Towards the Prevention of Behavioural and Psychiatric Disorders in People with Intellectual Disabilities

Abstract

Intervention for behavioural and psychiatric disorders in people with intellectual disabilities often only takes place once these conditions are well established and more resistant to change. As an alternative, this paper promotes a public health prevention model and maps out opportunities for intervention at primary, secondary and tertiary levels. The resulting model is partly derived from generic research into these issues and partly on specific evidence on interventions for people with intellectual disabilities; it also contains more theoretical considerations. The additional research that is necessary to demonstrate the efficacy of the interventions identified is also considered. Central to this proposal is a greater integration of issues for people with intellectual disabilities within much broader policy and research agendas.

Primary Care for Adults on the Autism Spectrum

“…Some of the excess frequency of psychiatric illness may be preventable. 26 Mainstream mental health and disability support services often have inadequate training to work with autistic adults. 27 Referral to regional subspecialty services may be required.…”

Trauma and Life Events in Adults with Intellectual Disability

“…Reviews of measures of anxiety and depression describe several assessment tools available for this population group though note limited evidence of reliability, validity, sensitivity and specificity [56,57]. Having reliable and valid assessments for specific mental health disorders is important, and use of these as screening tools can reduce the chances of psychological pathology with mental health diagnoses made early and accurately avoiding chronicity, imperviousness to treatment, complication and misdiagnosis [58].…”

Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders

“…For example, recent research has drawn attention to the importance of such factors as parental education, wealth, optimism, social support and health as protective factors among parents of children with intellectual disability when faced with adversity in early childhood (Azad, Blacher, & Marcoulides, in press;Ellingsen, Baker, Blacher, & Crnic, 2014;McConnell, Savage, & Breitkreuz, 2014). Finally, while our analyses cannot attribute causal relationships between exposure to adversity and the prevalence and persistence of conduct difficulties, they do provide some circumstantial evidence to support the case (especially for children with intellectual disability) for increased investment in the development, evaluation and scaling up of environmentally focused early intervention strategies to reduce the incidence and persistence of conduct difficulties (Allen et al, 2013;Einfeld, Tonge, & Clarke, 2013;Tellegen & Sanders, 2013).…”