Prevalence of mental health conditions, sensory impairments and physical disability in people with co-occurring intellectual disabilities and autism compared with other people: a cross-sectional total population study in Scotland

Abstract

ObjectivesTo investigate prevalence of mental health conditions, sensory impairments and physical disability in children, adults and older adults with co-occurring intellectual disabilities and autism, given its frequent co-occurrence, compared with the general population.DesignWhole country cohort study.SettingGeneral community.Participants5709 people with co-occurring intellectual disabilities and autism, compared with 5 289 694 other people.Outcome measuresRates and ORs with 95% CIs for mental health conditions, visual impairment, hearing impairment and physical disability in people with co-occurring intellectual disabilities and autism compared with other people, adjusted for age, sex and interaction between age and co-occurring intellectual disabilities and autism.ResultsAll four long-term conditions were markedly more common in children, adults and older adults with co-occurring intellectual disabilities and autism compared with other people. For mental health, OR=130.8 (95% CI 117.1 to 146.1); visual impairment OR=65.9 (95% CI 58.7 to 73.9); hearing impairment OR=22.0 (95% CI 19.2 to 25.2); and physical disability OR=157.5 (95% CI 144.6 to 171.7). These ratios are also greater than previously reported for people witheitherintellectual disabilitiesorautism rather than co-occurring intellectual disabilities and autism.ConclusionsWe have quantified the more than double disadvantage for people with co-occurring intellectual disabilities and autism, in terms of additional long-term health conditions. This may well impact on quality of life. It raises challenges for staff working with these people in view of additional complexity in assessments, diagnoses and interventions of additional health conditions, as sensory impairments and mental health conditions in particular, compound with the persons pre-existing communication and cognitive problems in this context. Planning is important, with staff being trained, equipped, resourced and prepared to address the challenge of working for people with these conditions.

Preliminary Findings From a Nationwide, Multicenter Mental Health Service for Adults and Older Adolescents With Autism Spectrum Disorder and ID

“…The aim of the network was to develop a unified, evidence‐based approach to address the challenges of treating these patients, and systematic documentation of change during the course of treatment will be of importance in order to assist policy makers and further development of services. Thus, indirectly, these results may improve access to mental health services for adults with ASD and ID (Dunn et al, 2020). However, it is also evident that not all participants showed the same level of improvements and there is clearly need for further detailed analysis of factors related to the extent of change.…”

“…People with ASD and ID represent a very heterogeneous group with respect to etiology and cognitive, language, motor, and social abilities (ICD‐10, World Health Organization, 1992). The prevalence and burden of co‐occurring psychiatric disorder is being increasingly recognized in individuals with ASD and ID (Dunn, Rydzewska, Fleming, & Cooper, 2020; Hollocks, Lerh, Magiati, Meiser‐Stedman, & Brugha, 2018; Lugo‐Marin et al, 2019; McCarthy et al, 2010; Rosen, Mazefsky, Vasa, & Lerner, 2018), and this group is particularly vulnerable to mental health problems even when compared to individuals with ASD or ID alone (Bakken, Helverschou, Høidal, & Martinsen, 2016; Dunn et al, 2020; Helverschou, Bakken, & Martinsen, 2011; Hove, 2004; Hove & Havik, 2010).…”

“…However, these studies have mainly involved younger individuals with ASD without ID (Kannabiran & McCarthy, 2009; Weston, Hodgekins, & Langdon, 2016; White, Ollendick, & Albanmo, 2013). Individuals with co‐occurring ASD and ID often need more complex treatment plans (Dunn et al, 2020) and almost no high quality, randomized control trials of psychosocial interventions for this group of adults exist. Among adults with ID without ASD, studies on cognitive‐behavioral therapies remain primarily at a descriptive stage (Dragan, Jackson, & Eastlake, 2018).…”

Implementation of Islamic religious learning strategies in children with autism in Indonesia

“…The second type usually consists of children with autism, children with attention deficit hyperactivity disorder or attention deficit hyperactivity disorder (ADHD), indigo, anxiety. The third category is based on physical and multiple disorders, and includes children with visual impairment, hearing impairment, physical impairment, and multiple hearing impairment (Dunn et al, 2020).…”

The Impact of Cognitive Impairment in Children with Intellectual Disabilities

“…A score of IQ 70 or less is a key indicator in the diagnosis of intellectual disability [Dunn, Rydzewska, Fleming & Cooper, 2020]. However, in this process, other aspects of neurodevelopment are also evaluated such as the assessments of cognitive and executive functions [Thygesen, Wolfe, McQuillin, Viñas-Jornet & Baena et al, 2018;Orsini, Carolina, Ferreira, de Assis & Magalhã al., 2018].…”