This largest-to-date study quantifies the extent of the substantial health disparities experienced by young people with intellectual disabilities compared with people without intellectual disabilities. The young population with intellectual disabilities have substantial health problems; therefore, transition between child and adult services must be carefully planned in order to ensure that existing health conditions are managed and emerging problems minimised.

There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it. This is the peer-reviewed version of the following article: YoungSouthward, G., Philo, C. and Cooper, S.-A. (2017) MethodPRISMA/MOOSE guidelines were followed. Search terms were defined, electronic searches of six databases were conducted, reference lists and key journals were reviewed and grey literature was searched. Papers were selected based on clear inclusion criteria. Data was extracted from the selected papers, and their quality was systematically reviewed. The review was prospectively registered on PROSPERO: CRD42015016905. Results 15,985 articles were extracted; of these 17 met the inclusion criteria. The results of these articles were mixed but suggested the presence of some health and wellbeing issues in this population during transition to adulthood, including obesity and sexual health issues.3 ConclusionThis review reveals a gap in the literature on transition and health, and points to the need for future work in this area.

The transition from school needs to be better supported in order to ease anxiety for young people during this difficult period.

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Reactive attachment disorder (RAD) is one of the least researched and most poorly understood psychiatric disorders. Very little is known about the prevalence and stability of RAD symptoms over time. Until recently it has been difficult to investigate RAD due to limited tools for informing a diagnosis. Utilising a newly developed observational tool along with the Disturbances of Attachment Interview. this short-term prospective longitudinal study explored RAD symptoms in maltreated young children in Scotland (n=100, age range =12-62 months) over 12 months. Children were recruited as part of The Best Services Trial (BeST), in which all infants who came in to the care of the local authority in Glasgow due to child protection concerns were invited to participate. Prevalence of RAD was found to be 5.0% (n=5, 95% CI [0.7-9.3]) when children were first placed in to foster care. Following at least 1 year of improved care conditions, prevalence in the 76 children remaining in the study was 2.1% (n=2, 95% CI [below 0-4.7]). RAD was associated with some mental health and cognitive difficulties. While levels of carer-reported RAD symptoms decreased significantly over time, observed symptoms did not. Findings suggest that RAD resolved in a small majority of cases but further exploration in larger samples would be invaluable.

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Young-Southward, G., Svelnys, C., Gajwani, R., Bosquet Enlow, M. and Minnis, H. (2019) Child maltreatment, autonomic nervous system responsivity, and psychopathology: current state of the literature and future directions. Child Maltreatment, (Abstract Child maltreatment may affect autonomic nervous system (ANS) responsivity, and ANS responsivity may influence the impact of child maltreatment on later outcomes, including long-term mental/physical health. This review systematically evaluated the evidence regarding effects of maltreatment on ANS responsivity in children and examined how ANS responsivity may influence the association between maltreatment and psychopathology, with attention to relevant developmental issues. We searched the literature for relevant studies using PRISMA guidelines. We searched five electronic databases, performed keyword searches in relevant journals, hand searched reference sections of relevant articles, and contacted experts in the field. Articles were extracted according to inclusion criteria and their quality assessed. The search produced 1,388 articles; 22 met inclusion criteria. Most of the studies suggested blunted cardiovascular responsivity generally and sympathetic activation specifically in response to stress in maltreated children compared to non-maltreated children.Findings around vagal responsivity and skin conductance were mixed. Limited evidence was found for ANS responsivity as a moderator or mediator of psychopathology risk among maltreated children. Maltreatment may be associated with blunted sympathetic activation in stressful situations. Differences in ANS responsivity may influence psychopathology risk among maltreated children. Further research is needed to confirm the nature and magnitude of such effects.

Reactive Attachment Disorder (RAD), is characterized by failure to seek and accept comfort in maltreated children. This lack of activation of the attachment system has profound developmental disadvantages yet, in early childhood, usually resolves quickly after placement in nurturing care. Persistence of RAD into middle childhood has been demonstrated in children reared in Romanian Institutions but, in family-reared children older children, there is controversy regarding whether RAD-like behaviors are genuinely attachment-related and stable from early childhood or are, in fact, related to PTSD. We conducted two pieces of research to investigate this: 1. a systematic review to examine persistence/resolution of RAD and 2. a case series of three boys whose RAD symptoms persisted despite living in placements judged by both social and child health services to be of good quality. Our systematic review revealed a paucity of longitudinal data. Except in atypical institutionalized samples, RAD had not been evidenced beyond pre-school. All three boys in the case series met DSM 5 criteria for RAD in late childhood/early adolescence and had stable RAD symptoms since before age 5. Qualitative interviews with their families revealed common themes of family strain, frustration and resentment at the lack of support from services. This paper provides the first opportunity to generate testable hypotheses about environmental circumstances and coexisting symptomatology that may influence RAD trajectories. Persistence of RAD has profoundly negative implications for children and their families. Recognition of RAD symptoms is challenging but crucial in order to improve care of these children and their families.