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1.
J Neurooncol ; 167(2): 315-322, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38409461

RESUMEN

PURPOSE: Neurofibromatosis (NF) is associated with low quality-of-life (QoL). Learning disabilities are prevalent among those with NF, further worsening QoL and potentially impacting benefits from mind-body and educational interventions, yet research on this population is scarce. Here, we address this gap by comparing NF patients with and without learning disabilities on QoL at baseline and QoL-related gains following two interventions. METHODS: Secondary analysis of a fully-powered RCT of a mind-body program (Relaxation Response Resiliency Program for NF; 3RP-NF) versus an educational program (Health Enhancement Program for NF; HEP-NF) among 228 adults with NF. Participants reported QoL in four domains (Physical Health, Psychological, Social Relationships, and Environmental). We compare data at baseline, post-treatment, and 12-month follow-up, controlling for intervention type. RESULTS: At baseline, individuals with NF and learning disabilities had lower Psychological (T = -3.0, p = .001) and Environmental (T = -3.8, p < .001) QoL compared to those without learning disabilities. Both programs significantly improved all QoL domains (ps < .0001-0.002) from baseline to post-treatment, regardless of learning disability status. However, those with learning disabilities exceeded the minimal clinically important difference in only one domain (Psychological QoL) compared to three domains in individuals without learning disabilities. Moreover, those with learning disabilities failed to sustain statistically significant gains in Psychological QoL at 12-months, while those without learning disabilities sustained all gains. CONCLUSION: Adults with NF and learning disabilities have lower Psychological and Environmental QoL. While interventions show promise in improving QoL regardless of learning disabilities, additional measures may bolster clinical benefit and sustainability among those with learning disabilities.


Asunto(s)
Discapacidades para el Aprendizaje , Neurofibromatosis , Adulto , Humanos , Calidad de Vida , Neurofibromatosis/psicología , Terapia por Relajación , Discapacidades para el Aprendizaje/etiología , Discapacidades para el Aprendizaje/terapia , Educación en Salud
2.
Dev Sci ; 27(2): e13443, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37675857

RESUMEN

Children with dyslexia frequently also struggle with math. However, studies of reading disability (RD) rarely assess math skill, and the neurocognitive mechanisms underlying co-occurring reading and math disability (RD+MD) are not clear. The current study aimed to identify behavioral and neurocognitive factors associated with co-occurring MD among 86 children with RD. Within this sample, 43% had co-occurring RD+MD and 22% demonstrated a possible vulnerability in math, while 35% had no math difficulties (RD-Only). We investigated whether RD-Only and RD+MD students differed behaviorally in their phonological awareness, reading skills, or executive functions, as well as in the brain mechanisms underlying word reading and visuospatial working memory using functional magnetic resonance imaging (fMRI). The RD+MD group did not differ from RD-Only on behavioral or brain measures of phonological awareness related to speech or print. However, the RD+MD group demonstrated significantly worse working memory and processing speed performance than the RD-Only group. The RD+MD group also exhibited reduced brain activations for visuospatial working memory relative to RD-Only. Exploratory brain-behavior correlations along a broad spectrum of math ability revealed that stronger math skills were associated with greater activation in bilateral visual cortex. These converging neuro-behavioral findings suggest that poor executive functions in general, including differences in visuospatial working memory, are specifically associated with co-occurring MD in the context of RD. RESEARCH HIGHLIGHTS: Children with reading disabilities (RD) frequently have a co-occurring math disability (MD), but the mechanisms behind this high comorbidity are not well understood. We examined differences in phonological awareness, reading skills, and executive function between children with RD only versus co-occurring RD+MD using behavioral and fMRI measures. Children with RD only versus RD+MD did not differ in their phonological processing, either behaviorally or in the brain. RD+MD was associated with additional behavioral difficulties in working memory, and reduced visual cortex activation during a visuospatial working memory task.


Asunto(s)
Dislexia , Discapacidades para el Aprendizaje , Niño , Humanos , Función Ejecutiva , Encéfalo , Memoria a Corto Plazo
3.
Dyslexia ; 30(4): e1788, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39155582

RESUMEN

Writing skills, crucial for various forms of expression, depend on effective planning and self-regulation. Competent writers emphasise pre-writing activities and self-regulation nevertheless students with Specific Learning Disabilities (SLD) often struggle with writing, impacting their academic achievement. This study explored the efficacy of the STOP and DARE strategy, grounded in the Self-Regulated Strategy Development (SRSD) model, for teaching persuasive writing to four high school students diagnosed with SLD. The study employed a multiple probe across subjects design to assess the impact of STOP and DARE on various persuasive writing skills. The intervention involved rigorous implementation of the strategy over 12-21 sessions, occurring 3 days a week for 80-90 min each day. The results indicated a functional relation between the strategy's implementation and improvements in persuasive essay elements, text length, use of linking words and holistic quality. Moreover, participants expressed a high level of satisfaction with the intervention. Future research could consider investigating functional text elements in addition to basic persuasive text elements. Furthermore, the adaptability of the STOP and DARE strategy to different languages and its applicability in diverse writing types, as well as its effectiveness in varied linguistic and cultural contexts, should be explored.


Asunto(s)
Estudiantes , Escritura , Humanos , Adolescente , Masculino , Femenino , Comunicación Persuasiva , Trastorno Específico de Aprendizaje , Discapacidades para el Aprendizaje , Instituciones Académicas
4.
Artículo en Inglés | MEDLINE | ID: mdl-38985327

RESUMEN

PURPOSE: People with learning disabilities have complex challenges and needs that differ from people without these conditions. Accessing needed health and mental health care may be affected by level of independence and severity of learning challenges. Our study examined factors and associations which impact help seeking and satisfaction with mental health care in a Canadian nationally representative sample. METHODS: Logistic regression and multinomial logistic regression was used to analyze the 2012 Canadian Community Health Survey- Mental Health (CCHS 2012) cross-sectional survey. We investigated the odds of distressed individuals (1) perceiving a need for mental health care, (2) seeking out professional mental health care, and (3) if their needs were met by mental health services. The presence of a learning disability was assessed as a moderator variable in all models. RESULTS: Distressed adults with learning disabilities did not perceive a need for mental health care as often as distressed adults without a learning disability (OR = 3.82;95%CI:1.64,8.93 vs. OR = 12.00;95%CI:9.19,15.67). Distressed adults with a learning disability weren't as likely to seek out mental health services, but were more satisfied with the mental health care they received as compared to adults without a learning disability. CONCLUSION: The findings suggest that adults with learning disabilities have unmet needs. They are less likely to perceive a need for treatment, or to seek treatment, when they are distressed. Future investigation is necessary to understand the factors that influence perceived need and treatment seeking in this under-served population.

5.
J Postgrad Med ; 70(1): 43-45, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38174529

RESUMEN

This retrospective study analyzed the quality of 1069 referral letters written by school principals to our learning disability clinic. Utilizing a self-devised checklist having four domains (with 26 items), the audit revealed that in only nine (34.6%) items, the necessary information was available in >90% of referral letters.


Asunto(s)
Derivación y Consulta , Instituciones Académicas , Humanos , Estudios Retrospectivos , Escritura
6.
Prev Sci ; 25(3): 448-458, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38236353

RESUMEN

Early childhood home visiting programs are well positioned to improve equity and reduce health disparities for families headed by caregivers with intellectual disabilities and other learning differences. Early identification of learning differences through screening may help home visiting staff tailor services and thus improve family engagement and outcomes. Using a mixed methods design, this study assessed potential determinants and outcomes related to implementation of a screening tool for learning differences adapted for the home visiting context. Participants were six home visiting staff and nine caregivers from multiple home visiting programs in one state. Staff completed surveys at enrollment and each time they conducted a screen with a caregiver. Staff also completed semi-structured interviews after conducting screens with at least two caregivers. Caregivers completed semi-structured interviews after taking part in a screen. At study enrollment, staff felt it was important to know if caregivers had learning differences, yet some believed caregivers would not like being asked about them. Survey and interview data aligned with theoretical determinants of implementation success, including staff competencies related to screening (e.g., knowledge, skills), perceived fit of screening with staff role and organizational context, and beliefs that the screening would improve engagement of caregivers and service delivery. Staff perceived the tool to be acceptable, feasible, and useful, although some acknowledged that caregivers might feel uncomfortable if the tool was not used carefully. Overall, caregivers found the tool to be acceptable and most believed it was helpful for the home visitor to have information about their learning experiences and needs. Findings lend initial support for the use of an adapted screening tool to identify potential learning differences.


Asunto(s)
Cuidadores , Estudios de Factibilidad , Humanos , Cuidadores/educación , Femenino , Masculino , Preescolar , Visita Domiciliaria , Adulto , Tamizaje Masivo , Encuestas y Cuestionarios , Lactante , Entrevistas como Asunto
7.
Community Dent Health ; 41(2): 111-116, 2024 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-38373221

RESUMEN

OBJECTIVES: Adults who have learning disabilities are a vulnerable group, little is known about their oral health and how this affects their quality of life. The aims of this secondary analysis of data from the 2009 Adult Dental Health Survey (ADHS) were to describe the oral health status of adults with learning disabilities, determine if severity of learning disability is associated with oral health and identify some of the methodological complexities of working with this population. The survey yields the most recent representative data on the oral health of adults with learning disabilities in England and importantly, contains information about oral health related quality of life (OHRQoL). BASIC RESEARCH DESIGN: Secondary analysis of data from a supplemental survey of adults with learning disabilities collected alongside the 2009 ADHS. PARTICIPANTS: 607 participants with a diagnosed learning disability aged 18 years and over. RESULTS: Adults with learning disabilities had similar levels of active dental caries, fewer natural teeth, and fewer fillings than comparable participants from the general population. Self-reported oral and general health were worse for adults with learning disabilities than the general population. Possible associations between the severity of learning disability and the numbers of decayed, missing or filled teeth were identified. However, large amounts of missing data limited the analysis. CONCLUSIONS: There are important questions relating to the accessibility of existing self-reported oral health questionnaires and the reliability of proxy-reported questions about OHRQoL that should be addressed to give a fuller picture of the oral health of adults with learning disabilities.


Asunto(s)
Encuestas de Salud Bucal , Discapacidades para el Aprendizaje , Salud Bucal , Humanos , Adulto , Discapacidades para el Aprendizaje/complicaciones , Femenino , Masculino , Persona de Mediana Edad , Adulto Joven , Calidad de Vida , Adolescente , Inglaterra/epidemiología , Caries Dental/epidemiología , Anciano
8.
J Appl Res Intellect Disabil ; 37(5): e13282, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39074852

RESUMEN

BACKGROUND: The aim of this feasibility study was to adapt and model a behavioural intervention for anxiety with autistic adults with moderate to severe intellectual disabilities. METHOD: Twenty-eight autistic adults with moderate or severe intellectual disabilities, 37 carers, and 40 therapists took part in this single-group non-randomised feasibility study designed to test intervention feasibility and acceptability, outcome measures, and research processes. RESULTS: The intervention was judged as feasible and acceptable by autistic adults with intellectual disabilities, carers, and therapists. Minor intervention revisions were suggested. Carers completed 100% of outcome measures and the missing data rate was low. Complying with legislation governing the inclusion of participants who lack capacity to decide whether they wanted to take part in this study led to an average 5-week enrolment delay. CONCLUSION: The intervention and associated study processes were judged to be feasible and acceptable and should now be tested within a larger randomised trial.


Asunto(s)
Trastorno Autístico , Terapia Conductista , Estudios de Factibilidad , Discapacidad Intelectual , Humanos , Discapacidad Intelectual/terapia , Adulto , Masculino , Femenino , Trastorno Autístico/terapia , Terapia Conductista/métodos , Adulto Joven , Persona de Mediana Edad , Ansiedad/terapia , Trastorno del Espectro Autista/terapia
9.
Br J Psychiatry ; 222(5): 191-195, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36786124

RESUMEN

Antiseizure medications (ASMs) are the second most widely prescribed psychotropic for people with intellectual disabilities in England. Multiple psychotropic prescribing is prevalent in almost half of people with intellectual disabilities on ASMs. This analysis identifies limited evidence of ASM benefit in challenging behaviour management and suggests improvements needed to inform clinical practice.


Asunto(s)
Discapacidad Intelectual , Humanos , Adulto , Discapacidad Intelectual/tratamiento farmacológico , Discapacidad Intelectual/epidemiología , Psicotrópicos/uso terapéutico , Inglaterra/epidemiología
10.
Dev Sci ; 26(2): e13294, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-35727164

RESUMEN

Phonological processing skills have not only been shown to be important for reading skills, but also for arithmetic skills. Specifically, previous research in typically developing children has suggested that phonological processing skills may be more closely related to arithmetic problems that are solved through fact retrieval (e.g., remembering the solution from memory) than procedural computation (e.g., counting). However, the relationship between phonological processing and arithmetic in children with learning disabilities (LDs) has not been investigated. Yet, understanding these relationships in children with LDs is especially important because it can help elucidate the cognitive underpinnings of math difficulties, explain why reading and math disabilities frequently co-occur, and provide information on which cognitive skills to target for interventions. In 63 children with LDs, we examined the relationship between different phonological processing skills (phonemic awareness, phonological memory, and rapid serial naming) and arithmetic. We distinguished between arithmetic problems that tend to be solved with fact retrieval versus procedural computation to determine whether phonological processing skills are differentially related to these two arithmetic processes. We found that phonemic awareness, but not phonological memory or rapid serial naming, was related to arithmetic fact retrieval. We also found no association between any phonological processing skills and procedural computation. These results converge with prior research in typically developing children and suggest that phonemic awareness is also related to arithmetic fact retrieval in children with LD. These results raise the possibility that phonemic awareness training might improve both reading and arithmetic fact retrieval skills. RESEARCH HIGHLIGHTS: Relationships between phonological processing and various arithmetic skills were investigated in children with learning disabilities (LDs) for the first time. We found phonemic awareness was related to arithmetic involving fact retrieval, but not to arithmetic involving procedural computation in LDs. The results suggest that phonemic awareness is not only important to skilled reading, but also to some aspects of arithmetic. These results raise the question of whether intervention in phonemic awareness might improve arithmetic fact retrieval skills.


Asunto(s)
Discapacidades para el Aprendizaje , Lingüística , Humanos , Niño , Lectura , Recuerdo Mental , Matemática , Fonética
11.
Compr Psychiatry ; 122: 152372, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36724728

RESUMEN

OBJECTIVE: The aim of this systematic review and meta-analysis (PROSPERO 2020 CRD42020169323) was to evaluate the efficacy of psychological therapy for people with intellectual disabilities. METHOD: A comprehensive literature search yielded 22,444 studies which were screened for eligibility. Studies were eligible for inclusion if a psychological therapy was delivered to people with intellectual disabilities compared to a group who did not receive the therapy. Thirty-three controlled trials were eligible for inclusion in the review, with 19 included within a DerSimonian-Laird random effects meta-analysis. Subgroup analysis was completed by clinical presentation, and by comparing randomised trials to non-randomised trials, and group-based to individually delivered psychotherapy. RESULTS: Following the removal of outliers, psychological therapy for a range of mental health problems was associated with a small and significant effect size, g = 0.43, 95% CI [0.20, 0.67], N = 698. There was evidence of heterogeneity and bias due to studies with small sample sizes and a lack of randomisation. Non-randomised studies were associated with a large effect size, g = 0.90, 95% CI [0.47, 1.32], N = 174, while randomised studies were associated with a small effect size, g = 0.36, 95% CI [0.17, 0.55], N = 438, excluding outliers. Individually delivered psychological therapy was associated with a small and non-significant effect size, g = 0.32, 95% CI [-0.01, 0.65], N = 146, while group-based interventions were associated with a small and significant effect size, g = 0.37, 95% CI [0.05, 0.68], N = 361, again, excluding outliers. Psychological therapy for anger was associated with a moderate effect size, g = 0.60, 95% CI [0.26, 0.93], N = 324, while treatment for depression and anxiety was associated with a small and non-significant effect size, g = 0.38, 95% CI [-0.10, 0.85], N = 216, after outliers were removed. CONCLUSIONS: Studies are fraught with methodological weaknesses limiting the ability to make firm conclusions about the effectiveness of psychological therapy for people with intellectual disabilities. Improved reporting standards, appropriately powered and well-designed trials, and greater consideration of the nature and degree of adaptations to therapy are needed to minimise bias and increase the certainty of conclusions.


Asunto(s)
Discapacidad Intelectual , Humanos , Psicoterapia , Ira , Ansiedad , Trastornos de Ansiedad
12.
Acta Obstet Gynecol Scand ; 102(4): 486-495, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36810769

RESUMEN

INTRODUCTION: The incidence of induction of labor, for both medical reasons and as an elective procedure, has been rising and a further increase in induction of labor following the ARRIVE trial may be expected. The effects of induction of labor at term on childhood neurodevelopment, however, are not well studied. We aimed to study the influence of elective induction of labor for each week of gestation separately from 37 to 42 weeks on offspring school performance at 12 years of age after uncomplicated pregnancies. MATERIAL AND METHODS: We performed a population-based study among 226 684 liveborn children from uncomplicated singleton pregnancies, born from 37+0 to 42+0 weeks of gestation in cephalic presentation in 2003-2008 (no hypertensive disorders, diabetes or birthweight ≤p5) in the Netherlands. Children with congenital anomalies, of non-white mothers and born after planned cesarean section were excluded. Birth records were linked with national data on school achievement. We compared, using a fetus-at-risk approach and per week of gestation, school performance score and secondary school level at age 12 in those born after induction of labor to those born after non-intervention, ie spontaneous onset of labor in the same week plus all those born at later gestations. Education scores were standardized to a mean of 0 and a standard deviation of 1 and adjusted in the regression analyses. RESULTS: For each gestational age up to 41 weeks, induction of labor was associated with decreased school performance scores compared with non-intervention (at 37 weeks -0.05 SD, 95% confidence interval [CI] -0.10 to -0.01 SD; adjusted for confounding factors). After induction of labor, fewer children reached higher secondary school level (at 38 weeks 48% vs 54%; adjusted odds ratio [aOR] 0.88, 95% CI 0.82-0.94). CONCLUSIONS: In women with uncomplicated pregnancies at term, consistently, at every week of gestation from 37 to 41 weeks, induction of labor is associated with lower offspring school performance at age 12 and lower secondary school level compared with non-intervention, although residual confounding may remain. These long-term effects of induction of labor should be incorporated in counseling and decision making.


Asunto(s)
Cesárea , Trabajo de Parto , Niño , Embarazo , Femenino , Humanos , Lactante , Estudios de Cohortes , Trabajo de Parto Inducido/métodos , Edad Gestacional
13.
BMC Public Health ; 23(1): 2099, 2023 10 25.
Artículo en Inglés | MEDLINE | ID: mdl-37880687

RESUMEN

BACKGROUND: Evidence from the UK from the early stages of the covid-19 pandemic showed that people with Intellectual Disabilities (ID) had higher rates of covid-19 mortality than people without ID. However, estimates of the magnitude of risk vary widely; different studies used different time periods; and only early stages of the pandemic have been analysed. Existing analyses of risk factors have also been limited. The objective of this study was to investigate covid-19 mortality rates, hospitalisation rates, and risk factors in people with ID in England up to the end of 2021. METHODS: Retrospective cohort study of all people with a laboratory-confirmed SARS-CoV-2 infection or death involving covid-19. Datasets covering primary care, secondary care, covid-19 tests and vaccinations, prescriptions, and deaths were linked at individual level. RESULTS: Covid-19 carries a disproportionately higher risk of death for people with ID, above their already higher risk of dying from other causes, in comparison to those without ID. Around 2,000 people with ID had a death involving covid-19 in England up to the end of 2021; approximately 1 in 180. The covid-19 standardized mortality ratio was 5.6 [95% CI 5.4, 5.9]. People with ID were also more likely to be hospitalised for covid-19 than people without ID. The main determinants of severe covid-19 outcomes (deaths and/or hospitalisations) in both populations were age, multimorbidity and vaccination status. The key factor responsible for the higher risk of severe covid-19 in the ID population was a much higher prevalence of multimorbidity in this population. AstraZeneca vaccine was slightly less effective in preventing severe covid-19 outcomes among people with ID than among people without ID. CONCLUSIONS: People with ID should be considered a priority group in future pandemics, such as shielding and vaccinations.


Asunto(s)
COVID-19 , Discapacidad Intelectual , Humanos , COVID-19/epidemiología , Pandemias , Discapacidad Intelectual/epidemiología , Estudios Retrospectivos , SARS-CoV-2 , Inglaterra/epidemiología
14.
BMC Health Serv Res ; 23(1): 1354, 2023 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-38049861

RESUMEN

BACKGROUND: One in five children with an intellectual disability in the UK display behaviours that challenge. Despite associated impacts on the children themselves, their families, and services, little research has been published about how best to design, organise, and deliver health and care services to these children. The purpose of this study was to describe how services are structured and organised ("service models") in England for community-based health and care services for children with intellectual disability who display behaviours that challenge. METHODS: Survey data about services were collected from 161 eligible community-based services in England. Staff from 60 of these services were also interviewed. A combination of latent class and descriptive analysis, coupled with consultation with family carers and professionals was used to identify and describe groupings of similar services (i.e., "service models"). RESULTS: The latent class analysis, completed as a first step in the process, supported a distinction between specialist services and non-specialist services for children who display behaviours that challenge. Planned descriptive analyses incorporating additional study variables were undertaken to further refine the service models. Five service models were identified: Child and Adolescent Mental Health Services (CAMHS) (n = 69 services), Intellectual Disability CAMHS (n = 28 services), Children and Young People Disability services (n = 25 services), Specialist services for children who display behaviours that challenge (n = 27 services), and broader age range services for children and/or adolescents and adults (n= 12 services). CONCLUSIONS: Our analysis led to a typology of five service models for community health and care services for children with intellectual disabilities and behaviours that challenge in England. Identification of a typology of service models is a first step in building evidence about the best provision of services for children with intellectual disabilities who display behaviours that challenge. The methods used in the current study may be useful in research developing service typologies in other specialist fields of health and care. STUDY REGISTRATION: Trial Registration: Current Controlled Trials ISRCTN88920546, Date assigned 05/07/2022.


Asunto(s)
Discapacidad Intelectual , Adulto , Adolescente , Humanos , Niño , Discapacidad Intelectual/terapia , Discapacidad Intelectual/psicología , Servicios de Salud Comunitaria , Inglaterra , Cuidadores/psicología , Encuestas y Cuestionarios
15.
Adv Exp Med Biol ; 1421: 63-78, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37524984

RESUMEN

Modern anatomy education has benefitted from the development of a wide range of digital 3D resources in the past decades, but the impact of the COVID-19 pandemic has sparked an additional demand for high-quality online learning resources. Photogrammetry provides a low-cost technique for departments to create their own photo-realistic 3D models of cadaveric specimens. However, to ensure accessibility, the design of the resulting learning resources should be carefully considered. We aimed to address this by creating a video based on a photogrammetry model of a cadaveric human lung. Students evaluated three different versions of this video in a Likert-type online survey. Most responding students found this type of video useful for their learning and helpful for the identification of anatomical structures in real cadaveric specimens. Respondents also showed a preference for specific design features such as a short video length, white text on black background, and the presence of captions. The positive student feedback is promising for the future development of photogrammetry-based videos for anatomy education and this study has provided pilot data to improve the accessibility of such videos.

16.
BMC Med Educ ; 23(1): 818, 2023 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-37915002

RESUMEN

BACKGROUND: People with intellectual disabilities are a marginalized group whose health experiences and outcomes are poor. Lack of skill and knowledge in the healthcare workforce is a contributing factor. In England, there is a new legislative requirement for mandatory intellectual disability training to be given to the existing healthcare workforce, including doctors. There is a lack of evidence about effective models of educational delivery of such training in medical schools. We undertook a scoping review to assess the range of intellectual disabilities educational interventions and their effectiveness. METHODS: We included any study from 1980 onwards which reported an educational intervention on intellectual disability, or intellectual disability and autism, for medical students from any year group. Databases searched included PUBMED, ERIC, Scopus and Web of Science as well as searches of grey literature and hand searching two journals (Medical Education and Journal of Learning Disabilities). 2,020 records were extracted, with 1,992 excluded from initial screening, and a further 12 excluded from full-text review, leaving 16 studies for inclusion. Data was extracted, quality assessed, and findings collated using narrative analysis. RESULTS: We found a variety of intervention types: classroom-based teaching, simulation, placement, home visits, and panel discussions. There was substantial variation in content. Most studies involved lived experience input. Across studies, interventions had different learning outcomes which made it difficult to assess effectiveness. Overall study quality was poor, with high use of non-validated measures, making further assessment of effectiveness problematic. CONCLUSIONS: There is a need for more consistency in intervention design, and higher quality evaluation of teaching in this area. Our review has drawn attention to the variety in teaching on this topic area and further research should focus on updating this review as curriculum changes are implemented over time.


Asunto(s)
Educación Médica , Discapacidad Intelectual , Estudiantes de Medicina , Humanos , Aprendizaje , Curriculum
17.
Neuropsychol Rehabil ; 33(8): 1325-1348, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35876193

RESUMEN

Learning disabilities (LDs) and working memory problems (WM) are common brain-related comorbidities in Duchenne muscular dystrophy (DMD). Despite growing evidence on the efficacy of computerized WM training in children with LDs, research in DMD is lacking. This exploratory study assessed whether training (1) improves dystrophin-associated WM problems in DMD, (2) effects are present at post-intervention, 3 and 8 months follow-up, and (3) improves problems that arise from their LDs. A single case non-concurrent multiple baseline across patients design evaluated the target behaviour i.e. parental reports of WM problems of four DMD participants with LDs. Additionally, participants completed cognitive tests of verbal and visual WM, academics, attention, processing speed and fluid reasoning. Parents and teachers completed behavioural questionnaires. Testing and questionnaires were administered at baseline, post-intervention (T2), 3 (T3) and 8 (T4) months follow-up. Positive effects on target behaviour were found for three of four participants, but parental bias cannot be ruled out. Short and long-term, near-and far transfer effects were found for verbal and visual WM (T2:n = 2, T3&T4:n = 1), reading (T2:n = 4,T3:n = 3,T4:n = 2), arithmetic (all T:n = 1), processing speed (all T:n = 4) and fluid reasoning (T2:n = 1,T3&T4:n = 2). Behavioural questionnaires displayed minimal changes (T2:n = 1,T3&T4:n = 2). Promising WM training results are shown in DMD that merit further research.


Asunto(s)
Memoria a Corto Plazo , Distrofia Muscular de Duchenne , Masculino , Niño , Humanos , Distrofia Muscular de Duchenne/complicaciones , Distrofia Muscular de Duchenne/psicología , Proyectos de Investigación , Entrenamiento Cognitivo , Encéfalo
18.
Child Psychiatry Hum Dev ; 54(4): 1064-1074, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35072871

RESUMEN

While the field of learning disabilities has grown substantially over the past several decades (Grigorenko et al. in Am Psychol 75:37, 2020) little work has explored the role of internalizing symptoms among struggling students. The present study compared struggling and typical readers on several child reported internalizing measures at both the beginning and end of a school year during which time they received either classroom-as-usual or research-team provided intensive intervention. Struggling readers who did and did not meet reading benchmarks were also compared at year-end. While minimal differences were present at the beginning of the year, numerous differences were observed at the end, with students exhibiting persistent reading struggles reporting significantly greater distress. Bi-directional associations emerged with beginning of year group status predicting internalizing symptoms and beginning of year internalizing symptoms predicting end of year intervention response group status. Findings are discussed in terms of future directions for enhancing intervention studies of struggling readers.


Asunto(s)
Dislexia , Lectura , Niño , Humanos , Estudiantes , Instituciones Académicas , Dislexia/diagnóstico
19.
J Appl Res Intellect Disabil ; 36(5): 916-928, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37177858

RESUMEN

BACKGROUND: People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well-being. METHODS: An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015. RESULTS: Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability. CONCLUSION: A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep.


Asunto(s)
Discapacidad Intelectual , Problema de Conducta , Trastornos del Sueño-Vigilia , Humanos , Niño , Adulto , Discapacidad Intelectual/epidemiología , Calidad de Vida , Salud Mental , Trastornos del Sueño-Vigilia/epidemiología
20.
J Appl Res Intellect Disabil ; 36(4): 702-724, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37076958

RESUMEN

BACKGROUND: Falls are common among people with intellectual disabilities. Many falls happen within the home. Our scoping review aimed to identify evidence for falls-risk factors and falls-prevention interventions for this population. METHOD: We conducted a multi-database search to identify any type of published study that explored falls-risk factors or falls-prevention interventions for people with intellectual disabilities. Following a process of (i) title & abstract and (ii) full-text screening, data was extracted from the included studies and described narratively. RESULTS: Forty-one studies were included. Risks are multifactorial. There was limited evidence of medical, behavioural/psychological, or environmental interventions to address modifiable risk factors, and no evidence of the interventions' cost-effectiveness. CONCLUSIONS: Clinically and cost effective, acceptable and accessible falls-prevention pathways should be available for people with intellectual disabilities who are at risk of falls from an earlier age than the general population.


Asunto(s)
Discapacidad Intelectual , Humanos , Factores de Riesgo
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