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What factors are related to a negative outcome of self-injurious behaviour during childhood in pervasive developmental disorders?
- Authors:
- BAGHDADLI A., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(1), March 2008, pp.142-149.
- Publisher:
- Wiley
This study aimed to explore the factors related to the outcome of self-injurious behaviour (SIB) in children with pervasive developmental disorders (PDD). Children with PDD were assessed on individual and environmental variables at time 1 and 3 years later. A questionnaire about the presence or absence of SIB was also administered at both times in order to examine the early course of SIB. The findings suggest an association between a negative outcome and several aspects of the children’s behaviour. Children with a negative outcome differed from the others in having greater speech impairment, more cognitive and adaptive deficits, and more severe signs of autism. When these variables were entered into a multivariate model for predicting the outcome of SIB, only speech deficits and autism severity were significant risk factors. The importance of these findings for improving our understanding of SIB is discussed.
Self-injurious behaviour in Cornelia de Lange syndrome: 1. Prevalence and phenomenology
- Authors:
- OLIVER C., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 53(7), July 2009, pp.575-589.
- Publisher:
- Wiley
Self-injurious behaviour is frequently identified as part of the behavioural phenotype of Cornelia de Lange syndrome (CdLS). The authors conducted a case-control study of the prevalence and phenomenology of self-injurious behaviour (SIB) in CdLS. A total of 54 participants with CdLS were compared with 46 individuals who were comparable on key variables including age, degree of intellectual disability and wheelchair use, using questionnaire and observational measures. Clinically significant self-injury was not more prevalent in the CdLS group (55.6%), nor was it different in presentation from that seen in the comparison group. Hyperactivity, stereotyped and compulsive behaviours predicted clinically significant self-injury in all participants. Hand directed, mild self-injury was more prevalent in CdLS. The results show that clinically significant self-injury may not be part of the behavioural phenotype of CdLS but a specific body target for proto-SIB is more common.
Challenging behaviours in adults with an intellectual disability: a total population study and exploration of risk indices
- Authors:
- BOWRING Darren L., TOTSIKA Vasiliki, HASTINGS Richard P.
- Journal article citation:
- British Journal of Clinical Psychology, 56(1), 2017, pp.16-32.
- Publisher:
- Wiley
Objectives: Considerable variation has been reported in the prevalence and correlates of challenging behaviour (CB) in adults with intellectual disabilities (ID). To provide a robust estimate of prevalence, we identified the entire administrative population of adults with ID in a defined geographical area and used a behaviour assessment tool with good psychometric properties. Methods: Data from 265 adults who were known to services were collected using a demographic survey tool and the Behavior Problems Inventory – Short Form. The prevalence of self-injurious, aggressive/destructive, stereotyped, and overall CB was evaluated. We explored the potential of developing cumulative risk indices (CRI) to inform longitudinal research and clinical practice. Results: The prevalence of overall CB was 18.1%. The prevalence of self-injurious behaviour was 7.5%, aggressive–destructive behaviour 8.3%, and stereotyped behaviour 10.9%. Communication problems and severity of ID were consistently associated with higher risk of CBs. CRIs were significantly associated with CBs, and the five methods of CRI development produced similar results. Conclusions: Findings suggest a multi-element response to CB is likely to be required that includes interventions for communication and daytime activity. Exploratory analyses of CRIs suggested these show promise as simple ways to capture cumulative risk in this population. Subject to longitudinal replication, such a tool may be especially useful in clinical practice to identify adults who are priority for interventions and predict future demand on services. (Edited publisher abstract)
Self-Injurious behavior in older adults with intellectual disabilities
- Authors:
- GLAESSER Richard S., PERKINS Elizabeth A.
- Journal article citation:
- Social Work: A journal of the National Association of Social Workers (NASW), 58(3), 2013, pp.213-221.
- Publisher:
- Oxford University Press
Self-injurious behavior (SIB) is a distressing type of problem behaviour that may be exhibited in individuals with intellectual disabilities (IDs). This article provides an overview of SIB, its underlying causes and functions, as well as other key variables associated with its manifestation. Adults with IDs are routinely living longer. Given this rapidly emerging and expanding population, special attention is given to SIB in aging adults with IDs that may result from age-related risk factors. Risks include increasing and unresolved health issues, physical changes, declining physical abilities, transitions to new residential environments, and the potential for experiencing loss and bereavement. The article concludes with practice implications for social workers who may encounter older individuals with IDs and SIB. (Publisher abstract)
An investigation of factors predictive of continued self-injurious behaviour in an intellectual disability service
- Authors:
- DANQUAH A., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(4), July 2009, pp.395-399.
- Publisher:
- Wiley
Self-injurious behaviour (SIB) is among the most serious problems faced by intellectual disability services. It is very difficult to treat and can become a chronic problem. Information on a number of variables was collected through a survey of service-users identified as displaying SIBs. Clinical opinion and a literature review guided the selection of potential predictors of continued SIB. Univariate statistical analyses were used to investigate associations between continued SIB and each of the variables identified. Variables shown to have a significant association with continued SIB were subjected to a multivariate analysis to isolate those variables that still predicted continued SIB once the influence of the others had been accounted for. Two factors, self-biting and verbal ability, were found to independently predict continued SIB. The results have implications for intellectual disability services, in terms of the importance of multidisciplinary team working, training and guidelines for problem management.
Early intervention and prevention of self-injurious behaviour exhibited by young children with developmental disabilities
- Author:
- RICHMAN D. M.
- Journal article citation:
- Journal of Intellectual Disability Research, 52(1), January 2008, pp.3-17.
- Publisher:
- Wiley
The ontogeny of self-injurious behaviour exhibited by young children with developmental delays or disabilities is due to a complex interaction between neurobiological and environmental variables. In this paper, the literature on emerging self-injury in the developmental disability population is reviewed with a focus on an operant conceptual model of how topographies of self-injurious behaviour can change structurally and become sensitive to various environmental consequences. Results of previous studies are reviewed in terms of extending our research focus from a reactive model of assessment and treatment of well-established cases of self-injury to an early intervention and prevention model.
Descriptive analysis of self-injurious behaviour and self-restraint
- Authors:
- FORMAN Debbie, HALL Scott
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 15(1), 2002, pp.1-7.
- Publisher:
- Wiley
Self-restraint often appears to be associated with self-injurious behaviour (SIB), and has been described as an attempt to prevent or escape from SIB. Research into the determinants of self-restraint is limited, and the present single case study assesses the environmental determinants of self-restraint and SIB, as well as describing the relationship between the two behaviours. Using observations in the natural environment were conducted for 16.5h and data were collected on SIB, self-restraint and environmental events. Sequential analysis showed that SIB and self-restraint were unrelated to environmental events and that the behaviours co-varied inversely. Self-injurious behaviour occurred at higher than chance levels immediately following self-restraint and also at high levels immediately prior to self-restraint. Whilst these results would appear to support the hypothesis that self-restraint was negatively reinforced by escape from SIB, the data cannot be explained solely by this theory. The implications of these findings for the behavioural theory of SIB and the conceptualisation of self-restraint are discussed.
Clozapine use in personality disorder and intellectual disabilities
- Authors:
- KIANI Reza, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(6), 2015, pp.364-370.
- Publisher:
- Emerald
Purpose: Clozapine is a well-known antipsychotic medication licensed for treatment-resistant schizophrenia, but there is limited research available to suggest its efficacy in the context of personality disorder and intellectual disabilities presenting with high-risk behaviour with or without psychotic symptoms. The purpose of this paper is to raise awareness of the benefits of using clozapine in patients with intellectual disabilities and personality disorder that present with a complex picture of serious risk of harm to both their life and the lives of others. Design/methodology/approach: The authors present five patients with intellectual disabilities and serious life-threatening challenging behaviour whom were started on clozapine as part of their multidisciplinary treatment plan to manage their presentation. The authors completed baseline assessment of five main symptom domains and then repeated this assessment following treatment with clozapine. Findings: In all five cases use of clozapine was objectively associated with an improvement in symptomatology, quality of life and a safe transfer to the community. Originality/value: The findings suggest that judicious use of clozapine could be considered as one of the effective pharmacological strategies in the management of patients with intellectual disabilities and personality disorder who present with serious life-threatening challenging behaviours. (Publisher abstract)
Risk assessment in people with learning disabilities
- Author:
- SELLARS Carol
- Publisher:
- British Psychological Society/Blackwell
- Publication year:
- 2002
- Pagination:
- 168p.,bibliog.
- Place of publication:
- Oxford
This book provides an explanation of the concept of risk, and a discussion of the key areas where risks need to be assessed in the lives of people with learning disabilities. It describes an approach to assessing risks and emphasizes the need to see risk assessment as an ongoing process in which all interested parties can consider the potential risks in any situation.