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1.
Artigo em Inglês | MEDLINE | ID: mdl-32048401

RESUMO

OBJECTIVE: The Scale of Emotional Development-Short (SED-S) is an instrument to assess the level of emotional development (ED) in people with intellectual and developmental disability. Index cases are developed as a didactic tool to standardize the application of the scale. METHOD: In a stepwise process, a European working group from six countries developed five index cases, one for each level of ED. All cases were first scored by 20 raters using the SED-S and then rephrased to reduce inter-rater variations (SD > 0.5). RESULTS: All five index cases yielded overall ratings that matched the intended level of ED. Across the range of ED, Regulating Affect needed rephrasing most to ensure a distinct description within each level of ED. CONCLUSIONS: The tri-lingual, cross-cultural evolution of five index cases contributes to a standardized application of the SED-S and can serve as training material to improve the inter-rater reliability of the SED-S across different cultures and languages.

2.
J Autism Dev Disord ; 49(9): 3732-3752, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31161304

RESUMO

Initial studies have presented the Music-based Scale for Autism Diagnostics (MUSAD) as a promising DSM-5-based observational tool to identify autism spectrum disorder (ASD) in adults with intellectual disability (ID). The current study is the first to address its clinical utility in a new sample of 124 adults with ID (60.5% diagnosed with ASD). The derived diagnostic algorithm differentiated well between individuals with and without ASD (sensitivity 79%, specificity 74%, area under the curve = 0.81). Inter-rater reliability, assessed by the scorings of four independent experts in 22 consensus cases, was excellent (ICC = 0.92). Substantial correlations with scores from other ASD-specific measures indicated convergent validity. The MUSAD yields accurate and reliable scores, supporting comprehensive ASD diagnostics in adults with ID.


Assuntos
Algoritmos , Transtorno do Espectro Autista/diagnóstico , Deficiência Intelectual/diagnóstico , Música/psicologia , Testes Psicológicos/estatística & dados numéricos , Adulto , Área Sob a Curva , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
3.
PLoS One ; 14(4): e0215474, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30998731

RESUMO

BACKGROUND: In persons with intellectual and developmental disabilities, not only cognitive brain functions, but also socio-emotional processing networks may be impaired. This study aims to validate the Scale of Emotional Development-Short (SED-S) to provide an instrument for the assessment of socio-emotional brain functions. METHOD: The SED-S was applied in 160 children aged 0-12 years. Criterion validity was investigated at item and scale level in terms of the agreement between the scale classification and the child's chronological age. Additionally, interrater reliability and internal consistency were assessed. RESULTS: For the majority of items, the expected response pattern emerged, showing the highest response probabilities in the respective target age groups. Agreement between the classification of the different SED-S domains and chronological age was high (κw = 0.95; exact agreement = 80.6%). Interrater reliability at domain level ranged from κw = .98 to 1.00 and internal consistency was high (α = .99). CONCLUSION: The study normed the SED-S in a sample of typically developing children and provides evidence for criterion validity on item, domain and scale level.


Assuntos
Desenvolvimento Infantil , Cognição , Deficiências do Desenvolvimento/fisiopatologia , Emoções , Deficiência Intelectual/fisiopatologia , Encéfalo/crescimento & desenvolvimento , Encéfalo/fisiopatologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
4.
Fortschr Neurol Psychiatr ; 87(8): 437-443, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-30791059

RESUMO

OBJECTIVES: Analysis of the causes of challenging behavior in individuals with intellectual disability (ID). METHODS: The relatedness and the impact of cognitive and emotional functioning on challenging behavior was investigated by correlation and regression analyses in 262 individuals with ID and mental disorders / challenging behavior. RESULTS: Despite the high correlation between ID and emotional development, cognitive-emotional developmental discrepancies were found in every second patient. The severity of challenging behavior was associated with a lower level of emotional development, especially in the area of "aggression regulation". CONCLUSION: The level of emotional development should be ascertained in the context of an assessment of challenging behavior in individuals with ID.


Assuntos
Agressão , Emoções , Deficiência Intelectual/psicologia , Humanos , Transtornos Mentais/psicologia
5.
Nervenarzt ; 90(5): 490-496, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-30377732

RESUMO

OBJECTIVE: Collation of frequencies and clinical characteristics of autism spectrum disorders (ASD) in persons with intellectual disability (ID). METHODS: Cross-sectional analysis of a clinical psychiatric sample of 710 adults with ID and mental disorders. RESULTS: The frequency of ASD in an adult sample with ID was 19%. The occurrence of ASD was associated with a higher severity of ID, male gender (in mild to moderate ID), anticonvulsive therapy and reduced employment rates in workshops. CONCLUSION: The ASD are a frequent clinical diagnosis in adults with ID.


Assuntos
Transtorno do Espectro Autista , Deficiência Intelectual , Adulto , Transtorno do Espectro Autista/complicações , Estudos Transversais , Feminino , Humanos , Deficiência Intelectual/complicações , Masculino
6.
Fortschr Neurol Psychiatr ; 86(7): 402-409, 2018 07.
Artigo em Alemão | MEDLINE | ID: mdl-30029279

RESUMO

INTRODUCTION: This study aimed to assess the prevalence and clinical characteristics of dementia in a clinical sample of adults with Down syndrome. Consequences for clinical practice were deduced. METHODS: Patient characteristics and prevalence rates of dementia were evaluated in adults with Down syndrome who were admitted to psychiatry from 2005 to 2012 (N = 75). RESULTS: In every third patient with Down syndrome, dementia was diagnosed in a second assessment 6 to 12 months after initial hospital admission. Patients with dementia were older and more often female, while no association was found with the level of intellectual disability. Thyroid function and calcium values were often abnormal in those with and without dementia. DISCUSSION: In persons with Down syndrome, dementia is a prevalent cause for admission to psychiatry, especially in females and those of advanced age. Services should be adapted to the increased demands.


Assuntos
Demência/complicações , Demência/terapia , Síndrome de Down/complicações , Psiquiatria , Adulto , Fatores Etários , Idoso , Cálcio/metabolismo , Demência/epidemiologia , Síndrome de Down/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Admissão do Paciente , Prevalência , Fatores Sexuais , Testes de Função Tireóidea
7.
J Autism Dev Disord ; 48(2): 341-350, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28988347

RESUMO

The study assessed the diagnostic validity of the diagnostic behavioral assessment for autism spectrum disorders-revised (DiBAS-R; 19-item screening scale based on ratings by caregivers) in a clinical sample of 381 adults with ID. Analysis revealed a sensitivity of 0.82 and a specificity of 0.67 in the overall sample (70.3% agreement). Sensitivity (0.79) and specificity (0.84) were balanced in individuals with mild to moderate ID (83.3% agreement), while specificity was lower in individuals with severe to profound ID (sensitivity: 0.83, specificity: 0.34, 51% agreement). The level of ID as well as its interaction with ASD explained a significant proportion of the variance in the DiBAS-R scores. The DiBAS-R is an adequate screening tool, especially in individuals with mild to moderate ID.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/epidemiologia , Inquéritos e Questionários/normas , Adulto , Transtorno do Espectro Autista/psicologia , Cuidadores/psicologia , Cuidadores/normas , Estudos Transversais , Feminino , Humanos , Deficiência Intelectual/psicologia , Classificação Internacional de Doenças/normas , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
8.
Dtsch Arztebl Int ; 116(48): 809-816, 2018 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31888794

RESUMO

BACKGROUND: An estimated 1.5 million persons in Germany are intellectually disabled. Persons with intellectual disability (ID) are especially vulnerable to somatic and mental illnesses. METHODS: This review is based on pertinent literature retrieved by selective searches in PubMed and the Cochrane Library. RESULTS: Genetic abnormalities are a frequent cause of diseases that affect multiple organs and need interdisciplinary treatment. A number of somatic diseases are more common in persons with ID than in the general population, including epilepsy (30-50% in persons with severe or very severe ID, vs. 0.5% in the general popu- lation) and dementia (five times more common than in the general population). Patients with Down syndrome are 20 times more likely than the general population to develop acute lymphoblastic leukemia. Some mental illnesses, too, are more common in persons with ID, e.g., autism spectrum disorders (7.5-15% vs. 1% in the general population). The history and the findings of the physical and psychiatric examination are assessed in accordance with the biopsychosocial model of disease, and in the light of the patient's mental developmental age. Structured instruments for behavioral evaluation and diagnosis are an important additional component of the diagnostic assessment. A holistic approach is required that takes multiple life areas into account and involves the patient's familial and social environment, while obeying the rules of simple language. Psychotherapeutic and psychosocial measures must be adapted to the patient's cognitive abilities and mental developmental age. CONCLUSION: Intellectually disabled persons can be treated in a multimodal, multiprofessional approach. As of early 2019, there were 38 medical centers for adults with intellectual disability or severe multiple disabilities in Germany (Medizinische Behandlungszentren für Erwachsene mit geistiger Behinderung oder schweren Mehrfachbehinderungen, MZEB), where they can be cared for with due attention to their special needs.


Assuntos
Deficiência Intelectual/terapia , Alemanha , Humanos
9.
Autism Res ; 10(9): 1481-1490, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28401739

RESUMO

Autism spectrum disorder (ASD) frequently co-occurs with intellectual disability (ID) and often remains undiagnosed until adulthood. The Social Communication Questionnaire (SCQ) is a widely used measure to screen for ASD. To improve the utility of the SCQ for adults with ID, the aim of this study was to develop an ID-specific and adult appropriate algorithm for the SCQ using a core set of valid items. These items were identified in one sample (N = 226) and further cross-validated in a second, independent sample (N = 225) from Germany, England and the U.S. The newly developed algorithm has 24 items compared with the 40 items in the original instrument. The reduced item core set yielded similar diagnostic validity as the original algorithm with good sensitivity values (0.81-0.89) and low specificity values (0.62-0.72). Overall, these results suggest that the removed items may not carry diagnostically relevant information in adults with ID; thus, excluding these items may result in a more efficient and age-appropriate screening measure for this population. However, due to the low specificity values, a comprehensive assessment is essential for a final diagnostic assignment. Autism Res 2017, 10: 1481-1490. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.


Assuntos
Transtorno do Espectro Autista/complicações , Comunicação , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/fisiopatologia , Comportamento Social , Inquéritos e Questionários , Adulto , Algoritmos , Transtorno do Espectro Autista/fisiopatologia , Berlim , Feminino , Humanos , Deficiência Intelectual/complicações , Londres , Masculino , Ohio , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
10.
J Autism Dev Disord ; 47(2): 393-404, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27873140

RESUMO

Diagnosing Autism Spectrum Disorders (ASD) is important throughout the lifespan. The objective was to investigate the transcultural diagnostic validity of the Social Communication Questionnaire (SCQ) in a clinical sample of 451 adults with Intellectual Developmental Disorder (IDD) with and without ASD in Germany, the U.S.A. and Great Britain. Variables associated with higher SCQ sum-scores were higher levels of IDD, male gender, a diagnosis of ASD and the study site (Germany > U.S.A > G.B.). An ROC analysis revealed a cut-score of 13, which resulted in a sensitivity of 0.87 and a specificity of 0.58. It is recommended to adjust the cut-score according to level of IDD and gender. Further research is needed to align diagnostic assignment of ASD across different sites and countries.


Assuntos
Transtorno do Espectro Autista/etnologia , Comunicação , Comparação Transcultural , Deficiência Intelectual/etnologia , Relações Interpessoais , Inquéritos e Questionários/normas , Adulto , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Berlim/etnologia , Feminino , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/psicologia , Londres/etnologia , Masculino , Ohio/etnologia , Reprodutibilidade dos Testes , Estudos Retrospectivos
11.
Res Dev Disabil ; 59: 166-175, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27614275

RESUMO

BACKGROUND: Intellectual disability (ID) is often accompanied by delays in emotional development (ED) that may result in challenging behavior. Insight into emotional functioning is crucial for appropriate diagnostic assessment in adults with ID. However, few standardized assessment instruments are available. AIMS: The aim of this study was to develop a short, psychometrically sound instrument for assessing levels of ED in individuals with ID: The Scale of Emotional Development - Short (SED-S), which can be applied to adults. METHODS AND PROCEDURES: The Scale for ED - Revised2 (SED-R2) was taken as a point of departure. In a first step, the validity and observability of the items (N=556) in the SED-R2 were assessed by 30 experts from Germany, Belgium, and The Netherlands. The SED-S was then constituted in a consecutive consensus process, in which items to be included were selected based on their assessments and subsequently rephrased, and in which the structure and method of administering the new scale were agreed upon. OUTCOMES AND RESULTS: The SED-S consists of 200 binary items describing five levels of emotional functioning (reference ages: 0-12 years) within eight domains: Relating to His/Her Own Body, Relating to Significant Others, Dealing with Change - Object Permanence, Differentiating Emotions, Relating to Peers, Engaging with the Material World, Communicating with Others, and Regulating Affect. CONCLUSIONS AND IMPLICATIONS: The SED-S offers an empirical-based, practical tool to assessing ED in adults with ID. Further research will be needed to meet the requirements of a standardized diagnostic instrument.


Assuntos
Desenvolvimento Infantil , Emoções , Deficiência Intelectual/psicologia , Bélgica , Criança , Pré-Escolar , Consenso , Alemanha , Humanos , Lactente , Países Baixos , Psicometria , Inquéritos e Questionários
12.
Res Dev Disabil ; 43-44: 123-35, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26183337

RESUMO

UNLABELLED: The MUSAD was developed as a diagnostic observational instrument in an interactional music framework. It is based on the ICD-10/DSM-5 criteria for autism spectrum disorder (ASD) and was designed to assess adults on a lower level of functioning, including individuals with severe language impairments. This study aimed to evaluate the psychometric properties of the newly developed instrument. METHODS: Calculations were based on a consecutive clinical sample of N=76 adults with intellectual and developmental disabilities (IDD) suspected of ASD. Objectivity, test-retest reliability, and construct validity were calculated and a confirmatory factor analysis was applied to verify a reduced and optimized test version. RESULTS: The structural model showed a good fit, while internal consistency of the subscales was excellent (ω>.92). Item difficulties ranged between .04≤pi≤.82 and item-total correlation from .21 to .85. Objectivity was assessed by comparing the scorings of two external raters based on a subsample of n=12; interrater agreement was .71 (ICC 2, 1). Reliability was calculated for four test repetitions: the average ICC (3, 1) was .69. Convergent ASD measures correlated significantly with the MUSAD, while the discriminant Modified Overt Aggression Scale (MOAS) showed no significant overlap. CONCLUSION: Confirmation of factorial structure and acceptable psychometric properties suggest that the MUSAD is a promising new instrument for diagnosing ASD in adults with IDD.


Assuntos
Transtorno Autístico/diagnóstico , Deficiências do Desenvolvimento/psicologia , Deficiência Intelectual/psicologia , Música , Adolescente , Adulto , Idoso , Transtorno Autístico/complicações , Transtorno Autístico/psicologia , Estudos de Coortes , Deficiências do Desenvolvimento/complicações , Análise Fatorial , Feminino , Humanos , Deficiência Intelectual/complicações , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Adulto Jovem
13.
Am J Intellect Dev Disabil ; 120(3): 203-14, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25928433

RESUMO

This study examined the validity of the Social Communication Questionnaire (SCQ) to identify autism spectrum disorder (ASD) in 151 adults with intellectual disabilities (ID) in Germany. Sensitivities and specificities for ASD were 98/47% for the SCQ-current version and 92/22% for the SCQ-lifetime version. Sensitivities and specificities were increased to 89/66% and 78/48% by adjusting the recommended cut-points. The SCQ-current score correlated with the Scale for Pervasive Developmental Disorders in Mentally Retarded Persons and the Autism Diagnostic Observation Schedule, whereas the SCQ-lifetime score correlated with the Autism Diagnostic Interview-Revised. Our findings support the use of the SCQ-current version for ASD screening in adults with ID, although the SCQ-lifetime version should be used with caution in this population.


Assuntos
Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Deficiência Intelectual , Escalas de Graduação Psiquiátrica/normas , Psicometria/instrumentação , Adolescente , Adulto , Idoso , Transtornos Globais do Desenvolvimento Infantil/epidemiologia , Comunicação , Comorbidade , Feminino , Humanos , Deficiência Intelectual/epidemiologia , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Inquéritos e Questionários/normas , Adulto Jovem
14.
Psychiatr Prax ; 42(3): 140-6, 2015 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-24643768

RESUMO

BACKGROUND: One in four individuals with intellectual disability (ID) are additionally diagnosed with autism spectrum disorders (ASD) that may not be recognized und thus remain untreated until adulthood. Diagnosing ASD in adults with ID is challenging and there is a lack of specific diagnostic measures. METHODS: The Diagnostic Behavioral Assessment for ASD (DiBAS) is a DSM-5/ICD-10 based caregiver-report screener consisting of 20 Likert-scaled items. This study evaluates the item validities and -difficulties, and the scale's feasibility and validity in a clinical, adult ID sample (N = 91) from 8/2009 to 12/2011. RESULTS: The DiBAS was applicable in all individuals (100 %) and yielded an adequate diagnostic validity reflected by ROC analysis and an AUC of 0.808. Using a cut-point of 30, the sensitivity and specificity values were 83 % and 64 %, the agreement with the final diagnostic classification was 74 %, and Cohen's kappa was 0.469. Single item analysis revealed 12 valid DiBAS variables that predominantly could be assigned to the social interaction and non-verbal communication domains; item difficulties varied from 0.21 to 0.84. The scale's internal consistency was appropriate (Cronbach's alpha 0.749). CONCLUSIONS: The DiBAS is a promising psychometrical sound scale of high feasibility to screen for ASD in adults with ID, which could be further specified by single item analysis.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Técnicas de Observação do Comportamento/estatística & dados numéricos , Determinação da Personalidade/estatística & dados numéricos , Adulto , Criança , Comorbidade , Diagnóstico Tardio , Feminino , Alemanha , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/psicologia , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/psicologia , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes
16.
Psychiatr Prax ; 41(1): 37-44, 2014 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-23681789

RESUMO

OBJECTIVE: To determine the validity of the Autism-Checklist (ACL) in adults with intellectual disability (ID) who are suspected of having autism spectrum disorder. METHODS: In 154 adults with ID the results of the ACL were compared to the results of the final diagnostic classification obtained by a multiprofessional case conference for autism. Psychometric properties of the ACL were evaluated. RESULTS: The internal consistency as indicated by Cronbach's alpha was 0.81. The ACL sum score highly correlated with established screening measures such as the Social Communication Questionnaire (SCQ: Spearman's rho = 0.620) and the Pervasive Developmental Disorder in Mental Retardation Scale (PDD-MRS: Spearman's rho = 0.490). ROC Analysis revealed an area under the curve of 0.859. The ACL classification complied with the final diagnostic classification in 80.5 % and Cohen's kappa revealed a moderate agreement of 0.596. Sensitivity/specificity of the ACL were 90.7 %/67.6 %, respectively. Interrater-intertime reliability was good (Cohen's kappa = 0.702; Spearman = 0.549; n = 53). In 19 patients (22 %) a diagnosis of ASD had been given prior to referral. CONCLUSION: The ACL is a suitable measure for adults with ID and suspicion of autism spectrum disorders.


Assuntos
Lista de Checagem/estatística & dados numéricos , Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Deficiência Intelectual/diagnóstico , Psicometria/estatística & dados numéricos , Adulto , Transtornos Globais do Desenvolvimento Infantil/psicologia , Comorbidade , Comportamento Cooperativo , Feminino , Humanos , Deficiência Intelectual/psicologia , Comunicação Interdisciplinar , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos
17.
J Autism Dev Disord ; 44(4): 786-800, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24002416

RESUMO

Individuals with intellectual disability (ID) show high rates of challenging behavior (CB). The aim of this retrospective study was to assess the factors underlying CB in an adult, clinical ID sample (n = 203). Low levels of emotional development (ED), as measured by the Scheme of Appraisal of ED, predicted overall CB, specifically irritability and self-injury, high unemployment and low occupation rates, while severity of ID controlled for ED did not. Autism was the only mental disorder associated with overall CB, stereotypy, lethargy, and predicted antipsychotic drug usage. Given the persistence and clinical significance of CB, evaluation of autism and ED may suggest priority areas for diagnostics and therapy, to provide the prerequisites for participation in society and living up one's potentials.


Assuntos
Transtorno Autístico/psicologia , Deficiências do Desenvolvimento/psicologia , Emoções , Deficiência Intelectual/psicologia , Adulto , Emprego , Feminino , Humanos , Humor Irritável , Masculino , Pessoa de Meia-Idade , Comportamento Autodestrutivo/psicologia , Índice de Gravidade de Doença , Adulto Jovem
18.
PLoS One ; 8(9): e74036, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24066092

RESUMO

Individuals with intellectual disability (ID) are at risk for additional autism spectrum disorders (ASD). A large amount of research reveals deficits in emotion-related processes that are relevant to social cognition in ASD. However, studies on the structure and level of emotional development (ED) assessing emotional maturity according to the normative trajectory in typically developing children are scares. The level of ED can be evaluated by the 'Scheme of Appraisal of Emotional Development' (SAED), a semi-structured interview with a close caregiver. The SAED assesses the level of emotional developmental based on a five stage system in 10 domains, for example, 'interaction with peers' or 'object permanence', which are conducive to the overall emotional developmental level. This study examined the ED as measured by the SAED in 289 adults (mean age: 36 years) with ID with and without additional ASD. A lower level in ED was observed in ASD/ID combined that corresponded to the ED of typically developing children aged 1.5-3 years versus an ED with a corresponding age of 3-7 years in ID individuals without ASD. Moreover, distinct strengths in 'object permanence', and weaknesses in 'interaction', 'verbal communication', 'experience of self', 'affect differentiation', 'anxiety', and 'handling of material objects' led to a characteristic pattern of ED in ASD. SAED domains with highest discriminative power between ID individuals with and without ASD (5/10) were used to predict ASD group membership. The classification using a selection of SAED domains revealed a sensitivity of 77.5% and a specificity of 76.4%. ASD risk increased 2.7-fold with every SAED level. The recognition of delayed and uneven pattern of ED contributes to our understanding of the emotion-related impairments in adults with ID and ASD these individuals. Assessment of intra-individual ED could add value to the standard diagnostic procedures in ID, a population at risk for underdiagnosed ASD.


Assuntos
Transtorno Autístico/psicologia , Emoções/fisiologia , Deficiência Intelectual/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Comportamento Social
19.
Res Dev Disabil ; 34(5): 1642-55, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23475013

RESUMO

Intellectual disability (ID) and autism spectrum disorder (ASD) are frequently co-occurring conditions. Carefully diagnosing ASD in individuals with ID would allow for more tailored clinical interventions that would improve mental health and quality of life. In this study, we evaluated the psychometric properties of the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) in a clinical sample of 79 adults with ID who were suspected of also having ASD. In the testable cases (68%), the ADOS was over-inclusive (specificity 45%) but highly sensitive (100%) of ASD. In the ADI-R, the feasibility was 37%, with a sensitivity of 88% and a specificity of 80%. Previously proposed adaptations of the ADOS algorithm were evaluated, and new items and tasks were suggested. The ADOS and the ADI-R were found to be valuable diagnostic tools for adults with ID. Adjustments of the setting and the tasks may further improve their feasibility and specificity.


Assuntos
Transtorno Autístico/diagnóstico , Deficiência Intelectual/diagnóstico , Psicometria/métodos , Psicometria/normas , Adulto , Algoritmos , Transtorno Autístico/complicações , Comunicação , Estudos de Viabilidade , Feminino , Humanos , Deficiência Intelectual/complicações , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Comportamento Social
20.
Psychiatr Prax ; 39(5): 228-38, 2012 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-22744151

RESUMO

OBJECTIVE: To specify frequently observed challenging behavior in adults with ID. METHODS: In a sample of individuals with ID and severe behavioral problems (n = 9), we assessed their emotional developmental level using Dosen's scheme for appraisal of emotional development. The clinical characteristics following the arrest of emotional development at various levels were evaluated by standardized behavioral assessments. The results were compared to a control group matched for sex, age, level of ID, and presence of autism spectrum disorder. RESULTS: We observed 3 categories of emotional developmental disorder: (1) Contact disorder (arrest in adaptation phase, 0-6 months, showing self injury, social withdrawal, stereotyped behaviors); (2) disintegrated disorder (arrest in socialization phase, 6-18 months, showing high irritability and aggression), and (3) disorganized disorder (arrest in individuation phase, 18-36 months, showing hyperactivity and attention seeking behavior). The individuals with emotional developmental disorders showed a significant increase in challenging behavior when compared to the control group, especially in terms of hyperactivity, irritability, and overall aggression, and were more often unemployed. CONCLUSIONS: Emotional developmental disorders may lead to severe behavioral problems.


Assuntos
Sintomas Afetivos/psicologia , Inteligência Emocional , Deficiência Intelectual/psicologia , Adulto , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/terapia , Estudos de Casos e Controles , Criança , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Transtornos Cognitivos/terapia , Comorbidade , Feminino , Seguimentos , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/terapia , Masculino , Transtornos do Comportamento Social/diagnóstico , Transtornos do Comportamento Social/psicologia , Transtornos do Comportamento Social/terapia , Adulto Jovem
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