The aim of this study was to evaluate the efficacy of psychological therapies for people with intellectual disabilities (IDs) through a systematic review and meta-analysis of the current literature. A comprehensive literature search identified 143 intervention studies. Twenty-two trials were eligible for review, and 14 of these were subsequently included in the meta-analysis. Many studies did not include adequate information about their participants, especially the nature of their IDs; information about masked assessment, and therapy fidelity was also lacking. The meta-analysis yielded an overall moderate between-group effect size, g = .682, while group-based interventions had a moderate but smaller treatment effect than individual-based interventions. Cognitive-behaviour therapy (CBT) was efficacious for both anger and depression, while interventions aimed at improving interpersonal functioning were not effectual. When CBT was excluded, there was insufficient evidence regarding the efficacy of other psychological therapies, or psychological therapies intended to treat mental health problems in children and young people with IDs. Adults with IDs and concurrent mental health problems appear to benefit from psychological therapies. However, clinical trials need to make use of improved reporting standards and larger samples.
Despite research that has investigated whether the financial benefits of open employment exceed the costs, there has been scant research as to the effect sheltered and open employment have upon the quality of life of participants. The importance of this research is threefold: it investigates outcomes explicitly in terms of quality of life; the sample size is comparatively large; and it uses an established and validated questionnaire.
One hundred and seventeen people with intellectual disability (ID) who were employed in either open or sheltered employment by disability employment agencies were interviewed. Quality of life was assessed using the Quality of Life Questionnaire. After making an initial assessment to see whether the outcomes achieved depended on type of employment, quality of life scores were analyzed
controlling for participants’ level of functional work ability (assessed via the Functional Assessment Inventory).
The results showed that participants placed in open employment reported statistically significant higher quality of life scores. When the sample was split based upon participants’ functional work ability, the type of employment had no effect on the reported quality of life for participants with a low functional work ability. However, for those participants with a high functional work ability, those in open employment reported statistically significantly higher quality of life.
The results of this study support the placement of people with ID with high functional work ability into open employment. However, a degree of caution needs to be taken in interpreting the results presented given the disparity in income levels between the two types of employment.
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.
Autism is a neurodevelopmental disorder with a high co-occurrence with intellectual disability. Adults with Autism and intellectual disability have a high incidence of challenging behaviour, defined as repetitive self injurious or aggressive behaviour. We underwent a systemic review of the evidence for treating challenging behaviours in adults with Autism and intellectual disability.
A literature search was conducted using three large databases to extract studies on the treatment of challenging behaviour among adults with Autism and intellectual disability. Papers, which met this criterion, were reviewed and analysed to assess study evidence and quality.
Seven articles were selected which included five agents: fluvoxamine, sertraline, clomipramine, risperidone, and ziprasidone. Randomized control studies of fluvoxamine and risperidone, provided efficacy for the treatment of challenging behaviour in adults with Autism and intellectual disability. Open label trials of sertraline, clomipramine and ziprasidone were also effective in treating challenging behaviours for this population.
Risperidone and fluvoxamine provided the best evidence for treating challenging behaviour, and risperidone was the only medication with multiple trials showing its efficacy. Further studies are required to demonstrate the efficacy of psychopharmacology in treating challenging behaviours among adults with Autism and intellectual disability.
Despite evidence from previous studies that support using Social Stories™ for problem behaviors, research conducted with more rigorous controls is needed to examine whether or not Social Stories constitute an evidence-based practice.This study employed an ABABCBC single-subject design comparing a Social Story presented in two formats across three elementary-age students with autism. Interpretation of the results documents a decrease in the frequency of problem behavior for each participant. Outcomes were slightly better for the PowerPoint™ format than for the paper format. Results were maintained in the training setting and were generalized to another setting with a single verbal prompt. Teachers reported that the PowerPoint format was easily implemented, and students indicated that they liked the computer-assisted format.