How is your mind-set? Proof of concept for the measurement of the level of emotional development

A brief version of the Scale of Emotional Development - Short

BACKGROUND

The Scale of Emotional Development - Short (SED-S) captures the level of emotional development in persons with a disorder of intellectual development (DID) with 200 items on five developmental levels. The study aims to develop a brief version of the SED-S.

METHODS

Based on item analysis (proportions, χ2 -test, Spearman's ρ and corrected item-total correlation), a brief version of the SED-S was developed in a sample of 224 adults with a DID (n1 ) and validated in a second independent matched sample (n2  = 223).

RESULTS

Item reliability ranged per item set from Cronbach's α = 0.835 to 0.924. Weighted kappa resulted in κω  = 0.743 (P < 0.001, 95% confidence interval = 0.690-0.802). Overall agreement of the brief version with the original SED-S was PO  = 0.7. The brief version of the SED-S showed weaknesses in distinguishing level 2 from the adjacent levels.

CONCLUSIONS

The brief version of the SED-S showed good reliability and moderate to good validity results. Items of phase 2 and, to some degree, of phase 5 should be revised to further improve the psychometric properties of the scale.

Scale of Emotional Development - Short: reliability and validity in adults with intellectual disability

BACKGROUND

Intellectual disability (ID) is often associated with delays in emotional development (ED). The Scale of Emotional Development - Short (SED-S) was developed to assess the level of ED and to adapt treatment and care accordingly.

METHODS

In a sample of 724 adults from five study sites in three countries, a confirmatory factor analysis with a one-factor model was conducted on the entire dataset as well as in different subgroups. Furthermore, internal consistency was investigated using Cronbach's alpha.

RESULTS

The confirmatory factor analysis indicated that a single-factor model fits the SED-S data well. The subgroup analyses revealed good model fit, regardless of the severity of ID and irrespective of sex or the presence of autism spectrum disorder or psychiatric disorders. Internal consistency was excellent for the entire sample (Cronbach's alpha = 0.93) and various subgroups (0.869-0.938).

CONCLUSION

The results of this study suggest that the SED-S is psychometrically sound and can be used to assess the level of ED in adults with ID.

Brief report comparing the Scale of Emotional Development - Short (SED-S) with other scales for emotional development

BACKGROUND

Different instruments were devised for assessing emotional development (ED) level in persons with an intellectual disability (ID), that is, the Scale of Emotional Development - Short (SED-S), the Scheme for Appraisal of Emotional Development (SAED), the Scale for Emotional Development - Second Revision (SED-R2 ) and the Schaal voor Emotionele Ontwikkeling - Lukas (SEO-Lukas). The aim of this study was to compare the level of emotional functioning as assessed with the SED-S with the SAED, SED-R2 and SEO-Lukas.

METHODS

Emotional development was measured in adults with ID with the SED-S (N = 186) and the SAED (n = 85), the SED-R2 (n = 50) and the SEO-Lukas (n = 51). Correlation analysis and Cohen's kappas were calculated between the SED-S and the three respective scales. Internal consistencies (Cronbach's alpha) of the four scales were determined.

RESULTS

The SED-S results correlated most with the SEO-Lukas (γ = 1; кω = 0.936) followed by the SAED (γ = 0.809; кω = 0.343) and least by the SED-R2 (γ = 0.665; кω = 0.182). The stage of ED assessed with the SED-S was lower than the ED results measured with the SAED, but higher than with the SED-R2 and most similar to the SEO-Lukas. Cronbach's alphas were high, ranging from 0.853 to 0.975.

CONCLUSIONS

Given the respective differences between the scales, the SED-S may equalise the results as compared with previous versions.

More than a Physical Problem: The Effects of Physical and Sensory Impairments on the Emotional Development of Adults with Intellectual Disabilities

With the introduction of the ICD-11 and DSM-5, indicators of adaptive behavior, including social-emotional skills, are in focus for a more comprehensive understanding of neurodevelopmental disorders. Emotional skills can be assessed with the Scale of Emotional Development-Short (SED-S). To date, little is known about the effects of physical disorders and sensory impairments on a person's developmental trajectory. The SED-S was applied in 724 adults with intellectual disabilities, of whom 246 persons had an additional physical and/or sensory impairment. Ordinal regression analyses revealed an association of movement disorders with more severe intellectual disability and lower levels of emotional development (ED) on the overall and domain levels (Others, Body, Material, and Communication). Visual impairments predicted lower levels of ED in the SED-S domains Material and Body, but not the overall level of ED. Hearing impairments were not associated with intellectual disability or ED. Epilepsy correlated only with the severity of intellectual disability. Multiple impairments predicted more severe intellectual disabilities and lower levels of overall ED. In conclusion, physical and sensory impairments may not only affect physical development but may also compromise intellectual and emotional development, which should be addressed in early interventions.

Developmental Delays in Socio-Emotional Brain Functions in Persons with an Intellectual Disability: Impact on Treatment and Support

Intellectual disability is a neurodevelopmental disorder with a related co-occurrence of mental health issues and challenging behaviors. In addition to purely cognitive functions, socio-emotional competencies may also be affected. In this paper, the lens of developmental social neuroscience is used to better understand the origins of mental disorders and challenging behaviors in people with an intellectual disability. The current concept of intelligence is broadened by socio-emotional brain functions. The emergence of these socio-emotional brain functions is linked to the formation of the respective neuronal networks located within the different parts of the limbic system. Thus, high order networks build on circuits that process more basic information. The socio-emotional skills can be assessed and complement the results of a standardized IQ-test. Disturbances of the brain cytoarchitecture and function that occur at a certain developmental period may increase the susceptibility to certain mental disorders. Insights into the current mental and socio-emotional functioning of a person may support clinicians in the calibration of treatment and support. Acknowledging the trajectories of the socio-emotional brain development may result in a more comprehensive understanding of behaviors and mental health in people with developmental delays and thus underpin supports for promotion of good mental health in this highly vulnerable population.

Social individuation: Extending the scale of emotional development - Short (SED-S) for adolescent reference ages

BACKGROUND

The SED-S is a standardized diagnostic instrument for assessing emotional development (ED) in people with a disorder of intellectual development. The SED-S defines five ED stages covering emotional reference ages up to 12 years in eight domains (5 items per domain). Stage 6 will extend the scale for early adolescent reference ages.

AIMS

The aim of this study is to define the SED-S items for stage 6 ('Social Individuation').

METHODS AND PROCEDURES

Experts in developmental psychology phrased 56 items (7 items/domain) describing typical behaviors for emotional reference ages 13th-18th year (145th-216th month) in English, German and Dutch. Twenty-eight independent experts assessed the items' content validity and observability on a Likert scale (0 = good to 3 = unacceptable). Two items/domain with the lowest ratings were excluded to finally select 5 items/domain for SED-S stage 6.

OUTCOMES AND RESULTS

The ratings were good with results ranging from 0.06 to 0.78 for validity and 0.06-1.78 for observability. After exclusion of the 2 lowest ranking items/domain, a set of 40 items was selected.

CONCLUSIONS AND IMPLICATIONS

The SED-S is extended to allow the assessment of emotional reference ages up to 18 years. Further research should evaluate the scale's psychometric properties. WHAT THIS PAPER ADDS?: The current version of the SED-S covers emotional reference ages up to 12 years (144 months). Extending the SED-S for emotional reference ages up to 18 years (145th-216th months of life) in Dutch, German and English allows better differentiation in the higher ED range and expands the applicability of the scale. Specifically, it makes it possible to apply the SED-S in people with borderline intellectual functioning. Accounting for the level of ED may provide valuable information about the behaviors and needs of individuals with higher reference ages and may support targeted treatment options in a population highly vulnerable to behavioral or mental disorders.

Behavioural phenomena in persons with an intellectual developmental disorder according to the level of emotional development

BACKGROUND

Challenging behaviours in people with an intellectual developmental disorder (IDD) are complex and often difficult to understand. The developmental perspective may provide additional insights into the specific behavioural patterns and underlying motives in different emotional reference ages.

METHODS

The behaviours of 185 adults with IDD who were admitted to psychiatry were systematically assessed with the Aberrant Behaviour Checklist (ABC) and the Modified Overt Aggression Scale (MOAS). The association of the different behaviours with various emotional reference age groups as assessed with the Scale of Emotional Development - Short (SED-S) was analysed to deduce behavioural patterns typical for a certain level of functioning.

RESULTS

Overall, the severity of challenging behaviours decreases in higher emotional reference age groups. Physical aggression was most prevalent in persons in the second phase of emotional development (7-18 months reference age). In SED-S-1 (reference age 0-6 months), the persons appeared to be searching for physical comfort and showed high scores in social withdrawal, stereotypies and aggression towards the self. Persons functioning in SED-S-2 (reference age 7-18 months) scored highest in irritability and physical aggression (searching for security), while those in SED-S-3 (19-36 months) exhibited the searching for autonomy type characterised by defiant and socially inappropriate behaviours. Persons with an emotional reference age of 4-7 years (SED-S-4) showed inappropriate speech, verbal self-regulation and depressive-like behavioural aspects (searching for identity).

CONCLUSIONS

The behavioural phenomena exhibited in a certain emotional reference age may support the clinician to differentiate behavioural problems from psychopathological symptoms to yield the proper diagnosis.

Scale of emotional development-short: Reliability and validity in two samples of children with an intellectual disability

BACKGROUND

Intellectual disability (ID) is often accompanied by more significant delays in emotional development than in cognitive development. Diagnostic assessment can provide insight into emotional functioning. However, few standardized assessment instruments are available.

AIMS

Examine the reliability and validity of the Scale of Emotional Development-Short (SED-S) in children with ID.

METHODS AND PROCEDURES

This methodological instrument validation study was conducted in the Netherlands and Switzerland with children (N = 118) older than 3 and younger than 18 years with ID ranging from profound to mild. Measures included: demographic and medical data, SED-S, and the Vineland. Coherence and reliability of the SED-S were determined using Cronbach's alpha, and validity was examined using Goodman and Kruskal's γ, Kruskal-Wallis H, and Mann-Whitney U tests.

OUTCOMES AND RESULTS

The reliability of the SED-S was high, the convergent validity was good, and divergent validity was indicated in relation to autism spectrum disorder (ASD), visual and/or auditory impairment, and adaptive functioning.

FURTHER RESEARCH

Research is needed to better understand the implications of ASD and visual and/or auditory impairment on emotional development and their association with (normal) intelligence. Children with ID may also benefit from (more) detailed guidelines for imbalanced profiles on the SED-S.

The impact of emotional development in people with autism spectrum disorder and intellectual developmental disability

BACKGROUND

Intellectual developmental disabilities (IDDs) and autism spectrum disorders (ASDs) are developmental conditions, which may also be associated with impairments in emotional development (ED). ED can be assessed using the Scale of Emotional Development - Short (SED-S), a five-stage model consisting of eight domains, which allows to study the relationship between ASD and ED in people with IDD.

METHODS

In this retrospective study, the level of ED was compared in 327 adults with IDD with [n = 83; mean age 38.3 years; level of IDD: mild (6), moderate (21), severe (45) and profound (11)] and without [n = 244, mean age 36.9 years; level of IDD: mild (67), moderate (73), severe (68) and profound (36)] ASD. The discriminative ability of the SED-S was determined by a regression in a training and a validation sample.

RESULTS

The level of ED correlated with the severity of IDD (r_s  = -.654) and the presence of ASD (r_s  = -.316). People with additional ASD showed lower levels of ED compared with those with IDD only (mean reference ages 7-18 vs 19-36 months). The developmental profiles were equally balanced in ASD and IDD-only. A regression analysis revealed three domains ('Relating-to-Peers', 'Differentiating-Emotions', and 'Regulating-Affect') to be useful for ASD assignment (AUC > 0.70, sensitivity 0.76-0.80, specificity 0.62-0.63).

CONCLUSIONS

In people with IDD, additional ASD was associated with delays in ED, which may be considered in diagnostics, treatment and care.

[Mental health in persons with intellectual disability]

People with intellectual disability (ID) have a high vulnerability to develop mental health problems. The prevalence of mental disorders is higher than in the general population and, in addition, adults with ID often show behavioral problems that imply a need for psychiatric psychotherapeutic care. In view of the impairments of intellectual functioning, impaired adaptive behavioral skills and physical illnesses, the needs of this target group are usually complex and require particular expertise. A number of specific assessment instruments are available for target group-specific diagnostics to collate the cognitive performance and emotional development as well as for psychopathological symptoms and behavioral disorders. To improve the accuracy of diagnosis in the ID population, existing alternatives to DSM or ICD should be applied especially to adults with moderate or severe ID. Guidelines for psychopharmacotherapy and adapted user guides for psychotherapeutic treatment provide support in the context of target group-specific treatment.