Outcome Measures for Core Symptoms of Intellectual Disability: State of the Field

Thurm, Audrey; Kelleher, Bridgette L.; Wheeler, Anne

doi:10.1352/1944-7558-125.6.418

Cited by 24 publications

(15 citation statements)

References 25 publications

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“…To diagnose ID, clinical judgment is also important in the selection, administration, and interpretation of standardized tests used to determine the “significance” of the limitations in the person’s intellectual and adaptive functioning, which is defined as two standard deviations or more below the population mean. This article does not focus on psychological treatments for the core symptoms of ID (for an interesting review on this topic see Thurm et al [ 7 ]); rather, it discusses the treatment of comorbid psychiatric or behavioral disorders in people with ID, the reason being that most interventions with this population are tertiary prevention methods aimed at treating associated conditions rather than its core features. These comorbidities are in fact one of the main causes of exclusion for people with ID and one of the most frequent reasons why they are referred to mental health services.…”

Section: Introductionmentioning

confidence: 99%

Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability

Gómez¹,

Navas²,

Verdugo³

et al. 2021

WJP

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This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability (ID) at all stages of their life. We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population, along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems. We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID. The review is structured around the three generations of therapies: Applied behavior analysis ( e.g. , positive behavior support), cognitive behavioral therapies ( e.g. , mindfulness-based cognitive therapy), and contextual therapies ( e.g. , dialectical behavior therapy). We conclude with some recommendations for professional practice in the fields of ID and psychiatry.

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Section: Introductionmentioning

confidence: 99%

Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability

Gómez¹,

Navas²,

Verdugo³

et al. 2021

WJP

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“…For both conditions, lack of sensitive outcome measures and rigorously controlled studies have impeded research efforts targeting core symptoms. 21 , 22 , 23 One exception to this may be social skills because there were a number of interventions targeting these deficits (eg, speech/language/communication) in the guidelines. However, very few intervention recommendations were proffered for the other core symptoms of ASD (eg, restricted and repetitive patterns of behavior) or ID (low intellectual and adaptive functioning).…”

Section: Discussionmentioning

confidence: 99%

Systematic Review: Recommendations for Rehabilitation in ASD and ID From Clinical Practice Guidelines

Wickstrom

Dell’Armo

Salzman

et al. 2021

Archives of Rehabilitation Research and Clinical Translation

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Objective To identify and summarize clinical practice guidelines for autism spectrum disorder (ASD) and intellectual disability (ID) for the Package of Interventions for Rehabilitation for the World Health Organization (WHO). Data Sources Academic databases, Google Scholar, guideline databases, and professional society websites were searched using the general criteria “ASD/ID” AND “rehabilitation” AND “guideline,” restricted to English-only guidelines. Study Selection Work group members independently screened titles and abstracts (1952 ASD; 1027 ID) and excluded articles if not (1) a guideline; (2) about rehabilitation; (3) published since 2008; or (4) about ASD/ID. Full-text screening (29 ASD; 5 ID) involved 3 additional exclusion criteria: (1) contained conflict of interest; (2) lacked information on strength of recommendation; or (3) failed the Appraisal of Guidelines for Research and Evaluation II instrument. Six guidelines (4 ASD: 2 on youth, 1 on adults, 1 on all ages; 2 ID: 1 on challenging behaviors, 1 on mental health) resulted. Data Extraction Work group members extracted 524 recommendations (386 ASD; 138 ID) from the guidelines including the level of evidence, diagnostic and age group, recommendation type (assessment, intervention, service), target, and valence. Data Synthesis Of the 270 intervention recommendations (212 ASD; 58 ID), only 36 for ASD and 47 for ID were empirically based. Most comprised biomedical (23%), pharmacologic (29%), and psychosocial (21%) interventions for ASD and behavioral (14%), pharmacologic (29%), and psychological (14%) interventions for ID. Intervention recommendations primarily targeted coexisting conditions (56% ASD; 93% ID), whereas core symptoms received much less attention (26% ASD). Conclusions Clinical practice guidelines reviewed for ASD and ID primarily contained recommendations based on expert opinion, with the plurality of recommendations relating to pharmacologic treatment. Vital next steps include identifying relevant interventions for inclusion in the WHO Package and continuing to conduct rigorous intervention research, particularly on core symptoms of these conditions, to extend recommendations for high-quality guidelines.

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“…For both ASD and ID, lack of sensitive outcome measures and rigorously controlled studies have been a stumbling block for research targeting core symptoms. [22][23][24] One exception to this may be social skills, as there were a number of interventions targeting speech/language/communication and social skills deficits in the guidelines. However, there remain few or no intervention recommendations for the other core symptoms of ASD (e.g., restricted and repetitive patterns of behavior) or ID (low intellectual and adaptive functioning).…”

Section: Discussionmentioning

confidence: 99%

“…Three members of each working group independently determined AGREE-II ratings to assess the quality of each clinical practice guideline. All items were scored by each member, but only nine AGREE-II items (4,7,8,10,12,13,15,22,23) were specifically used for the selection of guidelines as pre-determined by the WHO Rehabilitation Programme. 1 If the rating of any item differed by more than two points among the three members, the score was discussed to reach consensus.…”

Section: Full-text Screeningmentioning

confidence: 99%

Systematic Review: Recommendations for Rehabilitation in ASD and ID from Clinical Practice Guidelines

Wickstrom

Dell’Armo

Salzman

et al. 2021

Preprint

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Objective: Autism spectrum disorder (ASD) and intellectual disability (ID) were selected for inclusion in the development of a Package of Interventions for Rehabilitation for the World Health Organization (WHO). Here, we describe results of a search of guidelines for these conditions. Methods: A literature search for clinical practice guidelines was performed for ASD and ID. Using the Appraisal of Guidelines for Research and Evaluation instrument and other inclusion and exclusion criteria, guidelines were identified for abstraction of recommendations, which were collated into categories based on diagnosis, patient age, type and target of service, valence, and level of evidence. Results: Six guidelines remained after screening. Four ASD guidelines focused on diagnosis, management and support, and two ID guidelines covered the prevention, assessment, and management of challenging behavior and mental health problems, with 386 and 138 recommendations resulting for each group, respectively. Out of 524 total recommendations, 212 ASD and 58 ID recommendations focused on intervention. The primary type of intervention pertained to pharmacology for each group (27% ASD, 29% ID), followed by psychosocial (21%) and biomedical (23%) for ASD and behavioral (14%) and psychological (14%) for ID. Regarding target of intervention, recommendations primarily focused on coexisting conditions for each group (56% ASD, 93% ID) and core symptoms for ASD (26%), whereas adaptive functioning received little attention (11% ASD, 7% ID). Conclusions: Although these six guidelines provided many recommendations for comorbid and specific problems in ASD and ID, very few recommendations targeted core symptoms, and many were based on expert opinion. A vital next step includes identifying relevant interventions from the guidelines or that are missing to be included in the WHO Package of Interventions for Rehabilitation.

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Outcome Measures for Core Symptoms of Intellectual Disability: State of the Field

Cited by 24 publications

References 25 publications

Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability

Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability

Systematic Review: Recommendations for Rehabilitation in ASD and ID From Clinical Practice Guidelines

Systematic Review: Recommendations for Rehabilitation in ASD and ID from Clinical Practice Guidelines

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