Suchergebnisse

Background  Participation in sports has been linked to a range of physical, social and mental health benefits. Little is known about the extent to which people with intellectual disabilities take part in sports. This study looks at participation in sports and factors associated with participation by people with intellectual disabilities in England.Method  Data on participation in sports and measures of personal characteristics, living situation, social participation, and socioeconomic status associated with participation were analysed based on a sample of 2784 people with intellectual disabilities in England.Results  Overall, 41% of participants had taken part in sports in the past month, nearly all of whom had enjoyed it. Of those who did not take part, 34% said they would like to. Participation in sport was associated with some personal characteristics but not with support needs, and was also associated with indicators of socioeconomic status.Conclusions  Targeting interventions to increase participation in sports by people with intellectual disabilities may make a significant contribution to improving their health and well‐being.

Introduction:  There has been a recent increase in interest in research into the emotional and behavioural needs of children and adolescents with intellectual disability. The field has tended to focus on the association between emotional and behavioural needs and child characteristics. Little attention has been paid to the potential importance of social context.Method:  Cross‐sectional survey of teacher‐reported emotional and behavioural needs among 386 South Asian children and 118 Black children in a deprived urban conurbation.Results:  The results suggested that: (i) teachers reported higher rates of emotional and behavioural needs among Black (when compared with South Asian) children; (ii) increased rates of emotional and behavioural needs were generally associated with older child age, lower child ability, the absence of sensory impairments and male gender; and (iii) neighbourhood deprivation was associated with variation in emotional and behavioural need differently for the two ethnic groups. For Black children, increased deprivation was associated with increased need. However, for South Asian children increased deprivation was associated with decreased need.Discussion Results are discussed in relation to 'group density effects' which may reflect the potentially moderating effects of social support on the relationship between socioeconomic deprivation and mental health.

Background  The aim of the present study was to identify factors associated with the level of psychological distress reported by family carers of children with intellectual disability living in a large urban conurbation.Method  Information was collected by postal questionnaire (or interview for family carers who did not have English as their first language) from the family carers of 408 children with intellectual disability (31% of all children within the area administratively identified as having an intellectual disability).Results  Results indicated that 47% of primary carers scored above the threshold for psychological distress on the GHQ and that scoring above the threshold was strongly related to the emotional and behavioural needs of the index child and South‐Asian ethnicity and moderately associated with the severity of the child's delay in communication.Conclusions  The rates of psychological distress (47% overall, 70% among South‐Asian carers) were markedly higher than that found in previous studies of carers supporting a child with intellectual disabilities. It is suggested that these elevated rates of psychological distress may be mediated by socio‐economic deprivation.

This paper considers the extent to which awareness of the growing number of older people with intellectual disability in the UK has translated into action. It does so by looking at current policy, training and services for older people with intellectual disability. Information was collected from two sources: an analysis of the 1993/1994 Community Care Plans and a national survey on policy, training and services for older people with intellectual disability. The analysis of Community Care Plans revealed that 67% made no reference to older people with intellectual disability. The remaining 33% mentioned such people mainly in the context of the need for service development. 82% of the 236 replies to the national survey indicated that there was no policy in relation to older people with intellectual disability and 74% indicated an absence of specific staff training. 53% of respondents were aware of services in their area specifically for older people with intellectual disability and 76% were aware of generic services for the elderly in their area that were used by older people with intellectual disability. Finally, the results of a consultation exercise regarding the development of a training pack in ageing and intellectual disability are presented. The results highlight a lack of consensus about how services should be provided and, in many cases, a lack of provision.

BackgroundChildren with mild/moderate intellectual disabilities are at greater risk for mental health problems, with socio‐economic factors and adversity partly accounting for this. Fewer data are available for adolescents.MethodsSecondary analysis was undertaken of the Next Steps annual panel study following a cohort through adolescence into adulthood containing self‐report mental health data up to age 16/17. Participants with mild/moderate intellectual disabilities were identified through data linkage with educational records.ResultsAdolescents with mild/moderate intellectual disabilities were more likely than non‐disabled peers to experience socio‐economic disadvantage and bullying. Incidence rates of mental health problems were generally not significantly different between adolescents with and without intellectual disabilities.ConclusionsThese findings are consistent with higher rates of persistent mental health problems beginning earlier among children with intellectual disabilities. Greater attention needs to be paid to the timecourse of mental health problems, and the impact of socio‐economic factors, family and peers on mental health.

BackgroundConstipation can lead to serious health issues and death. This systematic review summarizes international research pertaining to the management of constipation in people with intellectual disability.MethodStudies published from 1990 to 2017 were identified using Medline, Cinahl, PsycINFO, Web of Science, email requests and cross‐citations. Studies were reviewed narratively in relation to identified themes.ResultsEighteen studies were reviewed in relation to three themes: laxative receipt; interventions (dietary fibre, abdominal massage and macrogol); and staff issues (knowledge and training). Laxative polypharmacy was common. Studies report positive results for dietary fibre and abdominal massage although study quality was limited.ConclusionThe main management response to constipation in people with intellectual disability is laxative use despite limited effectiveness. An improved evidence base is required to support the suggestion that an individualized, integrated bowel management programme may reduce constipation and associated health conditions in people with intellectual disability.

BackgroundPoor postural care can have severe and life‐threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function.MethodStudies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and Web of Science) covering January 1990 to March 2016, and email requests to researcher networks. Results were collated via descriptive numerical summary of studies and thematic analysis.ResultsTwenty‐three studies were identified and summarized narratively in relation to three themes: characteristics and prevalence, interventions and service related issues. The evidence base is small with significant gaps. Lack of evidence for night‐time positioning equipment and 24‐hr postural care needs to be addressed urgently.ConclusionFuture research should be clearly directed towards ascertaining how best postural care interventions can be employed to help improve the health and quality of life of people with intellectual disabilities.

BackgroundPeople with intellectual disability or borderline intellectual functioning may have poorer mental health than their peers. The present authors sought to (i) estimate the risk of poorer mental health among British adults with and without intellectual impairments and (ii) estimate the extent to which any between‐group differences in mental health may reflect between‐group differences in rates of exposure to common social determinants of poorer health.Materials and MethodsThe present authors undertook secondary analysis of confidentialized unit records collected in Wave 3 of Understanding Society.ResultsBritish adults with intellectual impairments living in general households are at significantly increased risk of potential mental health problems than their non‐disabled peers (e.g. GHQ Caseness OR = 1.77, 95% CI (1.25–2.52), P < 0.001). Adjusting for between‐group differences in age, gender and indicators of socio‐economic position eliminated this increased risk [GHQ Caseness adjusted OR = 1.06, 95% CI (0.73–1.52), n.s].ConclusionsOur analyses are consistent with the hypothesis that the increased risk of poor mental health among people with intellectual impairments may be attributable to their poorer living conditions rather than their intellectual impairments per se. Greater attention should be given to understanding and addressing the impact of exposure to common social determinants of mental health among marginalized or vulnerable groups.

BackgroundEpilepsy is highly prevalent in people with intellectual disabilities and is associated with increased mortality and high healthcare usage. This systematic review summarizes research on service responses to people with intellectual disabilities and epilepsy.MethodStudies published from 1990 were identified via electronic searches using Medline, Cinahl, PsycINFO and Web of Science, email requests to researcher networks, and cross‐citations. Information extracted from studies was reviewed narratively in relation to identified themes.ResultsThirty‐five studies met the inclusion criteria. Overall study quality was low, with no RCTs or similarly robust intervention study designs. Access to specialists was inconsistent. The importance of proxies and the need for education regarding epilepsy for staff, carers and people with intellectual disabilities were highlighted.ConclusionThere are no methodologically robust studies on service‐related interventions for people with intellectual disabilities and epilepsy. Further research on improving service delivery is required to substantiate findings reported here.

BackgroundSystematic reviews are important in evaluating evidence concerning the health of people with intellectual disabilities. This study conducts a systematic review to identify strengths and gaps in this evidence.MethodElectronic literature searches and email requests identified systematic reviews published in English from 2008 to 2013 on the health or health care of people with intellectual disabilities. Reviews were categorized using ICD‐10 chapter headings and information extracted regarding methods, number of studies reviewed and findings.ResultsNinety‐four reviews were identified: 52 related to ICD‐10 Chapter V: Mental or behavioural disorders, 28 to Chapter XXI: Factors influencing health status and contact with services, and 14 related to other chapters or encompassed multiple chapters. Nine reviews were 'empty'. No reviews were found for many ICD‐10 chapter headings.ConclusionsSystematic reviews are heavily weighted towards mental health, with little coverage of several areas important to the health and mortality of people with intellectual disabilities.

Background  Although interventions for children with pervasive developmental disorders (PDD) have been the focus of research effort and evidence reviews in many Western countries, this evidence has not been assessed in the context of low‐ and middle‐income (LAMI) countries especially in terms of the fit with different cultures and resources.Method  As a part of the WHO MH‐GAP project, we carried out a systematic review of published literature relating to interventions for PDD in LAMI countries. Given the small amount of direct evidence found, we supplemented the review with findings from existing relevant evidence reviews to draw practical recommendations.Results  We found only four controlled studies evaluating an intervention for children with PDD in a LAMI country. These studies all evaluated different interventions. A systematic search of controlled studies of evidence‐based parenting training interventions (Incredible Years and Triple P) in non‐LAMI countries identified two studies both indicating successful outcomes.Conclusions  The evidence base for interventions for PDDs in LAMI countries is sparse, and to inform practical and future research recommendations, it is important to consider potentially deliverable behavioural parent training interventions. Such interventions need to be explored in LAMI countries when delivered in primary and secondary healthcare contexts.