of Psychosocial Adjustment.

This study investigates the nature of the social interaction profiles observed among youth with intellectual disabilities (ID), defined while considering their relationships with their parents, peers, and teachers, as well as the implication of these profiles for self-esteem, aggressive behaviors, and prosocial behaviors. A sample of 393 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged between 11 and 22 (M = 15.70), was recruited in Canada (n = 141) and Australia (n = 253). Our results revealed four profiles, corresponding to Socially Isolated (23.24%), Socially Integrated (39.83%), Socially Rejected (28.37%) and Socially Connected (8.57%) youth with ID. The socially integrated and connected profiles both presented higher self-esteem, more prosocial behaviors, and less aggressive behaviors than the socially isolated and rejected profiles.

A psychometric validation of the motives for physical activity measure for youth with intellectual disabilities (MPAM-ID)

Purpose To validate a version of the Motives for Physical Activity Measure (MPAM) adapted for youth with intellectual disabilities (ID). Materials and methods A sample of 359 youth with mild to moderate ID from Australia and Canada respectively completed English and French versions of the MPAM-ID. Results Exploratory structural equation models supported the validity and reliability of the five-factor structure of the MPAM-ID, as well as the weak, latent variance-covariance, and latent mean invariance across linguistic versions. Additional results supported the partial strong and strict invariance of most MPAM-ID items across linguistic versions. The results also supported the complete measurement invariance of the MPAM-ID over time and revealed a lack of differential item functioning (DIF) as a function of youth’s age, body-mass index (BMI), ID level, and frequency of sport involvement (FSI). However, partial DIF was found as a function of youth’s sex. Additionally, latent mean differences in MPAM-ID’s factors were found as a function of youth’s ID level, sex, and FSI. Finally, results supported the convergent validity of the MPAM-ID factors with a measure of perceived physical abilities. Conclusion The MPAM-ID can be used among English- and French-speaking youth with ID irrespective of their age, BMI, ID level, sex, and FSI. IMPLICATIONS FOR REHABILITATION We propose English and French adaptations of the Motives for Physical Activity Measure for Youth with Intellectual Disabilities (MPAM-ID). The MPAM-ID was able to identify the same motives as the original measure. The MPAM-ID will facilitate the assessment of motives for physical Activity in cross-sectional and longitudinal studies. The MPAM-ID will facilitate the assessment of motives for physical Activity among English- and French-speaking youth with ID. The MPAM-ID could be used to compare youth motives for physical Activity as a function of their age, body-mass index, ID level, and frequency of sport involvement.

The Associations Between Accelerometer-Measured Physical Activity Levels and Mental Health in Children and Adolescents with Intellectual Disabilities During the COVID-19 Pandemic.

To examine the associations between physical activity (PA) levels and mental health in children and adolescents with intellectual disabilities (IDs) during the COVID-19 pandemic, 117 participants aged between 6 and 17 years with IDs from 10 Hong Kong special schools were included. There were positive dose–response associations between PA (i.e., light PA, moderate PA, and vigorous PA) and mental health, and participants with higher levels of moderate-to-vigorous PA (MVPA) and self-concept (SC) had better social quality of life (QoL) than those with lower levels of MVPA and SC. Moreover, personal and environmental factors such as age, body mass index, school, sex, ID level, and parental education level influenced the PA levels and QoL in children and adolescents with IDs.

The online mindset intervention 'The Growth Factory' for adolescents with intellectual disabilities: moderators and mediators.

BackgroundThe online mindset intervention The Growth Factory (TGF) has shown promising effects—increasing growth mindsets and perseverance and decreasing mental health problems among youth with intellectual disabilities (ID). Studying moderators and mediators of intervention effects is essential to elucidate for whom and why TGF works. Using a randomised controlled trial design, we examined youth's baseline mindset, gender, age, level of ID and intervention satisfaction as moderators of TGF effects and examined whether the intervention effects of TGF on improvements in mental health were mediated by perseverance.MethodsThe sample consisted of 119 participants with mild to borderline ID (M age = 15.83; SD = 2.23), randomly assigned to the intervention (n = 60) or passive control group (n = 59). Participants reported mindsets, perseverance, internalising, externalising, attention and total mental health problems at pre‐test, at post‐test and at 3‐month follow‐up. Additionally, youth in the intervention group graded their satisfaction with a score at the end of each session.ResultsFindings indicated that the effectiveness of TGF was not affected by participants' baseline mindsets, age and ID level. TGF was more effective in reducing internalising problems in girls and increasing perseverance in boys. In addition, in the intervention group TGF was more effective in improving internalising, externalising and total mental health problems for youth who reported higher levels of intervention satisfaction at post‐test. Finally, TGF indirectly decreased internalising and externalising problems at follow‐up through improvements in perseverance reported at post‐test.ConclusionsTGF offers a universal, ‘add‐on’ mindset intervention complementing usual care programmes. It improves mindsets, perseverance and mental health in youth with ID. Both practical and theoretical implications are discussed.

Physical Activity, Sedentary Behavior, Sleep Efficacy, And Quality Of Life In Children With Intellectual Disabilities

PURPOSE: Compared with children with typical development, children with intellectual disabilities (IDs) are found to be less physically active and have lower sleep efficacy and quality of life (QoL). The purpose of the current study was to examine the associations of physical activity and sedentary behavior with sleep efficacy and QoL in children with IDs during the COVID-19 pandemic. METHODS: Children aged between 5 and 17 years with mild and moderate IDs (N = 113) from 11 Hong Kong special schools were included in the cross-sectional study during the COVID-19 pandemic. Time spent in light physical activity (LPA), moderate to vigorous physical activity (MVPA), sedentary behavior, and sleep efficacy was measured by the accelerometer and split into quartiles (Q1-Q4), and QoL was measured by the Pediatric Quality of Life Inventory (PedsQL) ranging from 0 to 100. Multivariable linear regression and independent t-test were used to analyze the associations, mediating, and moderating effects. RESULTS: Positive associations were found between LPA quartiles and QoL in children with IDs during the COVID-19 pandemic, such as Emotional QoL (MD Q4 vs Q1 = 12.41, p < 0.05, 95% CI [0.44, 24.38]), Social QoL (MD Q4 vs Q1 = 17.58, p < 0.05, 95% CI [2.23, 32.93]), School QoL (MD Q2 vs Q1 = 13.50, p < 0.05, 95% CI [2.19, 24.80]), and Total QoL (MD Q4 vs Q1 = 11.78, p < 0.05, 95% CI [0.50, 23.06]). Positive associations were also found between MVPA quartiles and sleep efficacy (MD Q4 vs Q1 = 3.22, p < 0.05, 95% CI [0.09, 6.35]); while sedentary behavior quartiles were negatively associated with Physical QoL and sleep efficacy (Physical QoL: MD Q3 vs Q1 = -18.42, p < 0.05, 95% CI [-36.23, -0.61]; sleep efficacy: MD Q4 vs Q1 = -14.78, p < 0.01, 95% CI [-24.46, -5.10]). Moreover, sleep efficacy mediated the associations of LPA (β = -0.38, p < 0.01) and sedentary behavior (β = -3.76, p < 0.01) with School QoL. Age, gender, and ID level had moderating effects on physical activity, sedentary behavior, sleep efficacy, and QoL. CONCLUSIONS: Physical activity and sedentary behavior were significantly associated with sleep efficacy and QoL in children with IDs during the COVID-19 pandemic. Future studies should aim at promoting physical activity participation, sleep efficacy, and QoL in this under-researched population.

The Pictorial Screening Memory Test (P-MIS) for Adults with Moderate Intellectual Disability and Alzheimer's Disease.

In this study, we examined normative data and diagnostic accuracy of a pictorial screening test to detect memory impairment for mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in Spanish-speaking adults with intellectual disability (ID). A total of 94 volunteers with ID (60 controls, 17 MCI, and 17 AD), were evaluated by neuropsychological tests including the PMIS-ID in a cross-sectional validation study. Discriminative validity between the MCI, AD, and control group was analyzed by the area under the ROC curve. A cut-off score of 4.5 on the immediate recall trial had a sensitivity of 69% and a specificity of 80% to detect memory impairment (AUC = 0.685; 95% CI = 0.506–0.863) in the AD group. The PMIS-ID is a useful screening test to rule out a diagnosis of memory decline in people with moderate level of ID and AD, and it shows good psychometric properties.