The transition to school: adaptation in young children with and without intellectual disability

Is a bird in the hand worth two in the future? Intertemporal choice, attachment and theory of mind in school-aged children

Intertemporal choice is a decision-making dilemma related to outcomes of different entity located at different time points. Economic and psychological literature on this topic showed the phenomen of temporal discounting, i.e., the proclivity to devalue the outcome distant in time on the basis of the time delay necessary to obtain it. The goals of this research are to investigate two different components of intertemporal choice separately, namely time and outcome, in school-age children, and the possible link among such components and the security of attachment style and theory of mind. Ninety one children aged between 6 and 10 years performed two intertemporal choice tasks, first and second order false belief tasks and the Separation Anxiety Task in the Family and School versions. Results showed that the two components of intertemporal choice (waiting tolerance and sensitivity to delayed outcome) are stately interrelated; the quality of the attachment to the family caregiver affects the tolerance to waiting time and first order false belief understanding affects both the components of intertemporal choice.

Inhibition deficits in individuals with intellectual disability: a meta-regression analysis

BACKGROUND

Individuals with intellectual disabilities (ID) are characterised by inhibition deficits; however, the magnitude of these deficits is still subject to debate. This meta-analytic study therefore has two aims: first to assess the magnitude of inhibition deficits in ID, and second to investigate inhibition type, age, IQ and the presence/absence of comorbid problems as potential moderators of effect sizes.

METHOD

Twenty-eight effect sizes comparing ID and age matched normal controls on inhibition tasks were included in a random effects meta-regression. Moderators were age, IQ, inhibition type and presence/absence of comorbid disorder.

RESULTS

The analysis showed a medium to large inhibition deficit in ID. Inhibition type significantly moderated effect size, whereas age and comorbid disorder did not. IQ significantly moderated effect size indicating increasing effect size with decreasing IQ, but only in studies that included a sample of ID participants with mean IQ > 70. The analysis indicated comparable deficits in behavioural inhibition and interference control, but no significant deficits in cognitive inhibition and motivational inhibition.

CONCLUSIONS

These results indicate that ID is characterised by a medium to large inhibition deficit in individuals with ID. ID seems not to be characterised by deficits in cognitive and motivational inhibition, which might indicate that distinct processes underlie distinct inhibition capacities.

Students' and teachers' perceptions of aggressive behaviour in adolescents with intellectual disability and typically developing adolescents

This study investigated aggressive behaviour in Serbian adolescents with intellectual disability (ID) compared to typically developing peers. The sample consisted of both male and female adolescents aged 12-18 years. One hundred of the adolescents had ID, and 348 adolescents did not have ID. The adolescents were asked to complete the Reactive-Proactive Aggression Questionnaire (RPQ), and their teachers provided ratings of aggression for the adolescents using the Children's Scale of Hostility and Aggression: Reactive-Proactive (C-SHARP). Results indicated that adolescents reported a higher prevalence of aggressive behaviour than their teachers. Reactive aggression was more prevalent than proactive aggression in both subsamples. In the subsample of adolescents with ID, there were no sex or age differences for aggression. However, in the normative subsample, boys and older adolescents scored significantly higher on aggression. According to adolescent self-reports the prevalence of aggression was higher in adolescents without ID, while teachers perceived aggressive behaviour to be more prevalent in adolescents with ID. Scientific and practical implications are discussed.

Community participation patterns among preschool-aged children who have received Part C early intervention services

BACKGROUND

We examined activity-specific patterns and child, family and environmental correlates of participation restriction in nine community-based activities among preschoolers with disabilities who have received Part C early intervention services.

METHODS

Data were gathered from a subsample of 1509 caregivers whose children (mean age = 67.7 months) had enrolled in the National Early Intervention Longitudinal Study (NEILS) and completed a 40-min computerized telephone interview or 12-page mailed survey. Data were analysed on cases with complete data on the variables of interest. Bivariate relationships were examined between variables, including patterns of co-reporting participation difficulties for pairs of community activities.

RESULTS

Caregivers were more than twice as likely to report difficulty in one activity (20%) than difficulties in 2-3, 4-5, or 6-9 activities. Co-reporting paired difficulties was strong for activities pertaining to neighbourhood outings but less conclusive for community-sponsored activities and recreation and leisure activities. Our data show strong and positive associations between child functional limitations in mobility, toileting, feeding, speech, safety awareness, and friendships and participation difficulty in 7-9 activities. Lower household income was associated with participation difficulty in 7 out of 9 activities and difficulty managing problematic behaviour was strongly associated with participation difficulty in all 9 activities. Each of the three environmental variables (limited access to social support, transportation and respite) was associated with participation restrictions in all nine activities.

CONCLUSION

Results provide practitioners with detailed descriptive knowledge about modifiable factors related to the child, family and environment for promoting young children's community participation, as well information to support development of a comprehensive assessment tool for research and intervention planning to promote community participation for children enrolled in early intervention.

Friendship quality in adolescents with and without an intellectual disability

BACKGROUND

High friendship quality is often defined by high levels of intimacy, companionship, closeness and low levels of conflict. Quality friendships develop over time and may be influenced by both behaviour problems and social skills.

MATERIALS AND METHODS

Participants were 103, 13-year-old adolescents with or without intellectual disabilities in the United States. Adolescents and their mothers participated in an open-ended interview of friendship quality and completed measures of social skills and behaviour problems. This study addressed differences in friendship quality between children with and without intellectual disabilities and explored early indicators of friendship development.

RESULTS

Adolescents with intellectual disabilities (ID) had friendships characterized by significantly lower levels of warmth/closeness and positive reciprocity than their typically developing peers. Likewise, adolescents with ID spent less time with friends outside of school and were less likely to have a cohesive group of friends. Social skills and behaviour problems at age 9 predicted friendship quality at age 13 above and beyond disability status, with higher levels of social skills and lower levels of behaviour problems related to higher ratings on measures of friendship quality.

CONCLUSIONS

It appears that adolescents with intellectual disabilities have friendships that are characterized by less warmth/closeness and less positive reciprocity than the friendships of their typically developing peers. This discrepancy appears to be impacted by early social skills and behaviour problems in addition to the presence of the intellectual disability.

Syndrome specificity and mother-child interactions: examining positive and negative parenting across contexts and time

This study examined the extent to which child syndromes and observation context related to mothers' parenting behaviors. Longitudinal observations were conducted of parenting behavior across ages 3, 4, and 5 years during structured and unstructured activities. The 183 participants included mothers of children with autism spectrum disorders, cerebral palsy, Down syndrome, undifferentiated developmental delay, or typical cognitive development. Negative parenting behaviors were higher in structured activities and higher in mothers of children in all developmentally delayed groups. Positive parenting was higher in unstructured activities and especially high for mothers of children with Down syndrome. Despite differences found through direct observation of parenting children in different diagnostic groups, they are not as strong as syndrome-group differences found through more commonly used self-report questionnaires assessing domains like parenting stress.

Mothers' perceived physical health during early and middle childhood: relations with child developmental delay and behavior problems

The self-perceived physical health of mothers raising children with developmental delay (DD; N=116) or typical development (TD; N=129) was examined across child ages 3-9 years, revealing three main findings. First, mothers of children with DD experienced poorer self-rated physical health than mothers of children with TD at each age. Latent growth curve analyses indicated that mothers in the DD group experienced poorer health from age 3 but that the two groups showed similar growth across ages 3-9 years. Second, cross-lagged panel analyses supported a child-driven pathway in early childhood (ages 3-5) by which early mother-reported child behavior problems predicted poorer maternal health over time, while the reversed, health-driven path was not supported. Third, this cross-lagged path was significantly stronger in the DD group, indicating that behavior problems more strongly impact mothers' health when children have developmental delay than when children have typical development. The health disparity between mothers of children with DD vs. TD stabilized by child age 5 and persisted across early and middle childhood. Early interventions ought to focus on mothers' well-being, both psychological and physical, in addition to child functioning.

Cochlear implant considerations in children with additional disabilities

Early identification and management of disabilities in children are essential to reduce long-term developmental sequelae. Many of the causes of hearing loss also produce cognitive delays resulting in a large number of children with both deafness and developmental disabilities. Children who have hearing loss and additional disabilities require complex, individualized therapy to maximize their long-term quality of life. Hearing loss is often detected early because of widespread newborn hearing screening programs and the decision for cochlear implantation in children presenting with multiple medical and developmental disorders is still evolving. This article will review the literature regarding cochlear implant considerations in children with additional developmental disabilities in areas of family perception, speech and language development, cognitive development including adaptive behavior and intelligence, communication and functional skills, auditory outcomes, quality of life outcomes, predictors of outcomes and realistic expectations after cochlear implantation.

Correlates of Community Participation among Families Transitioning from Part C Early Intervention Services

The purpose of this study was to examine factors that best discriminated among families based on their level of community participation when transitioning from Part C early intervention services. Data were drawn from 2,003 families enrolled in the National Early Intervention Longitudinal Study and who completed a 40-minute computerized telephone interview. Classification and Regression Tree (CART) analysis was used to examine correlates of full and limited community participation among these families from variables representing child, family, and service factors. Two classification trees were developed that suggest difficulty in managing behavior is a significant barrier to community participation and is associated with degree of social support. Based on this association, occupational therapists could elicit information from caregivers about their strategies to manage problematic behavior during community events to identify whether families experience participation restriction. Future studies should examine whether problematic behavior restricts young children's participation in activities other than community events.

The Application of a Three-Tier Model of Intervention to Parent Training

A three-tier intervention system was designed for use with parents with preschool children with developmental disabilities to modify parent-child interactions. A single-subject changing-conditions design was used to examine the utility of a three-tier intervention system in reducing negative parenting strategies, increasing positive parenting strategies, and reducing child behavior problems in parent-child dyads (n = 8). The three intervention tiers consisted of (a) self-administered reading material, (b) group training, and (c) individualized video feedback sessions. Parental behavior was observed to determine continuation or termination of intervention. Results support the utility of a tiered model of intervention to maximize treatment outcomes and increase efficiency by minimizing the need for more costly time-intensive interventions for participants who may not require them.

Profiles of self-concept, goal orientation, and self-regulation in students with physical, intellectual, and multiple disabilities: Implications for instructional support

The present study explored physical self-concept, goal orientation in sport, and self-regulation in regard to a motor task, in 75 secondary students with physical, intellectual, and multiple disabilities, who were educated in the same special education units. It was found that students with intellectual disabilities generally presented a positive profile in all three psychosocial constructs, whereas students with physical disabilities presented low scores in most measures. Students with multiple disabilities did not differ essentially from students with intellectual disability in regard to physical self-concept and goal orientation; however, they compared unfavorably to them regarding self-regulation. The delineation of a distinct and defendable profile of self-concept, goal orientation, and self-regulation for each disability group allows the formulation of proposals for the implementation of appropriate instructional programs for students belonging to the above mentioned categories.

The siblings relationship of adolescents with and without intellectual disabilities

The sibling relationship of adolescents with and without intellectual disabilities was examined. Participants were 70 sibling dyads--each dyad was comprised of one 12-year old adolescent with (N=23) or without intellectual disabilities (N=47). Sibling relationships, behavior problems, and social skills were assessed using mother reports. Results revealed three findings. First, for typically developing adolescents, mothers reported more warmth in the sibling relationship for opposite sex dyads. For adolescents with intellectual disabilities, mothers reported more warmth in the sibling relationship for same-sex dyads. Second, for typically developing adolescents, mothers reported more status/power differences when the sibling was younger than when the sibling was older. For adolescents with intellectual disabilities, birth order did not affect status/power in the sibling relationship. Third, for typically developing adolescents, conflict was related to internalizing behavior problems. For adolescents with intellectual disabilities, conflict was related to externalizing behavior problems. Implications, limitations, and future directions are discussed.

Social skills in children with epilepsy: how do they compare to healthy and chronic disease controls?

Studies have shown poor long-term social outcomes in adults with childhood-onset epilepsy. Our goal was to compare social skills in children with epilepsy with those of healthy and chronic disease controls. Children (8-16 years) with epilepsy (n=59) were compared with age- and gender-matched children with chronic kidney disease (n=40) and healthy controls (n=41). Parents completed the Social Skills Rating System (SSRS) questionnaire. Children with epilepsy had significantly poorer SSRS total scores when compared with healthy controls (P=0.002); however, their scores did not differ from those of children with chronic kidney disease (P=0.52). Children with epilepsy were less cooperative (P=0.02), less assertive (P=0.004), and less responsible (P=0.05) and displayed poorer self-control (P=0.005) than healthy controls. Our results suggest that having a chronic disease plays a role in the social functioning of children with epilepsy. The impact of epilepsy itself on social functioning should be further elucidated through detailed prospective assessments over time.

Preschool Children with and without Developmental Delay: Risk, Parenting, and Child Demandingess

Although past literature has established relations between early child risk factors, negative parenting, and problematic child behavior, the nature of these interrelations and pathways of influence over time remains largely unknown, especially in children with developmental delays or disabilities. In the current study data were drawn from the longitudinal Collaborative Family Study and included a sample of 260 families with preschool children with and without developmental delays. Child-related risk was assessed at child age 36 months, maternal intrusiveness and negative affect at 48 months, and child demandingness at 60 months. Results indicated significant relations between early risk, negative parenting, and subsequent child demandingness. Sickliness as an infant was the most salient predictive risk factor of later child demandingness. Developmental delay was the most significant predictor of subsequent negative parenting. Results are discussed as being more indicative of additive rather than mediational processes given that early child risk and negative maternal parenting both contributed uniquely to the subsequent development of child demandingness.

Student-teacher relationship stability across early school years for children with intellectual disability or typical development

Student-teacher relationships of 37 children with moderate to borderline intellectual disability and 61 with typical cognitive development were assessed from child ages 6-8 years. Student-teacher relationship quality was moderately stable for the typical development group, but less so for the intellectual disability group. At each assessment these relationships were poorer for children with intellectual disability. Child behavior problems consistently predicted more conflict, whereas social skills predicted more closeness. Accounting for these child characteristics reduced the status group difference to nonsignificance. Earlier student-teacher relationships predicted subsequent changes in child behavior problems and social skills. Student-teacher relationships in the intellectual disability group were significantly lower for children in regular than special classes by age 8.

Parent training: a review of methods for children with developmental disabilities

Great strides have been made in the development of skills and procedures to aid children with developmental disabilities to establish maximum independence and quality of life. Paramount among the treatment methods that have empirical support are treatments based on applied behavior analysis. These methods are often very labor intensive. Thus, parent involvement in treatment implementation is advisable. A substantial literature on parent training for children has therefore emerged. This article reviews recent advances and current trends with respect to this topic.

Outcomes of child sleep problems over the school-transition period: Australian population longitudinal study

BACKGROUND

Adequate sleep optimizes children's learning and behavior. However, the natural history and impact of sleep problems during school transition is unknown.

OBJECTIVES

To determine (1) the natural history of sleep problems over the 2-year period spanning school entry and (2) associations of children's health-related quality of life, language, behavior, learning, and cognition at ages 6.5 to 7.5 years with (a) timing and (b) severity of sleep problems.

METHODS

Data were drawn from the Longitudinal Study of Australian Children. Children were aged 4 to 5 years at wave 1 and 6 to 7 years at wave 2. Parent-reported predictors included (1) timing (none, persistent, resolved, incident) of moderate/severe sleep problems over the 2 waves and (2) severity (none, mild, moderate/severe) of sleep problems at wave 2. Outcomes included parent-reported health-related quality of life and language, parent- and teacher-reported behavior, teacher-reported learning, and directly assessed nonverbal (matrix reasoning) and verbal (receptive vocabulary) cognition. Linear regression, adjusted for child age, gender, and social demographic variables, was used to quantify associations of outcomes with sleep-problem timing and severity.

RESULTS

Sleep data were available at both waves for 4460 (89.5%) children, of whom 22.6% (17.0% mild, 5.7% moderate/severe) had sleep problems at wave 2. From wave 1, 2.9% persisted and 2.8% developed a moderate/severe problem, whereas 10.1% resolved. Compared with no sleep problems, persistent and incident sleep problems predicted poorest health-related quality of life, behavior, language, and learning scores, whereas resolving problems showed intermediate outcomes. These outcomes also showed a dose-response relationship with severity at wave 2, with effect sizes for moderate/severe sleep problems ranging from -0.25 to -1.04 SDs. Cognitive outcomes were unaffected.

CONCLUSIONS

Sleep problems during school transition are common and associated with poorer child outcomes. Randomized, controlled trials could determine if population-based sleep interventions can reduce the prevalence and impact of sleep problems.

Adapting Webster-Stratton's incredible years parent training for children with developmental delay: findings from a treatment group only study

BACKGROUND

Children with intellectual or developmental disabilities (ID/DD) are more likely than typically developing children to experience behaviour problems. Parent training, such as the Incredible Years Parent Training (IYPT) series, has been a widely used intervention to support families with children with or at-risk for behaviour problems; yet to date, this programme has not been used with parents with young children with developmental delay or disabilities.

METHOD

This preliminary treatment group only study assessed the feasibility of implementing a modified parent training programme (IYPT-DD) with 25 families with 2-5-year-old children with developmental delay. Intervention consisted of 12 weekly (2.5 h) sessions with topics covering developmentally appropriate play, praise, rewards, limit setting and handling challenging behaviour.

RESULTS

Results suggest preliminary evidence of efficacy in reducing negative parent and child behaviour and increasing parental perceptions of child positive impact.

CONCLUSIONS

This study provides evidence for the feasibility of the DD modifications applied to the IYPT. Although this approach is promising, additional evidence is needed to address the efficacy of IYPT-DD in children with developmental delay.

Parent training for young children with developmental disabilities: randomized controlled trial

A randomized controlled trial was used to evaluate a parent training intervention for caregivers with preschool-age children with developmental disabilities. The 21 families in the experimental group received usual care plus the 12-week Incredible Years Parent Training Program with developmental delay modifications. Families in the control group (n = 23) received usual care, including early childhood education and related services. Results suggest that this parent training intervention was superior to usual care for young children with developmental delays or disabilities in reducing negative parent-child interactions and child behavior problems. Participants in the experimental group indicated high satisfaction with treatment. Additional research is necessary to document maintenance and generalization of treatment outcomes.

Effects of individualized video feedback combined with group parent training on inappropriate maternal behavior

The effects of adding individualized video feedback (IVF) to Webster-Stratton's (2000, 2001) group-based parent training program (GT) were evaluated using a multiple baseline design across four mother-child dyads. During all phases of the study, inappropriate maternal behavior was recorded from videotapes of playtime with their preschoolers with developmental disabilities. Results suggested that GT+IVF reduced inappropriate maternal behavior to levels below GT alone.

Is social anxiety disorder in childhood associated with developmental deficit/delay?

Children with social anxiety disorder (SAD) have been reported to display reduced social skills. Less attention has been paid to whether neurodevelopmental deficits/delays (NDD's) in language and motor function may contribute to their impaired social skills. The present study aimed to assess the extent of language and motor impairment in children with SAD. A population-based screened sample consisting of 150 children (11-12 years) was assessed with a diagnostic interview (Kiddie-SADS), the Wechsler Abbreviated Scale of Intelligence (WASI) and the Motor Assessment Battery for Children (MABC). Test results were compared across five diagnostic groups: SAD (n=29); ADHD (n=23); SAD and ADHD (n=6); "other disorder" (n=44) and "no disorder" (n=48). Delays in language and motor development as reported by mother were also investigated. Verbal IQ and motor skills were reduced and maternally reported delay was more frequent in the SAD group compared to the "other disorder" and "no disorder" group.

A Three-Tier Model of Parent Education in Early Childhood: Applying a Problem-Solving Model

Young children with developmental disabilities may be at heightened risk for experiencing problem behavior. Evidence suggests that inappropriate behavior in young children may be related to negative parent-child interactions. Parent education and support programs have a long history of utility and effectiveness in reducing negative parent-child interactions and behavior problems. Although these programs may be effective in preventing and resolving childhood behavioral problems, not every family benefits uniformly. This article discusses how a three-tier model of intervention can be applied to parent education for young children with developmental disabilities in the context of early childhood education programs. Furthermore, the authors discuss how a problem-solving model can be used to make decisions regarding intervention provision.

Early Student-Teacher Relationships of Children With and Without Intellectual Disability: Contributions of Behavioral, Social, and Self-Regulatory Competence

We investigated the student-teacher relationships (STRs) of 6-year-old children with (n=58) and without (n=82) intellectual disability (ID). We also examined early (age 3) and concurrent (age 6) child behavioral, self-regulatory, and social characteristics as predictors of age 6 STR quality. Children with ID experienced significantly poorer relationships with their teachers, marked by less closeness and more conflict and dependency, compared to typically-developing children. This group difference was not accounted for entirely by IQ differences. The relation between ID status and STR quality was fully mediated by four age 6 child variables: mother- and teacher-reported behavior problems and mother- and teacher-reported social skills. The quality of children's relationships with teachers was also predicted by child characteristics as early as age 3, including early behavior problems, self-regulation, and behavior during parent-child interactions. The relation of ID status to STR quality at age 6 was fully mediated by children's self-regulatory abilities at age 3. Our findings demonstrate the importance of child behavioral and social characteristics in predicting relationships with teachers for children with and without ID.

Intelligence, parental depression, and behavior adaptability in deaf children being considered for cochlear implantation

Cognitive ability and behavioral adaptability are distinct, yet related, constructs that can impact childhood development. Both are often reduced in deaf children of hearing parents who do not provide sufficient language and communication access. Additionally, parental depression is commonly observed due to parent-child communication difficulties that can lead to parents' feelings of inadequacy and frustration. We sought to assess whether adaptive behavior in deaf children was associated with nonverbal intelligence and parental depression. Parents of precochlear implant patients seen for neuropsychological assessment were administered the Parenting Stress Index and Vineland Behavior Adaptive Scales to obtain measures of parental distress and child's behavioral adaptability. Precochlear implant patients' cognitive functioning was assessed via the Mullen Scales of Early Learning or the Leiter International Performance Scale-Revised, depending on the child's age at the time of testing. Regardless of age or neurological status, the deaf child's adaptive behavior consistently showed a strong relationship with intelligence. Moderate correlation between parental depression and the child's adaptive behavior was observed only in the younger group. The relationship between parental depression and communication subscale was moderated by intelligence for deaf children without neurological complications. The findings provide important implications for promoting family-centered interventions with early communication and language development.