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Williams CA, Thompson PA, Hayden NK, Hastings RP. Sibling Relationship and Behavioral Adjustment in Families of Disabled Children: Cross-Lagged Associations. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:73-85. [PMID: 38147889 DOI: 10.1352/1944-7558-129.1.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/23/2023] [Indexed: 12/28/2023]
Abstract
Cross-lagged panel designs were used to examine longitudinal and potential (bi)directional relationships between primary caregiver reported sibling relationship quality and the behaviors of children with intellectual disability (n = 297) and their closest in age siblings. The behavioral and emotional problems of the child with intellectual disability positively predicted sibling conflict over time. When accounting for control variables, this relationship was no longer present. Sibling warmth positively predicted the prosocial behaviors of the child with intellectual disability over time. When accounting for control variables, both sibling warmth and sibling conflict positively predicted the prosocial behaviors of the child with intellectual disability over time. Future research directions and clinical implications are discussed.
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Affiliation(s)
- Caitlin A Williams
- Caitlin A. Williams and Paul A. Thompson, Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
| | - Paul A Thompson
- Caitlin A. Williams and Paul A. Thompson, Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
| | - Nikita K Hayden
- Nikita K. Hayden, Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, and School of Education and iHuman, The University of Sheffield, Sheffield, UK
| | - Richard P Hastings
- Richard P. Hastings, Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
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Hayden NK, Hastings RP, Bailey T. Behavioural adjustment of children with intellectual disability and their sibling is associated with their sibling relationship quality. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:310-322. [PMID: 36602088 PMCID: PMC10952136 DOI: 10.1111/jir.13006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/04/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Understanding sibling relationship quality is important, as it is associated with mental health outcomes in both childhood and adulthood. Arguably, these relationships are even more important for individuals with intellectual disability, as siblings can be important sources of care, support, advocacy and friendship for one another. The intellectual disability field, however, has a tendency to assume that the relationship lacks reciprocity, and that it is the sibling with intellectual disability who affects the sibling, and that this effect is somehow 'negative'. METHODS We examined whether the behaviour problems and prosocial behaviour of 500 child sibling pairs, where one child has an intellectual disability, were associated with their sibling relationship quality. Measures included the Strengths and Difficulties Questionnaires and the Sibling Relationship Questionnaire. Family poverty, the gender of both children, birth order and whether the child with intellectual disability had autism or Down syndrome were also included in the analyses. RESULTS Confirmatory factor analysis indicated an adequate model fit for the latent variables measuring sibling relationships. The final structural model found that the prosocial behaviour and internalising problems of the children with intellectual disability, their typically developing siblings' prosocial behaviours and sibling birth order were associated with intimacy-companionship in the sibling relationship. The internalising, externalising and prosocial behaviours of the children with intellectual disability, their siblings' externalising behaviours and sibling birth order were associated with antagonism-quarrelling in the sibling relationship. CONCLUSIONS We found that the behaviours of both the child with intellectual disability and their sibling were associated with both 'positive' and 'negative' dimensions of their sibling relationship. This indicates a bidirectional and reciprocal effect.
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Affiliation(s)
- N. K. Hayden
- Centre for Educational Development, Appraisal and ResearchUniversity of WarwickCoventryUK
| | - R. P. Hastings
- Centre for Educational Development, Appraisal and ResearchUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of PsychiatryMonash UniversityMelbourneAustralia
| | - T. Bailey
- Centre for Educational Development, Appraisal and ResearchUniversity of WarwickCoventryUK
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Zabidi AS, Hastings RP, Totsika V. Spending leisure time together: Parent child relationship in families of children with an intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 133:104398. [PMID: 36565519 DOI: 10.1016/j.ridd.2022.104398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Relationship quality between a parent and a child typically differs between families with a child with intellectual disability (ID) and families with other children. Parent-child relationship quality matters in ID as it has been linked with child outcomes. However, there are few research studies examining factors that are related to parent-child relationship quality in ID. AIMS The aim of the present study was to investigate factors associated with parent-child relationship quality in families of children with ID. In particular, we aimed to examine the association between the amount of time parents and children spend together in leisure activities and parent-child relationship quality. METHODS AND PROCEDURES The sample was drawn from the 1000 Families Study, a survey including parent-reported data from families of children with ID aged 4-16 years. Measures of parent-child relationship quality and shared parent-child time were available. OUTCOMES Regression analyses showed that parental investment in shared leisure time was significantly associated with parent-child closeness and conflict, even after controlling for a number of factors related to relationship quality. Parental psychological distress was also associated with parent-child relationship quality. CONCLUSIONS AND IMPLICATIONS Interventions that aim to improve parent-child relationship quality may want to investigate the role of shared parent-child time in leisure activities as one of the mechanisms of change.
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Affiliation(s)
- Amira Sofia Zabidi
- UCL Division of Psychiatry, 6th Floor, Wing A, Maple House, 149 Tottenham Court Road, London W1T 7NF, United Kingdom
| | | | - Vaso Totsika
- UCL Division of Psychiatry, 6th Floor, Wing A, Maple House, 149 Tottenham Court Road, London W1T 7NF, United Kingdom; CEDAR, University of Warwick, Coventry CV4 7AL, United Kingdom; Tavistock & Portman NHS Foundation Trust, United Kingdom.
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Rixon L, Hastings RP, Kovshoff H, Bailey T. Short Report: Outcomes for siblings associated with sub-groups of autistic children with intellectual disability identified by latent profile analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 130:104337. [PMID: 36126532 DOI: 10.1016/j.ridd.2022.104337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/02/2022] [Accepted: 09/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Recent research suggests that having a brother or sister with autism may contribute to increased positive or negative emotional or psychological impact on siblings. AIMS To use a novel multidimensional data analysis method to further understand outcomes for siblings of autistic children. METHODS AND PROCEDURES 318 siblings of children with a recorded autism diagnosis and an intellectual disability were included for latent profile analysis. Five variables (DBC disruptive and anxiety; VABS II communication, daily living, and socialization skills) were used to identify sub-groups of autistic children. Primary carers reported on sibling relationship quality (items from the Sibling Relationship Questionnaire warmth/closeness and conflict scales), and siblings' behavioral and emotional problems. OUTCOMES AND RESULTS The profile groups differed in their levels of ID coupled with disruptive behavior, emotional problems and adaptive skills. Profiles included a severe ID, low behavior and emotional problems and low adaptive skills group; a group with mild ID coupled with high adaptive skills and low emotional and behavioral problems; and a mild ID group with high emotional and behavioral problems. Conflict in the sibling relationship differed across the profile groups (F (4304) = 15.13, p < .001). CONCLUSIONS AND IMPLICATIONS Siblings of autistic children with the highest support needs were reported to have the lowest conflict in their relationships. Conversely, siblings of the autistic children with the highest levels of externalizing behaviors and anxiety were reported to have the highest levels of conflict in the sibling relationship.
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Affiliation(s)
- Louise Rixon
- Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom.
| | - Richard P Hastings
- Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom; Centre for Developmental Psychiatry and Psychology, Monash University, Clayton, VIC 3168, Australia
| | - Hanna Kovshoff
- Department of Psychology, Highfield Campus, University of Southampton, SO17 1BJ, United Kingdom
| | - Tom Bailey
- Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom
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Wolstencroft J, Wicks F, Srinivasan R, Wynn S, Ford T, Baker K, Chawner SJRA, Hall J, van den Bree MBM, Owen MJ, Skuse D, Raymond FL. Neuropsychiatric risk in children with intellectual disability of genetic origin: IMAGINE, a UK national cohort study. Lancet Psychiatry 2022; 9:715-724. [PMID: 35932790 PMCID: PMC9636306 DOI: 10.1016/s2215-0366(22)00207-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children with intellectual disability frequently have multiple co-morbid neuropsychiatric conditions and poor physical health. Genomic testing is increasingly recommended as a first-line investigation for these children. We aim to determine the effect of genomics, inheritance, and socioeconomic deprivation on neuropsychiatric risk in children with intellectual disability of genetic origin as compared with the general population. METHODS IMAGINE is a prospective cohort study using online mental health and medical assessments in a cohort of 3407 UK participants with intellectual disability and pathogenic genomic variants as identified by the UK's National Health Service (NHS). Our study is on a subset of these participants, including all children aged 4-19 years. We collected diagnostic genomic reports from NHS records and asked primary caregivers to provide an assessment of their child using the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), the Adaptive Behaviour Assessment System 3 (ABAS-3), and a medical history questionnaire. Each child was assigned a rank based on their postcode using the index of multiple deprivation (IMD). We compared the IMAGINE cohort with the 2017 National Survey of Children's Mental Health in England. The main outcomes of interest were mental health and neurodevelopment according to the DAWBA and SDQ. FINDINGS We recruited 2770 children from the IMAGINE study between Oct 1, 2014 and June 30, 2019, of whom 2397 (86·5%) had a basic assessment of their mental health completed by their families and 1277 (46·1%) completed a medical history questionnaire. The mean age of participants was 9·2 years (SD 3·9); 1339 (55·9%) were boys and 1058 (44·1%) were girls. 355 (27·8%) of 1277 reported a seizure disorder and 814 (63·7%) reported movement or co-ordination problems. 1771 (73·9%) of 2397 participants had a pathogenic copy number variant (CNV) and 626 (26·1%) had a pathogenic single nucleotide variant (SNV). Participants were representative of the socioeconomic spectrum of the UK general population. The relative risk (RR) of co-occurring neuropsychiatric diagnoses, compared with the English national population, was high: autism spectrum disorder RR 29·2 (95% CI 23·9-36·5), ADHD RR 13·5 (95% CI 11·1-16·3). In children with a CNV, those with a familial variant tended to live in more socioeconomically deprived areas than those with a de novo variant. Both inheritance and socioeconomic deprivation contributed to neuropsychiatric risk in those with a CNV. INTERPRETATION Children with genomic variants and intellectual disability are at an increased risk of neuropsychiatric difficulties. CNV variant inheritance and socioeconomic deprivation also contribute to the risk. Early genomic investigations of children with intellectual disability could facilitate the identification of the most vulnerable children. Additionally, harnessing parental expertise using online DAWBA assessments could rapidly identify children with exceptional needs to child mental health services. FUNDING UK Medical Research Council and Medical Research Foundation.
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Affiliation(s)
- Jeanne Wolstencroft
- NIHR BRC Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Francesca Wicks
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ramya Srinivasan
- NIHR BRC Great Ormond Street Institute of Child Health, University College London, London, UK; UCL Division of Psychiatry, University College London, London, UK
| | | | - Tamsin Ford
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Kate Baker
- School of Clinical Medicine, University of Cambridge, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Samuel J R A Chawner
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK; Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK; Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | - Jeremy Hall
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK; Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Marianne B M van den Bree
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK; Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Michael J Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK; Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - David Skuse
- NIHR BRC Great Ormond Street Institute of Child Health, University College London, London, UK
| | - F Lucy Raymond
- School of Clinical Medicine, University of Cambridge, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK; NIHR Bioresource, Cambridge Biomedical Campus, Cambridge, UK.
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Support Needs and Parent Outcomes in Arab Families of Children with Autism Living in the United Kingdom. Brain Sci 2022; 12:brainsci12081114. [PMID: 36009177 PMCID: PMC9405880 DOI: 10.3390/brainsci12081114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/14/2022] [Accepted: 08/19/2022] [Indexed: 11/27/2022] Open
Abstract
Research on the experiences of Arab families of children with autism living in non-Arab countries is scarce. A survey investigated the support needs, psychological distress, and parental relationships of Arab parents (n = 100) of children with autism living in the United Kingdom (UK). The survey consisted of five main questionnaires: a demographic questionnaire, the GO4KIDDS Brief Adaptive Scale, the Family Needs Survey, the Strengths and Difficulties Questionnaire, and the Hospital Anxiety and Depression Scale. Descriptive analysis indicated that the most frequently identified support needs were information, community services, and explaining to others. Parents reported high levels of psychological distress, a high level of parental relationship satisfaction with their spouse, and few parental disagreements about their child with autism. Regression analyses showed that increased child behavior problems predicted more total family needs. Higher levels of child prosocial behavior, the better health status of parents, and a larger number of children in the family were associated with lower levels of parental psychological distress. A longer time living in the UK was associated with more parental disagreement over issues related to the child with ASD. Reducing child behavior problems and increasing child prosocial behavior may be important targets for support and intervention to improve outcomes for Arab parents of autistic children.
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Akhtar TN, McGibbon E. Blindspot in the evidence base: A systematic review of psychological interventions for children and adolescents with intellectual disabilities and co-occurring obesity. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104240. [PMID: 35500443 DOI: 10.1016/j.ridd.2022.104240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/25/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Children and adolescents with intellectual disabilities (C&A-ID) face many disadvantages in healthcare research and service delivery. Intellectual disabilities have been found to precipitate weight-related problems, and together, they may be indicators of rare genetic diseases (RGDs). C&A-ID may require support for health problems exacerbated by primary diagnoses. While it is generally agreed that C&A-ID have more complex needs than typically developing individuals, psychological services to address these needs are under-explored. AIMS This systematic review aimed to identify psychological interventions for weight management in C&A-ID. METHOD MEDLINE, PsycINFO, CINAHL, The Cochrane Library and SCOPUS were systematically searched. Data extraction and quality appraisal were performed for all eligible studies RESULTS: The search strategy yielded seven studies published in English between 2010 and 2022. All interventions addressed obesity through multi-disciplinary programmes and resulted in weight reductions, with most interventions theoretically influenced by principles of behaviourism. Quality appraisal revealed methodological weaknesses in six of seven studies, such as heterogeneity in samples, interventions, and outcome measures, disallowing meta-analyses and weakening the generalisability of interventions to diverse contexts and groups CONCLUSIONS AND IMPLICATIONS: A genuine disconnect between empirical evidence and services for C&A with complex needs was observed. This emphasises an urgency for increased inclusion in clinical and behavioural research and for robust enquiries to test/adapt psychological interventions for weight management for C&A-ID. The findings of this review hold clinical utility for clinicians working with C&A-ID, and with RGDs such as Bardet-Biedl, Prader-Willi and Down syndromes. Recommendations and a conceptual framework are provided herein for enhanced efficacy of interventions.
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Affiliation(s)
- Tooba Nadeem Akhtar
- The Great Ormond Street Institute of Child Health, University College London, United Kingdom.
| | - Emma McGibbon
- Wolfson Neurodisability Service, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom.
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Williams CA, Bailey T, Hastings RP. Modelling triadic relationships in families of children with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:843-855. [PMID: 35187793 PMCID: PMC9306971 DOI: 10.1111/jar.12988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 12/01/2022]
Abstract
Background Method Results Conclusions
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Affiliation(s)
- Caitlin A. Williams
- Centre for Educational Development, Appraisal, and Research (CEDAR) University of Warwick Coventry UK
| | - Tom Bailey
- Centre for Educational Development, Appraisal, and Research (CEDAR) University of Warwick Coventry UK
| | - Richard P. Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR) University of Warwick Coventry UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry Monash University Melbourne Victoria Australia
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Coulman E, Gore N, Moody G, Wright M, Segrott J, Gillespie D, Petrou S, Lugg-Widger F, Kim S, Bradshaw J, McNamara R, Jahoda A, Lindsay G, Shurlock J, Totsika V, Stanford C, Flynn S, Carter A, Barlow C, Hastings RP. Early Positive Approaches to Support (E-PAtS) for Families of Young Children With Intellectual Disability: A Feasibility Randomised Controlled Trial. Front Psychiatry 2021; 12:729129. [PMID: 34992552 PMCID: PMC8725992 DOI: 10.3389/fpsyt.2021.729129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Parents of children with intellectual disabilities are likely to experience poorer mental well-being and face challenges accessing support. Early Positive Approaches to Support (E-PAtS) is a group-based programme, co-produced with parents and professionals, based on existing research evidence and a developmental systems approach to support parental mental well-being. The aim of this study was to assess the feasibility of community service provider organisations delivering E-PAtS to parents/family caregivers of young children with intellectual disability, to inform a potential definitive randomised controlled trial of the effectiveness and cost-effectiveness of E-PAtS. Methods: This study was a feasibility cluster randomised controlled trial, with embedded process evaluation. Up to two parents/family caregivers of a child (18 months to <6 years old) with intellectual disability were recruited at research sites and allocated to intervention (E-PAtS and usual practise) or control (usual practise) on a 1:1 basis at cluster (family) level. Data were collected at baseline and 3 and 12 months' post-randomisation. The following feasibility outcomes were assessed: participant recruitment rates and effectiveness of recruitment pathways; retention rates; intervention adherence and fidelity; service provider recruitment rates and willingness to participate in a future trial; barriers and facilitating factors for recruitment, engagement, and intervention delivery; and feasibility of collecting outcome measures. Results: Seventy-four families were randomised to intervention or control (n = 37). Retention rates were 72% at 12 months post-randomisation, and completion of the proposed primary outcome measure (WEMWBS) was 51%. Recruitment of service provider organisations and facilitators was feasible and intervention implementation acceptable. Adherence to the intervention was 76% and the intervention was well-received by participants; exploratory analyses suggest that adherence and attendance may be associated with improved well-being. Health economic outcome measures were collected successfully and evidence indicates that linkage with routine data would be feasible in a future trial. Conclusions: The E-PAtS Feasibility RCT has demonstrated that the research design and methods of intervention implementation are generally feasible. Consideration of the limitations of this feasibility trial and any barriers to conducting a future definitive trial, do however, need to be considered by researchers. Clinical Trial Registration: https://www.isrctn.com, identifier: ISRCTN70419473.
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Affiliation(s)
- Elinor Coulman
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Nick Gore
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, United Kingdom
| | - Gwenllian Moody
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Melissa Wright
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Jeremy Segrott
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - David Gillespie
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Fiona Lugg-Widger
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Sungwook Kim
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jill Bradshaw
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, United Kingdom
| | - Rachel McNamara
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Andrew Jahoda
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Geoff Lindsay
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
| | | | - Vaso Totsika
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
- Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, VIC, Australia
| | - Catherine Stanford
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
| | - Samantha Flynn
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
| | - Annabel Carter
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, United Kingdom
| | - Christian Barlow
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Richard P. Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
- Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, VIC, Australia
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Murray CA, Hastings RP, Totsika V. Clinical utility of the parent-reported Strengths and Difficulties Questionnaire as a screen for emotional and behavioural difficulties in children and adolescents with intellectual disability. Br J Psychiatry 2021; 218:323-325. [PMID: 33198827 DOI: 10.1192/bjp.2020.224] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We assessed the clinical utility of the parent-reported Strengths and Difficulties Questionnaire (SDQ) as a screen for emotional and behavioural difficulties in 626 children and young people with intellectual disability. Using the Developmental Behavior Checklist (DBC2-P) to determine clinical caseness, the area under the curve for the SDQ total difficulties score was 0.876 (95% CI 0.841-0.911), indicating that it is a good measure for identifying significant emotional and behavioural difficulties requiring further investigation. Analyses supported the use of the same SDQ cut-off for those with and without intellectual disability, which may assist with consistent and comparable assessment in clinical practice.
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Affiliation(s)
- Caitlin A Murray
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK; and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK; and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia; and Division of Psychiatry, University College London, UK
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Langley E, Totsika V, Hastings RP, Bailey T. Family Relationships and Their Associations With Perceptions of Family Functioning in Mothers of Children With Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:187-202. [PMID: 33910238 DOI: 10.1352/1944-7558-126.3.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
We explored whether reports of three dyadic relationships (marital/partner, parent-child, sibling) were related to perceptions of family functioning in 467 mothers of children with intellectual disability aged 4-15 years. Structural equation models were fitted to examine associations between relationship indicators and family functioning. The final structural model showed that partner relationship satisfaction, partner disagreement, child-parent conflict, and sibling relationship warmth accounted for the most variance in family functioning, with partner relationship satisfaction having the strongest positive association. Dimensions of dyadic relationships appear to be associated with broader constructs of family functioning in this sample of mothers, signifying the potential for systemic intervention.
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Affiliation(s)
- Emma Langley
- Emma Langley, University of Warwick, Coventry, UK
| | | | | | - Tom Bailey
- Richard P. Hastings and Tom Bailey, University of Warwick, Coventry, UK
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Bailey T, Hastings RP, Totsika V. COVID-19 impact on psychological outcomes of parents, siblings and children with intellectual disability: longitudinal before and during lockdown design. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:397-404. [PMID: 33634520 PMCID: PMC8013753 DOI: 10.1111/jir.12818] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Parents of children with intellectual disability (ID) report comparatively lower levels of well-being than parents of children without ID. Similarly, children with ID, and to a lesser extent their siblings, are reported to show comparatively higher levels of behaviour and emotional problems. Psychological problems may be accentuated by restrictions associated with the COVID-19 pandemic, due to increased social, caring and economic stressors and reduced social support. However, existing studies have not been able to examine the impact of COVID-19 restrictions accounting for pre-COVID levels of well-being in these families. In a naturalistic design, we examined outcomes for parents, siblings and children with ID in a two-wave longitudinal study where Wave 2 data were gathered for some families before and some during COVID-19 restrictions. METHODS Parents of children with ID who took part in a Wave 2 survey pre-lockdown (n = 294) and during/post-lockdown (n = 103) completed a number of measures about their well-being and the behaviour and emotional problems of both their child with ID and their nearest-in-age sibling. These same measures had also been completed for all families 2-3 years previously in Wave 1 of the study. RESULTS After accounting for covariates including family socio-economic circumstances, pre-lockdown and post-lockdown groups did not differ on Waves 1 to 2 change for measures of parental psychological distress, life satisfaction, the impact of caregiving on their lives or perceived positive gains; nor child or sibling internalising or externalising behaviour problems. CONCLUSIONS Findings of the current study indicate that during and shortly after the COVID-19 lockdown in the United Kingdom, well-being in families of children with an ID (as reported by parents) was at similar levels compared with prior to the lockdown period.
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Affiliation(s)
- T. Bailey
- CEDARUniversity of WarwickCoventryUK
| | - R. P. Hastings
- CEDARUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVicAustralia
| | - V. Totsika
- CEDARUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVicAustralia
- Department of PsychiatryUniversity College LondonLondonUK
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Jess M, Flynn S, Bailey T, Hastings RP, Totsika V. Failure to replicate a robust Down syndrome advantage for maternal well-being. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:262-271. [PMID: 33404135 PMCID: PMC8049030 DOI: 10.1111/jir.12808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/26/2020] [Accepted: 12/08/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Family members caring for children with intellectual disability (ID) routinely report heightened levels of psychological distress. However, families of children with Down syndrome typically report better outcomes (known as the Down syndrome advantage). We examined whether the Down syndrome advantage would be present for maternal psychological distress, impact of caregiving, life satisfaction and perceived positive impact of the child with ID when controlling for external variables. METHODS Mothers of children with Down syndrome (n = 111) and mothers of children with ID of mixed aetiologies (n = 196) completed measures about their own mental health, perceived impact of caregiving, life satisfaction and perceived positive impact of their child on themselves and the family unit. RESULTS A series of group comparisons revealed small to moderate differences supporting the presence of a putative Down syndrome advantage in relation to personal maternal well-being outcomes. However, when child-related characteristics and external variables were controlled, the Down syndrome advantage was no longer present, with reduced, small effect sizes observed for all maternal outcomes. CONCLUSIONS Initial group differences in psychological distress and life satisfaction were largely associated with family poverty, indicating that the Down syndrome advantage may be less robust than previously thought. Future research should seek to move beyond examining the existence of the putative Down syndrome advantage and focus on how families of children with Down syndrome experience family life, including longitudinal research exploring responses to life cycle and transition challenges.
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Affiliation(s)
- M. Jess
- CEDARUniversity of WarwickCoventryUK
| | - S. Flynn
- CEDARUniversity of WarwickCoventryUK
| | - T. Bailey
- CEDARUniversity of WarwickCoventryUK
| | - R. P. Hastings
- CEDARUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
| | - V. Totsika
- CEDARUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
- Division of Psychiatry, Faculty of Brain SciencesUniversity College LondonLondonUK
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Jess M, Bailey T, Pit-Ten Cate IM, Totsika V, Hastings RP. Measurement invariance of the Positive Gains Scale in families of children with and without disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 103:103662. [PMID: 32438248 DOI: 10.1016/j.ridd.2020.103662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 04/18/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Despite the high frequency of case-control studies in the developmental disability literature, there is a paucity of research establishing the measurement equivalence of instruments used, and particularly those relating to positive perceptions and experiences in family disability research. AIMS The present study sought to establish measurement invariance for the Positive Gains Scale (PGS) across 1219 mothers of children with developmental disabilities, 234 mothers of children with spina bifida/hydrocephalus, and 157 mothers of children without disabilities. METHODS AND PROCEDURES A three-step test for measurement invariance across the three groups was conducted using Multigroup Confirmatory Factor Analysis. OUTCOMES AND RESULTS Loadings between the three groups were invariant, suggesting the criteria to assume metric invariance was met. However, the assumption of scalar invariance was not met, suggesting that item intercepts differed between the three groups. CONCLUSIONS AND IMPLICATIONS Our findings suggest that the PGS cannot be meaningfully used to compare outcomes between mothers of children with developmental disabilities and other mothers. These findings may have wider implications for research utilising well-being measures to make comparisons with carers of children with developmental disabilities.
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Affiliation(s)
- Mikeda Jess
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, UK
| | - Tom Bailey
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, UK.
| | - Ineke M Pit-Ten Cate
- Luxembourg Centre for Educational Testing (LUCET), University of Luxembourg, Luxembourg
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, UK; Division of Psychiatry, University College London, UK; Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, UK; Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Australia
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