Background The identification and treatment of psychiatric disorders in individuals with autism spectrum disorders (ASD) and ID presents many challenges. We describe the development of a professional network, together with a standardized protocol for clinical assessment, designed to promote clinical competence and professional development in eight clinical centers responsible for providing mental health services to autistic individuals with ID across all four health regions of Norway. Specific aims to describe: (1) patterns of psychiatric and behavior problems in patients treated by the network, (2) patterns of change over time, and (3) the relationship between psychiatric disorders and behavior problems. Method A standardized protocol was used to assess individual progress in 132 patients (inpatients and outpatients) with autism and ID over 2 years (at referral (T1), after 1 year (T2), and after 2 years (T3)). Changes in psychiatric symptoms and behavior problems were assessed with the Psychopathology in Autism Checklist (PAC) and Aberrant Behavior Checklist (ABC). Results Patients showed significant (p < .001) improvements from T1 to T2 on the psychosis, depression and anxiety subscales of the PAC, but no significant improvement on the obsessive compulsive disorder (OCD) subscale. Improvements were maintained from T2 to T3. Patients showed significant (p < .01) improvements on the ABC total score and on all ABC subscales except inappropriate speech from T1 to T2; these improvements were maintained from T2 to T3. Discussion The combination of a professional network and a standardized protocol for clinical assessment has promise as a strategy for improving professional competence and facilitating specialized mental health services for autistic individuals with ID and psychiatric disorders across an extensive geographical area.

The Hayes Ability Screening Index was developed primarily to provide a short, effective screening test to indicate possible mental retardation amongst persons who come in contact with the criminal justice system. This study examined the validity of a Norwegian version in a sample of 73 subjects. 45 were male and 28 were female (M = 33.3 yr, SD = 12.5; range = 17 to 60 years) consecutively selected from patients referred for neuropsychological examination. The Wechsler Adult Intelligence Scale (WAIS-III) was the criterion of validity. The correlation of .81 between scores on the WAIS-III and the Hayes Index was significant. At a stated cut-off score of 85, the sensitivity was 100% and specificity 57%. A suggested alternative cut-off score of 81 obtained a sensitivity of 95% and specificity of 72%. These results indicate that the Hayes Ability Screening Index is a useful, valid, and time-saving tool for screening of mental retardation for the Norwegian population.

Purpose The purpose of this paper is to present and discuss mental health services for people with intellectual disability (ID) in Norway. Design/methodology/approach A literature review and a survey were conducted to map services for people with ID and mental health problems in Norway. Findings The results were sparse and confirmed what is already known among clinicians working with these patients. The Norwegian services are fragmented and there are geographical differences. Research limitations/implications There are no special services for children with ID developing mental illness. For offenders with ID, a national unit assesses and follows up, also when the person is sentenced to compulsory care and services are provided in their home municipality. Practical implications More data about both the patients and the services are needed in order to improve mental health services for people with ID in Norway. Originality/value This paper describes mental health services for people with ID in Norway.

The Learning Disability Screening Questionnaire (LDSQ) was developed primarily to provide a short and effective screening instrument to indicate possible intellectual disability amongst persons who come in contact with the service system. This study examined the validity of the Norwegian version of LDSQ in a sample of 35 subjects. All participants were outpatients referred for neuropsychological examinations. WAIS-III full-scale score was used for criterion validity. At a stated cut-off score of 46.6%, LDSQ showed several false negatives and false positives but no true positives. This raises the question of whether this test represents a valid screening instrument for learning disabilities in a clinical sample.

HASI is associated with few false negatives, but a large number of false positives. This implies that an intellectual disability is concluded in too many cases; a positive screening should be followed up with a more thorough assessment.