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Feaster D, Franzen A. From stigma to acceptance: Intellectual and developmental disabilities in Central China. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 25:507-526. [PMID: 32425086 DOI: 10.1177/1744629520923264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Children with intellectual and developmental disabilities have historically been at high risk for social exclusion and other vulnerabilities. The Western world has shifted away from institutionally-based services and toward community-based services that allow for greater social inclusion as well as for meeting individual developmental needs, and China is beginning the process of exploring how to make this shift. In 2014 and 2015, a situation analysis examining the lived experiences of parents of children with disabilities in Zhengzhou, Henan, China, was undertaken. Perceptions of strengths, needs, opportunities, and barriers experienced by parents of children in intact families (i.e. families where children with disabilities remain in their birth families) were explored by means of parent interviews and focus groups. Families identify experiences of stigma and acceptance related to traditional and alternative social constructions of intellectual and developmental disabilities, and how they use social networks and information-sharing to help develop community-based services.
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Ma X, Tan J, Jiang L, Wang X, Cheng B, Xie P, Li Y, Wang J, Li S. Aberrant Structural and Functional Developmental Trajectories in Children With Intellectual Disability. Front Psychiatry 2021; 12:634170. [PMID: 33927652 PMCID: PMC8076543 DOI: 10.3389/fpsyt.2021.634170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/11/2021] [Indexed: 12/21/2022] Open
Abstract
Intellectual disability (ID) is associated with aberrant structural and functional development of the brain, yet how the dynamical developmental changes of the structure and function of ID from childhood to around puberty remains unknown. To explore the abnormal developmental trajectories of structure and function, 40 children with ID aged 6-13 years and 30 sex-, age-, and educational level-matched healthy controls (HC) with age range from 6 to 13 were recruited. The automatic voxel-based morphometry (VBM) and resting-state functional connectivity (FC) analyses were adopted to delineate the structural and functional differences. Significantly decreased total gray matter volume (GMV) and white matter volume (WMV) in children with ID were found, and the developmental trajectories of GMV and WMV in children with ID showed an opposite direction as compared with HC. The voxel-wise VMB analysis further revealed significantly increased GMV in the dorsal medial prefrontal cortex (dmPFC), bilateral orbital part of the inferior frontal gyrus (orb_IFG.L, orb_IFG.R), right cuneus (cuneus.R), and bilateral middle frontal gyrus (MFG.L, MFG.R) in children with ID. The following seed-based whole-brain functional connectivity analyses of the brain areas with changed GMV found decreased FCs between the cuneus.R and left intraparietal sulcus (IPS.L) and between the MFG.R and anterior cingulate cortex (ACC) in children with ID. Moreover, negative correlations between GMV values in the dmPFC, orb_IFG.L, cuneus.R, and intelligence quotient (IQ) scores and positive correlations between the FCs of the cuneus.R with IPS.L and MFG.R with ACC and IQ scores were found in children with ID and HC. Our findings provide evidence for the abnormal structural and functional development in children with ID and highlight the important role of frontoparietal network in the typical development. The abnormal development of GMV and functional couplings found in this study may be the neuropathological bases of children with ID.
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Affiliation(s)
- Xuejin Ma
- Department of Radiology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jianxia Tan
- Department of Radiology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Lin Jiang
- Department of Radiology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xuqin Wang
- Department of Child Health, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Peng Xie
- Department of Critical Care Medicine, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yuanyuan Li
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiaojian Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Shiguang Li
- Department of Radiology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Xiao T, Xia S, Zeng L, Lin G, Wei Q, Zhou W, Zhuang D, Chen X, Yi B, Li L, Mi H, Yin Z, Cheng X, Wang L, Hu X, Zhou W. A multicentre observational study on neonates exposed to SARS-CoV-2 in China: the Neo-SARS-CoV-2 Study protocol. BMJ Open 2020; 10:e038004. [PMID: 32699166 PMCID: PMC7380854 DOI: 10.1136/bmjopen-2020-038004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/25/2020] [Accepted: 07/03/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, China starting in December 2019. Yet the clinical features and long-term outcomes of neonates with SARS-CoV-2 exposure are lacking. The purpose of this study is to describe the clinical course and prognosis of the neonates exposed to SARS-CoV-2. METHODS AND ANALYSIS This is a multicentre observational study conducted at the designated children and maternal and child hospitals in the mainland of China. Neonates exposed to SARS-CoV-2 infection will be recruited. The data to be collected via case report forms include demographic details, clinical features, laboratory and imaging results, as well as outcomes. Primary outcomes are the mortality of neonates with COVID-19 and SARS-CoV-2 infection of neonates born to mothers with COVID-19. Secondary outcomes are the birth weight, premature delivery and neurological development of neonates exposed to SARS-CoV-2. The neurological development is assessed by the Chinese standardised Denver Developmental Screening Test at the corrected age of 6 months. ETHICS AND DISSEMINATION This study has been approved by the Children's Hospital of Fudan University ethics committee (No. (2020)31). The study findings will be disseminated in peer-reviewed journals and presented at national and international conferences in order to improve the understanding of the clinical course among neonates exposed to SARS-CoV-2 and to provide evidence-based treatment and prevention strategies for this group. TRIAL REGISTRATION NUMBER NCT04279899.
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Affiliation(s)
- Tiantian Xiao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shiwen Xia
- Department of Neonatology, Hubei Maternal and Child Health Hospital, Wuhan, China
| | - Linkong Zeng
- Department of Neonatology, Wuhan Children's Hospital, Wuhan, China
| | - Guang Lin
- Department of Pediatrics, Zhu Hai Maternal and Children's Hospital, Zhuhai, China
| | - Qiufen Wei
- Department of Neonatology, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Zhuang Autonomous Region, China
| | - Wei Zhou
- Department of Neonatology, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, China
| | - Deyi Zhuang
- Department of Pediatrics, Xiamen Children's Hospital, Xiamen, China
| | - Xiao Chen
- Department of Pediatrics, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Bin Yi
- Department of Neonatology, Gansu provincial maternity and child-care hospital, Lanzhou, China
| | - Long Li
- Department of Neonatology, People's Hospital of Xinjiang Your Autonomous Region, Xinjiang, China
| | - Hongying Mi
- Department of Neonatology, The First People's Hospital Of Yunnan Province, Kunming, China
| | - Zhaoqing Yin
- Department of Neonatology, Dehong People Hospital, Dehong, China
| | - Xiuyong Cheng
- Department of Neonatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Laishuan Wang
- Department of Pediatrics, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaojing Hu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
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Comer-HaGans D, Weller BE, Story C, Holton J. Developmental stages and estimated prevalence of coexisting mental health and neurodevelopmental conditions and service use in youth with intellectual disabilities, 2011-2012. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:185-196. [PMID: 31894615 DOI: 10.1111/jir.12708] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/10/2019] [Accepted: 11/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Few studies exist on mental health and neurodevelopmental conditions and service use among youth with intellectual disabilities (IDs), which makes it difficult to develop interventions for this population. The objective of the study is to (1) estimate and compare the prevalence of mental health and neurodevelopmental conditions in youth with and without ID across three developmental stages and (2) estimate and compare mental health service use in youth with and without ID across three developmental stages. METHODS We conducted secondary data analysis using cross-sectional data collected from caregivers completing the 2011-2012 National Survey of Children's Health. The data set represents a nationally representative sample of youth (0-17 years) in the USA with one child from each household being randomly selected. Data were collected from caregivers in 50 states, Washington D.C. and the US Virgin Islands. We restricted the sample to parents of youth between 3-17 years (N = 81 510). RESULTS Compared with youth without ID, youth ages 3-17 with ID had a statistically significantly higher prevalence of (1) mental health and neurodevelopmental conditions and (2) mental health care use and medication use for mental health and neurodevelopmental issues (other than attention deficit disorder/attention deficit hyperactivity disorder). Clinically significant differences in coexisting conditions and service use were also found across developmental stages. CONCLUSIONS Youth with ID are at greater risk of having coexisting mental health and neurodevelopmental conditions than youth without ID and are more likely to receive treatment. Therefore, clinicians should consider mental health and neurodevelopmental conditions and the unique needs of youth by developmental stage when tailoring interventions for youth with ID.
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Affiliation(s)
- D Comer-HaGans
- Department of Health Administration, College of Health and Human Services, Governors State University, University Park, IL
| | - B E Weller
- College of Health and Human Services, School of Social Work, Western Michigan University, Kalamazoo, MI
| | - C Story
- Community and Public Health, College of Health and Behavioral Sciences, Middle Tennessee State University, Murfreesboro, TN
| | - J Holton
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
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Social correlates of mental, neurological, and substance use disorders in China and India: a review. Lancet Psychiatry 2016; 3:882-99. [PMID: 27528098 DOI: 10.1016/s2215-0366(16)30166-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/18/2016] [Accepted: 06/20/2016] [Indexed: 01/10/2023]
Abstract
Understanding the epidemiological profiles of mental, neurological, and substance use disorders provides opportunities for the identification of high-risk population subgroups and for the development of effective country-specific prevention and intervention strategies. Guided by the Conceptual Framework for Action on the Social Determinants of Health by WHO we reviewed the literature to examine the association between a range of social correlates (eg, sex, age, education, income, urbanicity, marital status, and regional differences) and mental, neurological, and substance use disorders in China and India, the most populous countries in the world. We looked for papers on mental, neurological, and substance use disorders with location identifiers and socioeconomic correlates published between 1990 and 2015 and our search found 65 relevant studies from China and 29 from India. Several association patterns between social correlates and mental, neurological, and substance use disorders were not consistent with those reported in high-income countries, including a high concentration of middle-aged men with alcohol use disorders in China and to a lesser extent in India, and a positive association between being married and depression among women in India. Consistent with previous global reports, low education and poverty were associated with higher occurrence of dementia in both China and India, although there is evidence of an interaction between education and income in the risk for dementia in China. Large variations across regions and ethnic groups were consistently documented in China. These unique correlation patterns for mental, neurological, and substance use disorders identified in China and India emphasise the importance of understanding the local social context when planning targeted strategies to reduce the burden of these disorders. High-quality, up-to-date information about the constantly changing pattern of societal factors correlated with mental, neurological, and substance use disorders is urgently needed to help reduce the large and increasing negative social and economic effects that these conditions are having in China, India, and other low-income and middle-income countries.
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Silva ÂCDD, Engstron EM, Miranda CTD. [Factors associated with neurodevelopment in children 6-18 months of age in public daycare centers in João Pessoa, Paraíba State, Brazil]. CAD SAUDE PUBLICA 2016; 31:1881-93. [PMID: 26578013 DOI: 10.1590/0102-311x00104814] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 03/02/2015] [Indexed: 11/22/2022] Open
Abstract
This study aimed to determine the prevalence of altered neurodevelopment in children in public daycare centers in João Pessoa, Paraíba State, Brazil, and to analyze factors associated with child development. A cross-sectional study was conducted in a sample of children 6 to 18 months of age enrolled in daycare. Child development was assessed by the Denver II Screening Test. Biological, riables were studied with a questionnaire and form. Associations were adjusted using logistic regression. Altered development was present in 52.7% of the children and was associated with age > 12 months (OR = 4.3), vaginal delivery (OR = 4.4), neonatal phototherapy (OR = 7.9), and daycare centers not supported by the Family Health Strategy (OR = 2.9). The findings suggest that child development reflects the family's conditions and the care received from educational and healthcare services.
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Abstract
OBJECTIVE Children whose parents do not speak English experience significant disparities in the identification of developmental delays and disorders; however, little is known about the availability and validity of translations of developmental screeners. The goal was to create a map of the scientific evidence regarding translations of the 9 Academy of Pediatrics-recommended screening instruments into languages other than English. METHODS The authors conducted a systematic search of Medline and PsycINFO, references of identified articles, publishers' Web sites, and official manuals. Through evidence mapping, a new methodology supported by AHRQ and the Cochrane Collaboration, the authors documented the extent and distribution of published evidence supporting translations of developmental screeners. Data extraction focused on 3 steps of the translation and validation process: (1) translation methods used, (2) collection of normative data in the target language, and (3) evidence for reliability and validity. RESULTS The authors identified 63 distinct translations among the 9 screeners, of which 44 had supporting evidence published in peer-reviewed sources. Of the 63 translations, 35 had at least some published evidence regarding translation methods used, 28 involving normative data, and 32 regarding reliability and/or construct validity. One-third of the translations found were of the Denver Developmental Screening Test. Specific methods used varied greatly across screeners, as did the level of detail with which results were reported. CONCLUSION Few developmental screeners have been translated into many languages. Evidence map of the authors demonstrates considerable variation in both the amount and the comprehensiveness of information available about translated instruments. Informal guidelines exist for conducting translation of psychometric instruments but not for documentation of this process. The authors propose that uniform guidelines be established for reporting translation research in peer-reviewed journals, similar to those for clinical trials and studies of diagnostic accuracy.
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Sharma S, Raina SK, Bhardwaj AK, Chaudhary S, Kashyap V, Chander V. Socio demography of mental retardation: A community-based study from a goitre zone in rural sub-Himalayan India. J Neurosci Rural Pract 2015; 6:165-9. [PMID: 25883473 PMCID: PMC4387804 DOI: 10.4103/0976-3147.153220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Mental retardation is one of the most common disabilities of childhood which can be prevented by timely identification of the causative agent and an adequate management accordingly. District Kangra lies in the sub-Himalayan belt and forms a part of the 2400 km long goitre belt along the southern slopes of the Himalayas. OBJECTIVE To study the prevalence of mental retardation among children (1-10) years of age. MATERIALS AND METHODS A two-phase cross-sectional study was conducted in the rural area of district Kangra. A 30-cluster sampling technique was used to screen a population of children 1-10 years of age from five randomly selected panchayats (village government units) of district Kangra. The screening was based on a modified version of the ten questions screen, adapted to the local population. In the first phase a door to door survey was done to identify suspects of mental retardation. In the second phase, the children found positive in the first phase were called for examination by the pediatrician to confirm mental retardation. RESULTS A total of 2420 children were screened in the first phase of which 95 tested positive. About 52 of these children were found to be mentally retarded in the second phase giving a prevalence of 2.15%. The 69% of these children belonged to the lower middle class and 28.3% belonged to middle class families using the Uday Parekh scale for assessment of the socio-economic status. CONCLUSION Prevalence of mental retardation is high in district Kangra of Himachal Pradesh in comparison to other states of India. This could be attributed to the good primary health care in Himachal Pradesh where institutional deliveries are about 70%. This may have led to better survival of children with congenital disorders and those that suffer perinatal trauma.
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Affiliation(s)
- Shailja Sharma
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Himachal Pradesh, India
| | - Sunil Kumar Raina
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Himachal Pradesh, India
| | - Ashok Kumar Bhardwaj
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Himachal Pradesh, India
| | - Sanjeev Chaudhary
- Department of Paediatrics, Dr. Rajendra Prasad Government Medical College, Himachal Pradesh, India
| | - Vipasha Kashyap
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Himachal Pradesh, India
| | - Vishav Chander
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Himachal Pradesh, India
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Lin E, Balogh R, Cobigo V, Ouellette-Kuntz H, Wilton AS, Lunsky Y. Using administrative health data to identify individuals with intellectual and developmental disabilities: a comparison of algorithms. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:462-477. [PMID: 23116328 DOI: 10.1111/jir.12002] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Individuals with intellectual and developmental disabilities (IDD) experience high rates of physical and mental health problems; yet their health care is often inadequate. Information about their characteristics and health services needs is critical for planning efficient and equitable services. A logical source of such information is administrative health data; however, it can be difficult to identify cases with IDD in these data. The purpose of this study is to evaluate three algorithms for case finding of IDD in health administrative data. METHODS The three algorithms were created following existing approaches in the literature which ranged between maximising sensitivity versus balancing sensitivity and specificity. The broad algorithm required only one IDD service contact across all available data and time periods, the intermediate algorithm added the restriction of a minimum of two physician visits while the narrow algorithm added a further restriction that the time period be limited to 2006 onward. The resulting three cohorts were compared according to socio-demographic and clinical characteristics. Comparisons on different subgroups for a hypothetical population of 50,000 individuals with IDD were also carried out: this information may be relevant for planning specialised treatment or support programmes. RESULTS The prevalence rates of IDD per 100 were 0.80, 0.52 and 0.18 for the broad, intermediate and narrow algorithms, respectively. Except for 'percentage with psychiatric co-morbidity', the three cohorts had similar characteristics (standardised differences < 0.1). More stringent thresholds increased the percentage of psychiatric co-morbidity and decreased the percentages of women and urban residents in the identified cohorts (standardised differences = 0.12 to 0.46). More concretely, using the narrow algorithm to indirectly estimate the number of individuals with IDD, a practice not uncommon in planning and policy development, classified nearly 7000 more individuals with psychiatric co-morbidities than using the intermediate algorithm. CONCLUSIONS The prevalence rate produced by the intermediate algorithm most closely approximated the reported literature rate suggesting the value of imposing a two-physician visit minimum but not restricting the time period covered. While the statistical differences among the algorithms were generally minor, differences in the numbers of individuals in specific population subgroups may be important particularly if they have specific service needs. Health administrative data can be useful for broad-based service planning for individuals with IDD and for population level comparisons around their access and quality of care.
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Affiliation(s)
- E Lin
- Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.
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Lai DC, Tseng YC, Hou YM, Guo HR. Gender and geographic differences in the prevalence of intellectual disability in children: analysis of data from the national disability registry of Taiwan. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:2301-2307. [PMID: 22877930 DOI: 10.1016/j.ridd.2012.07.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 06/30/2012] [Accepted: 07/02/2012] [Indexed: 06/01/2023]
Abstract
Intellectual disability (ID) is not uncommon in children, but data at the national level are limited, especially those on geographic differences. On the basis of the Disabled Welfare Law, Taiwan began to certify disabled residents and provide various services in 1980. All the cases are registered, and the registry provides a rare opportunity for studying ID at the national level. Using the data from 2004 to 2010, we calculated the prevalence of ID in children by age, gender, and geographic area and assessed the changes over time. We limited analyses to children at least 3 years of age, because certification before 3 years old is discouraged by the government. We found that from 2004 to 2010, the registered cases between 3 and 17 years old ranged from 20,531 to 23,547, and the prevalence of ID increased constantly from 4.40/1000 to 5.79/1000 (p<0.01), which generally increased every year in all age groups (p<0.01). In each year there were more boy cases than girl cases, and the boy-to-girl ratio generally decreased with age (p<0.01 for chi-square test for trend in all years). The prevalence rate ratio ranged from 1.33 to 1.37 (p<0.01 in all years), and the changes in the rate ratio were small over the years. We observed a higher prevalence in the rural areas over the years, and the prevalence rate ratio ranged from 1.34 to 1.43 (p<0.01 in all years), with an increasing trend over time (p<0.01).
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Affiliation(s)
- Der-Chung Lai
- Department of Physical Medicine and Rehabilitation, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
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Zheng X, Chen R, Li N, Du W, Pei L, Zhang J, Ji Y, Song X, Tan L, Yang R. Socioeconomic status and children with intellectual disability in China. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2012; 56:212-220. [PMID: 21917049 DOI: 10.1111/j.1365-2788.2011.01470.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Intellectual disability (ID) accounts for 70% of all disabilities among children in China's Second National Sampling Survey on Disability. Although studies have shown a relationship between social class and ID in children, none have investigated the association of socioeconomic variables in Chinese children with mild or severe ID. METHODS Data for children aged 0-6 years with and without ID were abstracted from the Second National Sampling Survey on Disability in China, conducted in 2006. Crude odds ratios showed the effect of sociodemographic factors on mild and severe ID. Adjusted odds ratios (OR(a) ) (95% confidence intervals) estimated the independent effects of these factors. RESULTS For both mild and severe ID, risk of having ID increased with male sex, birth to a woman aged 35 years and older, lower maternal education, mother's older age at delivery, lower income and rural residence. After age, gender and parent disability were controlled, mothers aged 35 years and older were more likely to have a child with ID: mild ID, OR(a) 1.47 (1.15-1.88); severe ID, OR(a) 1.32 (1.00-1.73). There was an approximate increasing monotonic risk of severe ID with increasing socioeconomic disadvantage: lowest income, OR(a) 3.00 (2.19-4.12); low income, OR(a) 2.28 (1.63-3.19); lower middle income, OR(a) 1.72 (1.27-2.33); middle income, OR(a) 1.73 (1.28-2.36). CONCLUSIONS There is a significant relationship between sociodemographic factors and ID. Similar patterns were found for both mild and severe ID. Recommendations are given for preventing ID in Chinese children.
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Affiliation(s)
- X Zheng
- Institute of Population Research/WHO Collaborating Center for Reproductive Health and Population Science, Chinese Center of Disability and Development, Peking University, Beijing, China.
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McKenzie K, Megson P. Screening for Intellectual Disability in Children: A Review of the Literature. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011; 25:80-7. [DOI: 10.1111/j.1468-3148.2011.00650.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Perspectives of intellectual disability in the People's Republic of China: epidemiology, policy, services for children and adults. Curr Opin Psychiatry 2011; 24:408-12. [PMID: 21670685 DOI: 10.1097/yco.0b013e328348810c] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review aims to provide an overview of the current status and recent developments in epidemiology, public policy and services for children and adults with intellectual disability in China. RECENT FINDINGS The most recent national survey on disability conducted in 2006 estimated that the prevalence of intellectual disability was 0.75% in China. People with intellectual disability accounted for 11.9% of all the people with disabilities and they have an uneven geographical distribution. The prevalence in urban areas was 0.4%, whereas that in rural areas was 1.02%. The Constitution of the People's Republic of China stated that people with disabilities have the right to receive assistance from the state and society. Based on this, laws have been formulated and revised to protect people with disabilities in areas of education, employment and rehabilitation. The variety, capacity and quality of services for people with intellectual disability are steadily increasing or improving, but there are still gaps and deficiencies such as mental health care and professional services. SUMMARY Supported by the Central Government of the People's Republic of China, there has been remarkable progress in the formulation of policies and provision of services for people with intellectual disability in recent years. However, there continue to be a lot of unmet needs among this population, particularly those living in rural areas. Therefore, further commitment, coordination and resource allocation are required to improve the lives of people with intellectual disability in China.
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Brito CML, Vieira GO, Costa MDCO, Oliveira NFD. Desenvolvimento neuropsicomotor: o teste de Denver na triagem dos atrasos cognitivos e neuromotores de pré-escolares. CAD SAUDE PUBLICA 2011; 27:1403-14. [DOI: 10.1590/s0102-311x2011000700015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 04/26/2011] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi verificar a prevalência e fatores associados no que se refere ao desempenho anormal do desenvolvimento neuropsicomotor de crianças matriculadas na educação infantil pública em Feira de Santana, Bahia, Brasil, em 2009 (n = 438). Esta é uma pesquisa epidemiológica de corte transversal, com amostragem por conglomerado e sorteio das escolas e crianças. Foram verificados os fatores associados por meio de aplicação de questionário às mães e de teste Denver II ao filho. A análise estatística realizou o teste χ2 com intervalo de 95% de confiança e α = 5%. A prevalência de desempenho anormal do desenvolvimento foi 46,3%. Na análise de regressão logística, as variáveis estatisticamente significantes associadas foram: sexo masculino (RP = 1,43; p = 0,00), cinco anos de idade (RP = 1,42; p = 0,00), não realização de pré-natal (RP = 1,41; p = 0,00), início do pré-natal > 3 meses (RP = 1,25; p = 0,00) e consumo alcoólico na gestação (RP = 1,55; p = 0,00). A prevalência foi elevada, apontando a necessidade de pré-natal precoce, alertando sobre o consumo alcoólico, e de vigilância nos primeiros anos de vida, visando a prevenir ou tratar precocemente as alterações.
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Maulik PK, Mascarenhas MN, Mathers CD, Dua T, Saxena S. Prevalence of intellectual disability: a meta-analysis of population-based studies. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:419-36. [PMID: 21236634 DOI: 10.1016/j.ridd.2010.12.018] [Citation(s) in RCA: 831] [Impact Index Per Article: 63.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 12/08/2010] [Accepted: 12/14/2010] [Indexed: 05/23/2023]
Abstract
Intellectual disability is an extremely stigmatizing condition and involves utilization of large public health resources, but most data about its burden is based on studies conducted in developed countries. The aim of this meta-analysis was to collate data from published literature and estimate the prevalence of intellectual disability across all such studies. The review includes studies published between 1980 and 2009, and includes data from populations that provided an overall estimate of the prevalence of intellectual disability. Meta-analysis was done using random effects to account for heterogeneity. Sub-group analyses were also done. The prevalence of intellectual disability across all 52 studies included in the meta-analysis was 10.37/1000 population. The estimates varied according to income group of the country of origin, the age-group of the study population, and study design. The highest rates were seen in countries from low- and middle income countries. Studies based on identification of cases by using psychological assessments or scales showed higher prevalence compared to those using standard diagnostic systems and disability instruments. Prevalence was higher among studies based on children/adolescents, compared to those on adults. Higher prevalence in low and middle income group countries is of concern given the limitations in available resources in such countries to manage intellectual disability. The importance of using standardized diagnostic systems to correctly estimate the burden is underlined. The public health and research implications of this meta-analysis have been discussed.
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Affiliation(s)
- Pallab K Maulik
- The George Institute for Global Health, Plot 839C, Road 44A, Jubilee Hills, Hyderabad 500033, India.
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Bruckner TA, Scheffler RM, Shen G, Yoon J, Chisholm D, Morris J, Fulton BD, Dal Poz MR, Saxena S. The mental health workforce gap in low- and middle-income countries: a needs-based approach. Bull World Health Organ 2011; 89:184-94. [PMID: 21379414 PMCID: PMC3044251 DOI: 10.2471/blt.10.082784] [Citation(s) in RCA: 222] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 11/04/2010] [Accepted: 11/08/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To estimate the shortage of mental health professionals in low- and middle-income countries (LMICs). METHODS We used data from the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS) from 58 LMICs, country-specific information on the burden of various mental disorders and a hypothetical core service delivery package to estimate how many psychiatrists, nurses and psychosocial care providers would be needed to provide mental health care to the total population of the countries studied. We focused on the following eight problems, to which WHO has attached priority: depression, schizophrenia, psychoses other than schizophrenia, suicide, epilepsy, dementia, disorders related to the use of alcohol and illicit drugs, and paediatric mental disorders. FINDINGS All low-income countries and 59% of the middle-income countries in our sample were found to have far fewer professionals than they need to deliver a core set of mental health interventions. The 58 LMICs sampled would need to increase their total mental health workforce by 239,000 full-time equivalent professionals to address the current shortage. CONCLUSION Country-specific policies are needed to overcome the large shortage of mental health-care staff and services throughout LMICs.
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Affiliation(s)
- Tim A Bruckner
- Department of Public Health and Planning, Policy and Design, University of California, Irvine, CA 92697-7075, USA.
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Lai DC, Tseng YC, Guo HR. Gender and geographic differences in developmental delays among young children: analysis of the data from the national registry in Taiwan. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:63-69. [PMID: 20864309 DOI: 10.1016/j.ridd.2010.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 08/23/2010] [Indexed: 05/29/2023]
Abstract
Although developmental delays are not uncommon in children, the incidence is seldom assessed, and the reported prevalence varies widely. In Taiwan, the government mandates the reporting of suspected cases. Using the national registry data, we conducted a study to estimate the incidence and prevalence of developmental delays in young children in Taiwan and to assess the gender and geographic differences. According to the law, each city and county in Taiwan needs to establish a reporting and referral center. The Department of Interior constructed a surveillance system on the basis of these centers and publishes the registry data annually. We analyzed the data from 2003 to 2008. From 2003 to 2008, 73,084 new cases were registered, and the incidence was 5.7-11.1 per 1000 person-year under 3 years of age and 7.9-11.4 per 1000 person-year at 3-5 years of age. The estimated prevalence was 8.6-16.6 per 1000 under 3 years of age and 26.2-47.6 per 1000 at 3-5 years of age. The average age at reporting decreased from 3.4 years in 2003 to 3.1 years in 2008. In addition, we found that boys had higher incidence than girls all through the years. Rural areas had higher incidence than urban areas, except for 2003.
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Affiliation(s)
- Der-Chung Lai
- Department of Physical Medicine and Rehabilitation, Chiayi Christian Hospital, Chiayi, Taiwan
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Peng X, Song S, Sullivan S, Qiu J, Wang W. Ageing, the urban-rural gap and disability trends: 19 years of experience in China - 1987 to 2006. PLoS One 2010; 5:e12129. [PMID: 20730089 PMCID: PMC2921329 DOI: 10.1371/journal.pone.0012129] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Accepted: 07/17/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As the age of a population increases, so too does the rate of disability. In addition, disability is likely to be more common in rural compared with urban areas. The present study aimed to examine the influence of rapid population changes in terms of age and rural/urban residence on the prevalence of disability. METHODS Data from the 1987 and 2006 China Sampling Surveys on Disability were used to estimate the impacts of rapid ageing and the widening urban-rural gap on the prevalence of disability. Stratum specific rates of disability were estimated by 5-year age-group and type of residence. The decomposition of rates method was used to calculate the rate difference for each stratum between the two surveys. RESULTS The crude disability rate increased from 4.89% in 1987 to 6.39% in 2006, a 1.5% increase over the 19 year period. However, after the compositional effects from the overall rates of changing age-structure in 1987 and 2006 were eliminated by standardization, the disability rate in 1987 was 6.13%, which is higher than that in 2006 (5.91%). While in 1987 the excess due to rural residence compared with urban was <1.0%, this difference increased to >1.5% by 2006, suggesting a widening disparity by type of residence. When rates were decomposed, the bulk of the disability could be attributed to ageing, and very little to rural residence. However, a wider gap in prevalence between rural and urban areas could be observed in some age groups by 2006. CONCLUSION The increasing number of elderly disabled persons in China and the widening discrepancy of disability prevalence between urban and rural areas may indicate that the most important priorities for disability prevention in China are to reinforce health promotion in older adults and improve health services in rural communities.
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Affiliation(s)
- Xiaoxia Peng
- School of Public Health and Family Medicine, Capital Medical University, Beijing, China
| | - Shige Song
- Institute of Sociology, Chinese Academy of Social Sciences, Beijing, China
| | - Sheena Sullivan
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Jingjun Qiu
- School of Public Health and Family Medicine, Capital Medical University, Beijing, China
| | - Wei Wang
- School of Public Health and Family Medicine, Capital Medical University, Beijing, China
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia
- Graduate School, Chinese Academy of Sciences, Beijing, China
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Perspectives of intellectual disability in Asia: epidemiology, policy, and services for children and adults. Curr Opin Psychiatry 2009; 22:462-8. [PMID: 19625968 DOI: 10.1097/yco.0b013e32832ec056] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Given the scarcity of Asian literature on intellectual disability, the aim of this review article is to shed light on the epidemiology, policy, and services for children and adults with intellectual disability in Asia. RECENT FINDINGS The prevalence of intellectual disability across Asia appears to be consistent with western estimates at 0.06-1.3%, with the exception being China at 6.68%. In the only two studies of mental health conducted in Asia, the prevalence ranged from 4.4 to 48.3%. Some of the common physical health problems among Singaporean adults with intellectual disability are obesity, high blood pressure, and high blood cholesterol. All Asian countries/territories have at least one law or policy that promotes the well being of persons with disabilities, with Japan being the only country that has a law specifically enacted for persons with intellectual disability. Although there is an array of services being offered for children and adults with intellectual disability across south-east Asia, there is also a variation in the proportion of countries that offer these services. SUMMARY Overall, the challenge for Asia will be to develop a localized base of knowledge by conducting epidemiological studies, modeling after evidence-based practices, and evaluating its effectiveness. By adopting a scientific approach and formal publication of data, intellectual disability standards can be evaluated, managed, and improved in a systematic manner.
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