Behavioural phenomena in persons with an intellectual developmental disorder according to the level of emotional development

Abstract

Background Challenging behaviours in people with an intellectual developmental disorder (IDD) are complex and often difficult to understand. The developmental perspective may provide additional insights into the specific behavioural patterns and underlying motives in different emotional reference ages. Methods The behaviours of 185 adults with IDD who were admitted to psychiatry were systematically assessed with the Aberrant Behaviour Checklist (ABC) and the Modified Overt Aggression Scale (MOAS). The association of the different behaviours with various emotional reference age groups as assessed with the Scale of Emotional Development -Short (SED-S) was analysed to deduce behavioural patterns typical for a certain level of functioning. Results Overall, the severity of challenging behaviours decreases in higher emotional reference age groups. Physical aggression was most prevalent in persons in the second phase of emotional development (7-18 months reference age). In SED-S-1 (reference age 0-6 months), the persons appeared to be searching for physical comfort and showed high scores in social withdrawal, stereotypies and aggression towards the self. Persons functioning in SED-S-2 (reference age 7-18 months) scored highest in irritability and physical aggression (searching for security), while those in SED-S-3 (19-36 months) exhibited the searching for autonomy type characterised by defiant and socially inappropriate behaviours. Persons with an emotional reference age of 4-7 years (SED-S-4) showed inappropriate speech, verbal self-regulation and depressive-like behavioural aspects (searching for identity). Conclusions The behavioural phenomena exhibited in a certain emotional reference age may support the clinician to differentiate behavioural problems from psychopathological symptoms to yield the proper diagnosis.

Mental health, challenging behaviour, diagnosis, and access to employment for people with intellectual disabilities in Norway

“…This was unexpected since this type of behaviour can be difficult to handle in collaborative work, where trust and politeness are needed between the employees. However, a recent study by Hermann et al (2022) found inappropriate speech to be associated with higher cognitive functioning in people with intellectual developmental disorder. Our study found that people with mild intellectual disabilities, and likely higher cognitive functioning, have better odds of being employed than those with severe intellectual disabilities.…”

Scale of Emotional Development – Short: reliability and validity in adults with intellectual disability

“…2021; Hermann et al . 2022). In persons with severe to profound ID, stages 1 to 3 were most frequently found.…”

“…Interestingly, not only the severity but also the quality of problem behaviours changes according to the developmental level of a person as shown by Hermann et al . (2022). In the adaptation phase, stereotypy, self‐aggression, hyperactivity, social withdrawal and isolation can be observed.…”

“…2014; Hermann et al . 2022). The level of emotional functioning can provide insight into the inner experience, basic emotional needs and behaviour of people who may have difficulty communicating these verbally (Dosen, 2005a, 2005b).…”

Brief report comparing the Scale of Emotional Development – Short (SED‐S) with other scales for emotional development

“…All scales can help to achieve a better understanding of ED and thus help to better understand the needs of persons with ID. This can further help to differentiate between behaviours that challenge due to unmet needs versus psychiatric disorders (Melville et al 2016;Hermann et al 2022) and make interventions more specific and helpful.…”