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Instruments for the detection of depressive symptoms in people with intellectual disabilities: a systematic review
- Authors:
- PEREZ-ACHIAGA N., NELSON S., HASSIOTIS A.
- Journal article citation:
- Journal of Intellectual Disabilities, 13(1), March 2009, pp.55-76.
- Publisher:
- Sage
- Place of publication:
- London
Affective disorders, particularly depression, are common in adults with intellectual disabilities. However the detection of these disorders is hindered by the varied presentation of depressive symptoms across the range of intellectual disability. A systematic review of the available English-language diagnostic instruments for depressive disorders for adults with all levels of intellectual disability was undertaken. Studies were appraised based on the instruments' psychometric properties, sensitivity and specificity. Twenty one of 28 identified studies which contained original data on validity and reliability; the `gold standard' ranged from clinical opinion to other established instruments, some of which had limited validation in people with intellectual disability. In view of the benefits of psychological treatments for common mental disorders, it is important to develop instruments to be used in monitoring cognitive as well as behavioural outcomes for people with intellectual disability and depressive disorders.
Relationship between diagnostic criteria, depressive equivalents and diagnosis of depression among older adults with intellectual disability
- Authors:
- LANGLOIS L., MARTIN L.
- Journal article citation:
- Journal of Intellectual Disability Research, 52(11), November 2008, pp.896-904.
- Publisher:
- Wiley
This study uses the interRAI ID assessment instrument to investigate the relationship between standard diagnostic criteria for depression, depressive equivalents and a diagnosis of depression among older and younger adults with ID in community and institutional settings in Ontario, Canada. Items in the interRAI ID assessment instrument that were representative of The Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) criteria and depressive equivalents were examined among persons with ID in institutional (census-level data) and in community-based (sample) residential settings. Bivariate logistic regression was used to examine the relationship between depressive symptoms and a diagnosis of depression. Descriptive statistics were used to examine the prevalence of depressive symptoms among those who did not have a diagnosis of depression. The results indicate that DSM-IV diagnostic criteria and depressive equivalents were significantly related to a diagnosis of depression among older and younger adults with ID, and that both types of symptoms were exhibited by a non-trivial proportion of individuals without a diagnosis of depression. The depression rating scale embedded in the interRAI ID is helpful in identifying older adults at risk of depression. Contrary to other studies, few significant differences were found in depressive symptoms by age.
Searching for a diagnosis
- Author:
- MCKENZIE Karen
- Journal article citation:
- Learning Disability Today, October 2012, pp.12-15.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Being identified as having a learning disability is crucial to ensure that an individual has access to appropriate support. Increasing restriction of budgets may mean that learning disability services will be reluctant to provide support until the person has been diagnosed. Unfortunately, many people with a learning disability continue to go undiagnosed. The assessment of intellectual functioning must be carried out by a qualified applied psychologist, on an individual basis, using a properly standardised test that has good psychometric properties. The limited number of available psychologists may result in a bottleneck while individuals wait for diagnostic assessment before being able to access services. In addition, in some settings where there is an urgent need to identify whether someone has a learning disability, such as police stations and accident and emergency departments, access to a psychologist is likely to be limited. The challenges to quick and accessible diagnostic assessment have led to increasing interest in the use of screening tools in a range of settings. Screening tools can offer a practical solution where services are unable to meet demand for diagnostic assessment in a timely way. This article presents 2 evidence-based screening tools: the Learning Disability Screening Questionnaire, for adults aged 16 upwards; and the Child and Adolescent Intellectual Disability Screening Questionnaire, for children aged 8-18 years.
A comparison of intellectual assessments over video conferencing and in-person for individuals with ID: preliminary data
- Authors:
- TEMPLE V., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 54(6), June 2010, pp.573-577.
- Publisher:
- Wiley
Although the potential of video conferencing (VC) technology in healthcare has been realised for a number of years, interest in using it for the delivery of services such as psychological assessment is relatively new. Previous studies have reported some success in validating a limited number of psychological tests for VC administration but VC has not been investigated for use with persons with intellectual disabilities (ID). This brief report describes preliminary data comparing test results for two well known and widely used assessment instruments to establish whether scores for VC administration would differ significantly from in-person assessments. Nineteen individuals with ID aged 23–63, living in Toronto were assessed once in-person and once over VC using the Wechsler Abbreviated Scale of Intelligence (WASI) and the Beery-Buktenica Test of Visual-Motor Integration (VMI). Full-scale IQ on the WASI and standard scores for the VMI were found to be very stable across the two administration conditions, with a mean difference of less than one IQ point/standard score. FSIQs were generally in the range 53-103. It appears that video conferencing administration does not alter test results significantly for these two instruments. The authors note some limitations of the study but suggest that further work with a larger sample is warranted.
Differentiating characteristics of deafblindness and autism in people with congenital deafblindness and profound intellectual disability
- Authors:
- HOEVENAARS-VAN DEN BOOM M.A.A., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 53(6), June 2009, pp.548-558.
- Publisher:
- Wiley
In persons with deafblindness, it is hard to distinguish autism spectrum disorders from several deafblind specific behaviours caused by the dual sensory impairments, especially when these persons are also intellectually disabled. As a result, there is an over-diagnosis of autism in persons who are deafblind leading to unsuitable interventions. Autism as specified by the DSM-IV was studied in 10 persons with congenital deafblindness with profound intellectual disabilities. Behaviours of people with deafblindness and autism (n = 5) and of people with deafblindness without autism (n = 5) were observed in a semi-standardised assessment. Results showed that all people with deafblindness had impairments in social interaction, communication and language. In contrast to persons without autism, people with deafblindness and autism showed significantly more impairments in reciprocity of social interaction, quality of initiatives to contact and the use of adequate communicative signals and functions. No differences between the groups were found for quantity and persistence of stereotyped behaviour, quality of play and exploration and adequate problem-solving strategies. This study indicates that there are some possibilities to differentiate autism from behaviours specific for deafblindness. It also confirms the large overlap in overt behaviours between people with deafblindness and persons with autism.
Checklists for general practitioner diagnosis of depression in adults with intellectual disability
- Authors:
- TORR J., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 52(11), November 2008, pp.930-941.
- Publisher:
- Wiley
In Australia, diagnosis and management of depression in adults with intellectual disability (ID) often occurs within the primary care setting. Few tools are available to assist general practitioners (GPs) in the diagnostic process. The study aim was to assess properties of carer and GP checklists developed to address this problem. Participants were 49 adults with ID and their paid carers (support workers), and GPs for 27 adults. Data from carer and GP checklists were gathered, in addition to carer completed Developmental Behaviour Checklist – Adults (DBC-A). Adults with ID also received a comprehensive psychiatric assessment. Both checklists demonstrated good internal consistency (KRS-20 = 0.90). A factor analysis of the carer checklist indicated a single factor on which three section totals had loadings of greater than 0.722 (depressed mood, loss of interest, and social interaction and communication). This factor was interpreted to be depression. The GP checklist data were insufficient for factor analysis, but section totals were moderately correlated with most corresponding carer checklist section totals. Carer section totals related to depression also correlated highly with the DBC-A Depression sub-scale, demonstrating good concurrent validity. Contrasting results were obtained for the GP checklist. Most (n = 42) of the participants were diagnosed with a psychiatric disorder, precluding the testing of checklist specificity and sensitivity. The carer checklist shows promise as a means of gathering information needed by a GP in the diagnosis of depression in adults with ID. Further research into its underlying properties and clinical uses of a combined depression checklist is warranted.
Autism screening tools: an evaluation of the Social Communication Questionnaire and the Developmental Behaviour Checklist-Autism Screening Algorithm
- Authors:
- WITWER Andrea N., LECAVALIER Luc
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 32(3), September 2007, pp.179-187.
- Publisher:
- Taylor and Francis
This study is the first to evaluate the Social Communication Questionnaire (SCQ) and the Developmental Behaviour Checklist-Autism Screening Algorithm (DBC-ASA) in the same sample of school-aged children with intellectual disability (ID) with and without Pervasive Developmental Disorders (PDDs). Parents of 49 children (36 with PDDs and 13 with ID) recruited from schools in Ohio in the United States completed a survey that included a demographic form, a measure of adaptive behaviour (the SIB-R), the SCQ, and the DBC-ASA. According to established cut-offs, the SCQ's sensitivity was .92 and specificity was .62, and the DBC-ASA's sensitivity was .94 and specificity was .46. Six of the seven false positives on the DBC-ASA had DBC Total Problem Behaviour scores above the clinical cut-off. By contrast, all six true negatives had Total Problem Behaviour scores below the clinical cut-off. No such pattern was noted for the SCQ. While both instruments have good psychometric properties, the results of this study suggest that clinicians and researchers should exercise caution when utilising the DBC-ASA to screen for PDDs in individuals with significant behaviour problems, as this could decrease its diagnostic validity.
Invariance of parent ratings of attention deficit hyperactivity disorder symptoms for children with and without intellectual disability
- Authors:
- ARIAS Víctor B., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 32(2), 2019, pp.288-299.
- Publisher:
- Wiley
Background: Although attention deficit hyperactivity disorder (ADHD) is considered a valid diagnosis for children with intellectual disability, no studies have evaluated the invariance of ADHD symptom ratings across children with and without intellectual disability. Method: Parents completed ratings on the ADHD symptoms for 189 children with intellectual disability and for 474 children without intellectual disability. Differential item functioning analysis was used to determine the equivalence of the ADHD symptoms across the two groups. Results: The symptoms loses things, talks too much, and blurts out answers showed significant bias against children with intellectual disability. The prevalence of ADHD in children with intellectual disability was 18% (according to the symptom criterion), and 7.4% when the academic and/or social impairment criterion was also considered. Conclusions: Most of the ADHD symptoms can be valid for the assessment of ADHD in children with mild and moderate intellectual disability. ADHD symptoms may be used in further studies to establish base rates of the disorder in the intellectual disability population. (Edited publisher abstract)
A review of measures used in the screening, assessment and diagnosis of dementia in people with an intellectual disability
- Authors:
- MCKENZIE Karen, METCALFE Dale, MURRAY George
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 31(5), 2018, pp.725-742.
- Publisher:
- Wiley
Background: The increasing number of individuals with an intellectual disability who are at risk of developing dementia highlights the need to use measures with strong psychometric properties as part of the screening, assessment and diagnostic process. Method: Searches were made of clinical and good practice guidelines and English language journal articles sourced from Proquest, Web of Science and Scopus databases (up to July 2017) for tools which were designed or adapted for the purpose of helping to diagnose dementia in people with intellectual disability. Results: Based on a detailed review of 81 articles and guidelines, the present authors identified 22 relevant tools (12 cognitive, 10 behaviour). These were reviewed in terms of their psychometric properties. Conclusions: A number of tools were found to be available for use with people with intellectual disability; however, few were specifically standardized for this purpose which also had comprehensive information about reliability and validity. (Edited publisher abstract)
Message received?
- Authors:
- GIBSON Lynn, MATTHEWS Dorothy, REGNARD Claud
- Journal article citation:
- Learning Disability Today, 10(8), October 2010, pp.24-25.
- Publisher:
- Pavilion
- Place of publication:
- Hove
This article examines the identification of distress in people with learning disabilities who have trouble communicating. Correct identification of distress among this group will lead to enhanced diagnosis, better symptom control, and ultimately much improved health care. Undetected symptoms in people with learning disabilities are often due to lack of communication. This article argues that meaningful communication depends on the ability of people to recognise and translate the many different cues available and not just those verbally expressed. Observation by key people in the lives of people with learning disability, particularly carers, can be crucial to identify and treat the symptoms of distress. The article describes the Disability Distress Assessment Tool (DisDAT), an observational tool developed to document content and distressed states. DisDAT can be completed with the involvement of friends and family, and ensures that the carers’ knowledge and contribution is accepted in any discussions on what is wrong with the patient.