Relationship between the Vineland Adaptive Behaviour Scales and the Wechsler Adult Intelligence Scale IV in adults with intellectual disabilities

Formal support and service needs of family caregivers of adults with intellectual and/or developmental disabilities in India

BACKGROUND

Despite the enactment of disability laws/policies in India, research shows that caregivers of adults with intellectual and/or developmental disabilities experience inadequate formal supports/services due to dissemination barriers and lack of awareness about them. To address discrepancy between caregivers' support needs and the professionals' understanding of their needs, the study proposed to conduct a caregiver needs assessment so that culturally-tailored programs are developed.

METHOD

A strengths-based mixed methods needs assessment was conducted with a convenience sample of 100 caregivers in Hyderabad, India. One hundred caregivers completed the survey and 15 caregivers participated in semi-structured interviews.

RESULTS

Caregivers needed more and improved formal supports/services, particularly from the government. Caregivers faced systemic and attitudinal barriers, and personal impediments to accessing them. Needs differed by care recipients' intellectual disability level, gender, and intellectual disability related conditions.

CONCLUSIONS

Researchers, service providers and policymakers need to adopt innovative strategies to improve formal supports/services access.

Cognitive Profile Discrepancies among Typical University Students and Those with Dyslexia and Mixed-Type Learning Disorder

BACKGROUND

Previous studies have identified areas of cognitive weakness in children diagnosed with Specific Learning Disorder (SLD), in the areas of working memory and processing speed in particular. In adulthood, this literature is still scant, and no studies have compared the cognitive profile of university students with dyslexia (DD) with that of students with Mixed-type SLD.

METHOD

Thus, in this study, the WAIS-IV was used to examine the cognitive functioning of three groups of university students: students with DD, with Mixed-type SLD, and typical students. Statistical analyses were performed to examine differences in WAIS-IV FSIQ, main, and additional indexes and subtests.

RESULTS

The results showed strengths in perceptual reasoning and good verbal comprehension abilities in both the DD and Mixed-type SLD group, with weaknesses in working memory and processing speed, leading to a pattern of a better General Ability Index (GAI) than Cognitive Proficiency Index (CPI) in both clinical groups. Thus, discrepancies between GAI and CPI, well documented in children with SLD, still manifest in adulthood in university students. Our findings also revealed worse cognitive performance in university students with mixed learning disorder relative to students with only a reading deficit.

CONCLUSIONS

The cognitive features and distinctive subtest profiles that emerged should guide the assessment and the definitions of intervention programs, special educational needs, and strategies of compensation.

Red blood cells as glucose carriers to the human brain: Modulation of cerebral activity by erythrocyte exchange transfusion in Glut1 deficiency (G1D)

Red blood cells circulating through the brain are briefly but closely apposed to the capillary endothelium. We hypothesized that this contact provides a nearly direct pathway for metabolic substrate transfer to neural cells that complements the better characterized plasma to endothelium transfer. While brain function is considered independent of normal fluctuations in blood glucose concentration, this is not borne out by persons with glucose transporter I (GLUT1) deficiency (G1D). In them, encephalopathy is often ameliorated by meal or carbohydrate administration, and this enabled us to test our hypothesis: Since red blood cells contain glucose, and since the red cells of G1D individuals are also deficient in GLUT1, replacing them with normal donor cells via exchange transfusion could augment erythrocyte to neural cell glucose transport via mass action in the setting of unaltered erythrocyte count or plasma glucose abundance. This motivated us to perform red blood cell exchange in 3 G1D persons. There were rapid, favorable and unprecedented changes in cognitive, electroencephalographic and quality-of-life measures. The hypothesized transfer mechanism was further substantiated by in vitro measurement of direct erythrocyte to endothelial cell glucose flux. The results also indicate that the adult intellect is capable of significant enhancement without deliberate practice.      ClinicalTrials.gov registration: NCT04137692 https://clinicaltrials.gov/ct2/show/NCT04137692.

Development and validation of a functional screening tool for adults with intellectual disabilities

BACKGROUND

The dynamic nature of intellectual disability necessitates repeated screening.

METHOD

The functional screening tool (FST-ID) for individuals with intellectual disabilities was carefully constructed intellectual disabilities.

RESULTS

The FST-ID General Adaptive Composite score (GAC) runs between 0 and 68 points. Criterion validity-high-positive correlations were found between FST-ID and ABAS-II (Gold standard), and between the severity of the intellectual disability and the FST-ID (r = 0.78, p < .001). The scale holds high-internal consistency, intra and inter-rater reliability values. The cut-off point between mild and moderate disability is 50.4 (Sensitivity: 87%, Specificity 86%, p < .001) and 29.4 between moderate to severe-profound (Sensitivity: 96%, Specificity 94%, p < .001).

CONCLUSIONS

The FST-ID presents high-psychometric properties and requires less than 5 min to complete. Using this tool may support efficient screening practices and improved supports for adults with intellectual disability.

The ADaptive Ability Performance Test (ADAPT): A new instrument for measuring adaptive skills in people with intellectual disabilities and borderline intellectual functioning

BACKGROUND

Since the DSM-5, adaptive functioning has taken a prominent place in the classification of intellectual disability (ID). The ADAPT was developed to assess adaptive skills in individuals with ID.

METHOD

A total of 2,081 ADAPTs from clients with suspected ID or borderline intellectual functioning and 129 ADAPTs from people from the general population (non-ID) were collected, along with background characteristics.

RESULTS

Internal consistency of the ADAPT was high (α = 0.98). ADAPT scores were positively associated with IQ, educational level and level of independent living. Furthermore, individuals without ID scored significantly higher than the clients on all of the 65 ADAPT items. Reference values were established for different IQ groups and living situations.

CONCLUSION

Results suggest that the ADAPT is a valid instrument for measuring adaptive skills in individuals with ID. The reference values may be used for the purpose of estimating the level of ID and the needed intensity of support.

Short forms of Prudhoe Cognitive Function Test in adults and aging people with intellectual disabilities: Italian validation study

BACKGROUND

We aimed to validate the Italian version of the two parallel short forms of the Prudhoe Cognitive Function Test (s-PCFT-I) in adults and seniors with intellectual disabilities (ID) of any aetiology and level of severity.

METHODS

Our validation is a multicentre study attended by 211 subjects with ID, 125 male and 86 female, aged 40 years and above for people with Down syndrome and aged 50 years for people with other forms of disabilities.

RESULTS

The s-PCFT-I shows a wide range of scores in the absence of floor effects with minimal ceiling effects. A Cronbach's α coefficient of 0.85 and a mean inter-item correlation of 0.21 indicate high internal consistency. The tool demonstrates good agreement between testers and near excellent temporal stability with intraclass correlation coefficients respectively of 0.85 and 0.90. s-PCFT-I total scores do not differ by sex or age, while statistically significant differences are observed between people with different levels of severity of ID. Moderate to good and highly significant correlations (-0.40 to -0.66) among the s-PCFT-I total scores and subscores and the Sum of Cognitive Score of the informant-based Dementia Questionnaire for Persons with Intellectual Disabilities suggest an acceptable level of concurrent criterion validity. Cognitive decliners according to Prasher's Dementia Questionnaire for Persons with Intellectual Disabilities cut-off scores perform significantly lower on s-PCFT-I than non-decliners.

CONCLUSIONS

The s-PCFT-I has good psychometric properties and user friendliness and may therefore be a valuable addition to the current informant-rated tools for screening and assessment of cognition in aging people with ID.