Interactional patterns between staff and clients with borderline to mild intellectual disabilities.

BACKGROUND: Client-centred models of care imply that clients should have a collaborative relationship with staff providing support. This study investigates whether dialogues between staff and clients in naturally occurring contexts reflect this collaborative ideal. METHODS: Nineteen staff members video recorded a social interaction with one of their clients. The topic of the interaction concerned an aspect of their support needs. The recordings were transcribed and analysed using the Initiative Response Analysis designed by Linell et al. RESULTS: Staff were more dominant than clients, albeit the level of asymmetry in the dialogues was relatively small. However, a different pattern of turns was used by staff and clients. Staff asked more direct questions and sometimes neglected meaningful client contributions. Clients, on the other hand, provided more extended turns in response to staff members' questions, thereby helping to maintain the dialogue. However, in a notable minority of communicative turns, the clients failed to link with the staff member's contribution. CONCLUSIONS: The interactional patterns found in this study suggest that staff and clients can face difficulties establishing collaborative dialogues on shared topics. Future research should take account of what staff and clients want to achieve in dialogues, along with the nature of their non-verbal communication.

Accidental and Ambiguous Situations Reveal Specific Social Information Processing Biases and Deficits in Adolescents with Low Intellectual Level and Clinical Levels of Externalizing Behavior.

Addressing aggression in youth requires understanding of the range of social problem situations that may lead to biased social information processing (SIP). The present study investigated situation-specificity of SIP and analyzed whether SIP deficits and biases are found in ambiguous as well as clearly accidental situations in adolescents with clinical levels of externalizing behavior or with low intellectual level, congruent with mild intellectual disability. Adolescents (N = 220, Mage = 15.21) completed a SIP test on a mobile app with six videos with ambiguous, hostile, and accidental social problems. Caretakers, teachers, and adolescents themselves reported on youth externalizing behavior problems. In accidental situations specifically, adolescents with low IQ scores more often attributed purposeful intent to perpetrators than peers with borderline or average IQ scores. In accidental situations, adolescents with clinical levels of externalizing behavior generated and selected more aggressive responses than nonclinical adolescents, regardless of their cognitive level. In line with previous literature, the ambiguous situations also brought out SIP differences between IQ groups. These results suggest that not only ambiguous situations should be considered informative for understanding SIP biases, but situations in which adolescents are clearly accidentally disadvantaged bring out SIP biases as well, that may lead to conflicts with others.

Social information processing in boys with autistic spectrum disorder and mild to borderline intellectual disabilities.

BACKGROUND: Children with autistic spectrum disorders (ASD) and mild to borderline intellectual disability (ID) have less adaptive behaviour and more behaviour problems than children with mild to borderline ID. Social information processing appears to be an important mechanism in the explanation of the socially inadequate behaviour of children with mild to borderline ID; however, little is known about the social information processing skills of children with ASD and mild to borderline ID. METHOD: In the present study, a total of 136 boys in the age of 10-14 years participated; 26 with ASD (specifically Pervasive Developmental Disorder--Not Otherwise Specified) and mild to borderline ID, 54 with mild to borderline ID without ASD and 56 typically developing boys. They completed the Social Problem Solving Test to measure their social information processing. RESULTS: The research results show boys with PDD-NOS and mild to borderline ID to differ from typically developing boys in their encoding of information; they focus on negative and emotional information in the social situation. They differ from boys with mild to borderline ID in response generation, evaluation of inadequate solutions (aggressive and submissive responses) and assertive response decision. CONCLUSIONS: The present study extends our knowledge regarding social information processing of children with ASD (PDD-NOS) and mild to borderline ID. This knowledge may be helpful in designing and adapting programmes (e.g. social skills training, self-management training) for the management of behaviour problems and development of adaptive behaviour of children with ASD and mild to borderline ID.

Impulse control and aggressive response generation as predictors of aggressive behaviour in children with mild intellectual disabilities and borderline intelligence.

BACKGROUND: A growing interest exists in mechanisms involved in behaviour problems in children with mild intellectual disabilities and borderline intelligence (MID/BI). Social problem solving difficulties have been found to be an explanatory mechanism for aggressive behaviour in these children. However, recently a discrepancy was found between automatic and reflective responding in social situations. We hypothesise that low impulse control and aggressive social problem solving strategies together may explain mechanisms involved in aggressive behaviour by children with MID/BI. METHOD: In a clinical sample of 130 children with MID/BI receiving intramural treatment, main, moderating and mediating effects of impulse control and aggressive response generation on aggressive behaviour were examined by conducting hierarchical linear multiple regression analyses. RESULTS: Independent main effects of both impulse control and aggressive response generation on aggressive behaviour were found. Results indicated that low impulse control and aggressive response generation each explain unique variance in aggressive behaviour. CONCLUSIONS: As this study is the first that has shown both impulse control and aggressive response generation to be important predictors for aggressive behaviour in children with MID/BI, future research should further examine the nature of relations between low impulse control and social problem solving.

[Formula: see text]Executive functions and social information processing in adolescents with severe behavior problems.

One tradition in research for explaining aggression and antisocial behavior has focused on social information processing (SIP). Aggression and antisocial behavior have also been studied from the perspective of executive functions (EFs), the higher-order cognitive abilities that affect other cognitive processes, such as social cognitive processes. The main goal of the present study is to provide insight into the relation between EFs and SIP in adolescents with severe behavior problems. Because of the hierarchical relation between EFs and SIP, we examined EFs as predictors of SIP. We hypothesized that, first, focused attention predicts encoding and interpretation, second, inhibition predicts interpretation, response generation, evaluation, and selection, and third, working memory predicts response generation and selection. The participants consisted of 94 respondents living in residential facilities aged 12-20 years, all showing behavior problems in the clinical range according to care staff. EFs were assessed using subtests from the Amsterdam Neuropsychological Test battery. Focused attention was measured by the Flanker task, inhibition by the GoNoGo task, and working memory by the Visual Spatial Sequencing task. SIP was measured by video vignettes and a structured interview. The results indicate that positive evaluation of aggressive responses is predicted by impaired inhibition and selection of aggressive responses by a combination of impaired focused attention and inhibition. It is concluded that different components of EFs as higher-order cognitive abilities affect SIP.

The social experiences of cancer patients under treatment: a comparative study.

As part of a larger study on the quality of life of cancer patients under treatment, the positive and negative experiences in social interaction have been examined as compared to those of a control group (nonpatients, n = 201). Two patient groups were included: 109 patients who had recently undergone surgery and 108 patients receiving chemotherapy. The respondents returned a mailed questionnaire. Contrary to the assumptions based on a review from the literature, cancer patients appear to have more positive and fewer negative social experiences than a random sample from the 'normal' population. Even under more severe medical circumstances (a poor prognosis or heavy chemotherapy, a large number of chemotherapy cycles, poor progress after surgery) the poorer the patients, medically speaking, the more help and support they perceive. The results of this study do not support the idea of stigmatization. The personality characteristics, neuroticism and self-esteem are especially important for the having of positive and negative experiences in social interaction. Positive social experiences show a relationship with self-esteem and negative social experiences show a relationship with neuroticism.

(Social) Cognitive skills and social information processing in children with mild to borderline intellectual disabilities.

The purpose of this study was to examine the unique contributions of (social) cognitive skills such as inhibition, working memory, perspective taking, facial emotion recognition, and interpretation of situations to the variance in social information processing in children with mild to borderline intellectual disabilities. Respondents were 79 children with mild to borderline intellectual disabilities in the age of 8-12 who were given tasks on social cognitive skills and social information processing. The results from the present study show that emotion recognition, interpretation, working memory and inhibition skills predict social information processing skills. It is concluded that especially emotion recognition and interpretation skills are important cognitive skills that predict social information processing, and therefore should be the focus of treatment.

The development of a diagnostic instrument to measure social information processing in children with mild to borderline intellectual disabilities.

A growing interest exists in the measuring of social adaptive functioning in children with mild to borderline intellectual disabilities (MBID), but valid instruments to measure this construct are lacking. The aim of the present study was to develop such an instrument and to examine it on its discriminate validity. In 141 children aged 8-12 years a new test battery was examined in four groups either with MBID, behaviour problems or both, and typically developing peers. The results show that children with either MBID or behaviour problems or both show more hostile intent attributions, set more internal revenge goals, generate more aggressive and fewer assertive responses, feel more confident in inadequate responses en select fewer assertive responses, than their typically developing peers. Children with MBID are characterized by relying on earlier experiences in encoding information, a small response repertoire, positive evaluation of submissive but not assertive responses, and the selection of aggressive responses. In addition, they have more problems with perspective taking, problem recognition, interpretation in general, inhibition, working memory, and emotion recognition, than their typically developing peers. Further, children with MBID and behaviour problems have more difficulties in social information processing when the information in social situations is more complex. It is concluded that the tasks of the test battery can discriminate between groups, and after further development of the material, can be used to obtain information on the competencies and disabilities in social information processing and social cognitive skills, in order to be able to offer adequate treatment to these children.

Aggressive behavior in individuals with moderate to borderline intellectual disabilities who live in a residential facility: an evaluation of functional variables.

We explored functional variables for aggressive behavior in 87 individuals with moderate to borderline intellectual disability who lived in a residential facility. For this purpose we used the Questions About Behavioral Function scale (QABF; Matson, J., & Vollmer, T. (1995). Questions About Behavioral Function (QABF). Baton Rouge, LA: Scientific Publications). Results show that in most clients subscales describing social function (i.e., Attention, Escape/Avoidance, Tangible) had significantly higher mean scores than subscales describing non-social function (i.e., Self-stimulation, Physical discomfort). Except for gender, there were no significant associations between mean subscale scores and client variables, such as psychiatric disorder, age, level of intellectual disability. Female clients had higher mean scores on subscales of Attention, Self-stimulation, and Physical discomfort than male clients. Results of our study suggest that in most cases, aggressive behavior is positively/negatively reinforced by social events. Implications for functional assessment and function-based treatment of aggressive behavior in these clients are discussed.

Do social information-processing models explain aggressive behaviour by children with mild intellectual disabilities in residential care?

BACKGROUND: This study aimed to examine whether the social information-processing model (SIP model) applies to aggressive behaviour by children with mild intellectual disabilities (MID). The response-decision element of SIP was expected to be unnecessary to explain aggressive behaviour in these children, and SIP was expected to mediate the relation between social schemata and aggressive behaviour. METHOD: SIP and aggressive behaviour of 130 10- to 14-year-old children with MID in residential care were assessed. The fit of various SIP models was tested with structural equation modelling. RESULTS: The response-decision process was found not to be necessary to explain aggressive behaviour. Social schemata were indirectly related to aggressive behaviour with aggressive response generation as mediating variable. CONCLUSIONS: Implications for SIP theory and intervention are discussed.

Do children do what they say? Responses to hypothetical and real-life social problems in children with mild intellectual disabilities and behaviour problems.

BACKGROUND: Most research on children's social problem-solving skills is based on responses to hypothetical vignettes. Just how these responses relate to actual behaviour in real-life social situations is, however, unclear, particularly for children with mild intellectual disabilities (MID). METHOD: In the present study, the spontaneous and selected responses of 56 children with MID to hypothetical situations from the Social Problem-Solving Test for children with MID (SPT-MID) were compared to their actual behaviour in comparable staged standardized real-life conflict situations. Correlations to externalizing behaviour problems were assessed using the Teacher's Report Form (TRF). RESULTS: The results show children with MID and accompanying externalizing behaviour problems to behave more aggressively in the staged real-life conflicts and provide more spontaneous aggressive responses to the hypothetical vignettes than children with MID and no accompanying externalizing behaviour problems; they did not, however, select more aggressive responses from the hypothetical options provided. A moderate correlation was found between the aggressiveness of the spontaneous responses in the hypothetical situations and actual behaviour in the staged real-life situations. In addition, both the spontaneous aggressive responses under hypothetical circumstances and the actual aggressive behaviour under staged real-life circumstances were related to teacher-rated aggressive behaviour in the classroom. CONCLUSIONS: It is concluded that the hypothetical vignettes from the SPT-MID do provide information on both the actual behaviour and knowledge of social problem-solving skills of children with MID.