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BACKGROUND: This systematic review aimed to explore the effects of sport and physical activity on behaviour and emotional problems, mental health and psychosocial well-being of children and adolescents with intellectual disability. METHOD(S): Five databases were searched systematically (ERIC, MEDLINE, PsycINFO, SportDISCUS and SCOPUS), up to 28 February 2021. Thirty-two studies met criteria for inclusion. RESULT(S): Studies in this review included case studies (n = 15), treatment trials (n = 14), cross sectional studies (n = 2) and a cohort study (n = 1). Evidence was positive, though high risk of bias in treatment trials (7 of 14 rated high) meant generalisability of results was limited. CONCLUSION(S): The available evidence suggests a positive relationship between physical activity and improved behaviour and emotional problems, mental health and psychosocial well-being; however, more robust randomised controlled trials are required to confirm this.Copyright © 2021 John Wiley & Sons Ltd.

The Exploring Together program is a group-based parent training program that comprises separate parent, child, and teacher components, and a combined parent-child interactive component. A cluster-randomized trial design was used to compare the Exploring Together program with (Exploring Together; ET) and without (Exploring Together-Adapted; ET-Adapted) the parent-child interactive component. One hundred and thirty-six parents and their children (aged 5-10 years) with externalizing and/or internalizing problems participated in the trial, recruited from primary schools. There was a significant reduction in negative parenting behavior across both treatment groups (ET and ET-Adapted) but no significant improvement in positive parenting behaviors. Parenting self-efficacy improved significantly across both treatment groups however there was no significant change in parenting satisfaction or parenting stress. There was no consistent evidence of superiority of one version of the Exploring Together program over the other. Further investigation regarding treatment dosage and mastery of parenting skills associated with the program is warranted.Copyright © 2021. The Author(s).

Background: People with intellectual disability face a number of barriers to participation in physical activity. This paper aimed to determine rates of sport and physical activity participation in an Australian sample of adults with intellectual disability, compared with rates of participation in the general Australian population. A secondary aim was to investigate factors that may contribute to participation of adults with intellectual disability. Method(s): Participants were part of the Australian Child to Adult Development (ACAD) study, consisting of a community sample with intellectual disability (n = 305), groups of adults with autism (n = 94), Down syndrome (n = 64), fragile X syndrome (n = 52), Williams syndrome (n = 45), and Prader-Willi syndrome (n = 30). Participation in sport/physical activity was reported over the past 3 months. Rates of participation were reported for adults with intellectual disability and compared with rates in a general Australian population sample. The relationship between participation in physical activity and age, degree of intellectual disability, physical mobility, living situation, socio-economic disadvantage, and behaviour and emotional problems were also conducted. Result(s): Participants in the ACAD community sample with intellectual disability participated in sport/physical activity at lower rates than the general Australian population (42% compared with 71%). Having no physical mobility impairment was significantly associated with higher rates of participation. Those with Down syndrome participated in sport/physical activity at higher rates than the community sample with intellectual disability, while no difference in sport/physical activity participation was observed in the groups with autism or other syndromes. Conclusion(s): Australian adults with intellectual disability participate in sport and physical activity at lower rates than the general population. Having a physical mobility impairment was associated with lower

Background: Women of refugee background may be particularly vulnerable to perinatal mental illness, possibly due to increased exposure to psychosocial stressors associated with their forced migration and post-resettlement adjustment. Aim(s): This study aimed to compare psychosocial risk factors reported by women of refugee background receiving maternity services at a public hospital, to those reported by Australian-born women in the same hospital. It further aimed to examine the referrals offered, and accepted, by the women of refugee background reporting psychosocial risk factors for perinatal mental illness. Method(s): A retrospective hospital record review was conducted to compare the antenatal and postnatal psychosocial risk factors of 100 women of refugee background and 100 Australian-born women who gave birth at a public hospital in Victoria between 1 July 2015 and 30 April 2016, and who had completed the Maternity Psychosocial Needs Assessment. Finding(s): Women of refugee background were more likely than Australian-born women to report financial concerns and low social support at antenatal assessment, but were less likely to report prior mental health problems than Australian-born women at either assessment point. Both groups reported low rates of family violence compared to published prevalence rates. Of the women of refugee background assessed antenatally, 23% were offered referrals, with 52% take-up. Postnatally, 11.2% were offered referrals, with 93% take-up. Discussion/conclusion: This study showed elevated rates of psychosocial risk factors among women of refugee background, however, possible under-reporting of mental health problems and family violence raises questions regarding how to assess psychosocial risk factors with different cultural groups. Lower antenatal referral take-up suggests barriers to acceptance of referrals may exist during pregnancy.Copyright © 2020 Australian College of Midwives

Despite the longstanding theoretical association in the attachment literature between maternal trauma history and disturbances in the mother-infant interaction, few studies have investigated mechanisms of transmission of traumatogenic relational patterns in high-risk mother-infant dyads. This study investigated interrelationships among maternal trauma history, distorted maternal representations (DMRs, i.e. disturbed thoughts and feelings about the infant and self-as-parent), maternal mentalisation (i.e. capacity to conceive of self and other's intentions in terms of mental states including thoughts, feelings, and desires), and quality of interaction in a clinical sample of mothers with Borderline Personality Disorder (BPD) features and their infants (N = 61). Measures used included the Childhood Trauma Questionnaire, Parent Development Interview, Mother-Infant Relationship Scale, Borderline Symptom Checklist-23, and the Emotional Availability Scales. The results indicated BPD features mediated the relationship between maternal trauma history and DMRs predicting disturbance in interaction. In addition, analyses showed that maternal mentalisation had a buffering effect between DMRs and maternal non-hostility and yet the severity of BPD features moderated the relationship between mentalisation and DMRs. The findings suggest postpartum borderline pathology may adversely impact the experience of being a parent for women with a relational trauma history including deficits in mentalisation (i.e. hypermentalising) and disturbances in the mother-infant interaction. Implications for research and clinical practice are discussed.Copyright © 2020 Michigan Association for Infant Mental Health

Background: Parents of children with developmental or intellectual disabilities tend to report greater use of coercive parenting practices relative to parents of typically developing children, increasing the risk of adverse child outcomes. However, to date, there is limited research exploring the role and relative contribution of modifiable and nonmodifiable risk factors in parents of children with a disability. The present study aimed to explore the role of various modifiable and nonmodifiable parenting, family and sociodemographic factors associated with the use of coercive parenting practices in parents of children with a disability. Method(s): Caregivers (N = 1392) enrolled in the Mental Health of Young People with Developmental Disabilities (MHYPeDD) programme in Australia completed a cross-sectional survey about their parenting and their child aged 2-12 years with a disability. Measures covered a range of domains including relevant demographic and family background, use of coercive parenting practices, intensity of child behavioural difficulties and questions relating to parent and family functioning such as parental self-efficacy, adjustment difficulties and quality of family relationships. Result(s): Parents of older children, those who were younger at the birth of their child, and parents who were co-parenting or working reported more use of coercive parenting practices. Greater intensity of child difficulties, poorer parental self-efficacy and parent-child relationships, and more parental adjustment difficulties were also significantly associated with more use of coercive parenting. Examination of the relative contribution of variables revealed parent-child relationship was a key contributing factor, followed by intensity of child behaviour problems, parent adjustment and parent confidence. Conclusion(s): These findings highlight a range of factors that should be targeted and modified through upstream prevention programmes and further inform our understand

Background Children and young people with intellectual disability and/or Autism Spectrum Disorder (autism) experience higher rates of mental health problems, including depression, than their typically developing peers. Although international guidelines suggest psychological therapies as first-line intervention for children and young people, there is limited evidence for psychological therapy for depression in children and young people with intellectual disability and/or autism. Aims To evaluate the current evidence base for psychological interventions for depression in children and young people with intellectual disability and/or autism, and examine the experiences of children and young people with intellectual disability and/or autism, their families and therapists, in receiving and delivering psychological treatment for depression. Method Databases were searched up to 30 April 2020 using pre-defined search terms and criteria. Articles were independently screened and assessed for risk of bias. Data were synthesised and reported in a narrative review format. Results A total of 10 studies met the inclusion criteria. Four identified studies were clinical case reports and six were quasi-experimental or experimental studies. All studies were assessed as being of moderate or high risk of bias. Participants with intellectual disability were included in four studies. There was limited data on the experiences of young people, their families or therapists in receiving or delivering psychological treatment for depression. Conclusions Well-designed, randomised controlled trials are critical to develop an evidence base for psychological treatment for young people with intellectual disability and/or autism with depression. Future research should evaluate the treatment experiences of young people, their families and therapists.Copyright © The Author(s), 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.

BACKGROUND: Children and young people with intellectual disability and/or Autism Spectrum Disorder (autism) experience higher rates of mental health problems, including depression, than their typically developing peers. Although international guidelines suggest psychological therapies as first-line intervention for children and young people, there is limited evidence for psychological therapy for depression in children and young people with intellectual disability and/or autism. AIMS: To evaluate the current evidence base for psychological interventions for depression in children and young people with intellectual disability and/or autism, and examine the experiences of children and young people with intellectual disability and/or autism, their families and therapists, in receiving and delivering psychological treatment for depression. METHOD(S): Databases were searched up to 30 April 2020 using pre-defined search terms and criteria. Articles were independently screened and assessed for risk of bias. Data were synthesised and reported in a narrative review format. RESULT(S): A total of 10 studies met the inclusion criteria. Four identified studies were clinical case reports and six were quasi-experimental or experimental studies. All studies were assessed as being of moderate or high risk of bias. Participants with intellectual disability were included in four studies. There was limited data on the experiences of young people, their families or therapists in receiving or delivering psychological treatment for depression. CONCLUSION(S): Well-designed, randomised controlled trials are critical to develop an evidence base for psychological treatment for young people with intellectual disability and/or autism with depression. Future research should evaluate the treatment experiences of young people, their families and therapists.

BACKGROUND: Behaviour and emotional problems are highly prevalent in children with autism spectrum disorder (ASD). In typically developing children, attachment quality acts as a risk/protective factor for behavioural outcomes and adjustment, warranting investigation in children with ASD. METHOD(S): We investigated the relationship between attachment and child behaviour and emotional problems in children with ASD and comorbid intellectual disability. Data were collected from parent-child dyads where children were diagnosed with ASD and ID (n = 28) or other developmental disabilities (n = 20). RESULT(S): Children with ASD had higher levels of behaviour and emotional problems and more attachment difficulties than children with other developmental disabilities. Poorer attachment quality contributed uniquely to the variance in child behaviour and emotional problems. CONCLUSION(S): Interventions targeting behaviour and emotional problems in children with ASD may benefit from an attachment model which addresses the child's difficulty in using caregivers as a coregulatory agent of emotions.Copyright © 2019 John Wiley & Sons Ltd.

Objective: Over half of the world's refugee population are under the age of 18 years. This systematic review aims to summarize the current body of evidence for the prevalence of mental illness in child and adolescent refugee populations. Method(s): Eight electronic databases, gray literature, and Google Scholar were searched for articles from 1 January 2003 to 5 February 2018. Strict inclusion criteria regarding the diagnosis of mental illness were imposed. Study quality was assessed using a template according to study design, and study heterogeneity using the I2 statistic. Random effects meta-analyses results were presented given heterogeneity among studies. The protocol for this systematic review was registered with PROSPERO (CRD42016046349). Result(s): Eight studies were eligible, involving 779 child and adolescent refugees and asylum seekers, with studies conducted in 5 countries. The overall prevalence of posttraumatic stress disorder (PTSD) was 22.71% (95% CI 12.79-32.64), depression 13.81% (95% CI 5.96-21.67), and anxiety disorders 15.77% (95% CI 8.04-23.50). Attention-deficit/hyperactivity disorder (ADHD) was 8.6% (1.08-16.12) and oppositional defiant disorder (ODD) was 1.69% (95% CI -0.78 to 4.16). Because of the high heterogeneity, further subgroup analyses were conducted. Conclusion(s): Refugee and asylum seeker children have high rates of PTSD, depression, and anxiety. Without the serious commitment by health and resettlement services to provide early support to promote mental health, these findings suggest that a high proportion of refugee children are at risk for educational disadvantage and poor social integration in host communities, potentially affecting their life course.Copyright © 2019 American Academy of Child and Adolescent Psychiatry

This systematic review and meta-analysis evaluates the efficacy of parent training group interventions to treat child externalizing and/or internalizing problems. A search identified 21 randomized controlled trials of parent group interventions aimed at ameliorating child externalizing and/or internalizing problems in children aged 4-12 years. Random effects meta-analyses yielded significant pooled treatment effect size (g) estimates for child externalizing (g=-0.38) and internalizing problems (g=-0.18). Child anxiety symptoms or internalizing problems evident in children with externalizing behavior problems did not change significantly following intervention. Study quality was a statistically significant moderator of treatment response for child externalizing problems, however hours of planned parent group treatment and treatment recipient were not. Findings support the use of parent group interventions as an effective treatment for reducing externalizing problems in children aged 4-12 years. Whilst statistically significant, programs had a limited impact on internalizing symptoms, indicating a need for further investigation.

Background: The Strengths and Difficulties Questionnaire (SDQ) is widely used to measure emotional and behavioural problems in typically developing young people, although there is some evidence that it may also be suitable for children with intellectual disability (ID). The Developmental Behaviour Checklist - Parent version (DBC-P) is a measure of emotional and behavioural problems that was specifically designed for children and adolescents with an ID. The DBC-P cut-off has high agreement with clinical diagnosis. The aim of this study was to estimate the relationship between DBC-P and SDQ scores in a sample of children with ID. Method(s): Parents of 83 young people with ID aged 4-17 years completed the parent versions of the SDQ and the DBC-P. We evaluated the concurrent validity of the SDQ and DBC-P total scores, and the agreement between the DBC-P cut-off and the SDQ cut-offs for 'borderline' and 'abnormal' behaviour. Result(s): The SDQ total difficulties score correlated well with the DBC-P total behaviour problem score. Agreement between the SDQ borderline cut-off and the DBC-P cut-off for abnormality was high (83%), but was lower for the SDQ abnormal cut-off (75%). Positive agreement between the DBC-P and the SDQ borderline cut-off was also high, with the SDQ borderline cut-off identifying 86% of those who met the DBC-P criterion. Negative agreement was weaker, with the SDQ borderline cut-off identifying only 79% of the participants who did not meet the DBC-P cut-off. Conclusion(s): The SDQ borderline cut-off has some validity as a measure of overall levels of behavioural and emotional problems in young people with ID, and may be useful in epidemiological studies that include participants with and without ID. However, where it is important to focus on behavioural profiles in children with ID, a specialised ID instrument with established psychometric properties, such as the DBC-P, may provide more reliable and valid information.Copyright © 2017 MENCAP and Intern

Background: Among children with intellectual disabilities, children with autism spectrum disorder (ASD) have higher rates of behaviour and emotional problems than those without ASD. Parent training programmes, such as Stepping Stones Triple P (SSTP), have been shown to reduce child behaviour and emotional problems. This study aimed to evaluate whether the community-based SSTP programme produced comparable outcomes for children with and without ASD (i.e. whether having ASD moderated the treatment outcome effect). Method(s): A subsample of 365 families who took part in the Stepping Stones Triple P (SSTP) programme was analysed, including children with an intellectual or developmental disability aged 2-10 years. Parents reported whether their child had been diagnosed with ASD and completed socio-demographic information and measures assessing child behaviour and emotional problems, and parenting style pre-, postintervention, and at 12-month follow-up. Result(s): Although the children with ASD (n = 230) had significantly higher rates of behaviour and emotional problems at all-time points compared to the children without ASD (n = 135), both groups demonstrated significant decreases in behaviour and emotional problems post-treatment. These gains were maintained at 12-month follow-up for overall behaviour and emotional problems, disruptive behaviours, self-absorbed behaviours and communication disturbance. There was however a small increase in anxiety at 12-month follow-up for children without ASD only. Additionally, there was a continued decrease in social relating problems for the children with ASD, but not for those without ASD. A similar pattern of improvement and maintenance was found for parenting skills (consistency, coercive and positive encouragement) between the parents of children with and without ASD. Conclusion(s): Overall, the community-based SSTP programme demonstrated a comparable effectiveness in reducing child behaviour and emotional problems and maintaini

Background Children with a developmental disability are three to four times more likely than their typically developing peers of developing significant emotional and behavioural problems. There is strong evidence to suggest that individual biological and psychological factors interact with family functioning to precipitate and perpetuate these problems. Aims This study examined the psychometric properties of a brief measure, the Parent and Family Adjustment Scales (PAFAS) for use with parents of children with a developmental disability. Methods A sample of 914 parents of children (M = 6.27 years) with a developmental disability participated in the study. Disabilities included Autism Spectrum Disorder and Intellectual Disability Results A confirmatory factor analysis supported a 16-item, four factor model of PAFAS Parenting, and an 11-item, three factor model of PAFAS Family Adjustment. The Parenting Scale measures parental consistency, coercive practices, use of encouragement and the quality of parent-child relationship. The Family Adjustment Scale measures parental emotional adjustment and partner and family support in parenting. Conclusions The current study indicated that the PAFAS demonstrates promise as a brief measure of multiple domains of family functioning important for families who have a child with a developmental disability.Copyright © 2017 Elsevier Ltd

BACKGROUND: For women of refugee background, the increased risk of mental illness associated with pregnancy is compounded by pre- and post-settlement stressors. In Australia, antenatal screening for depression and anxiety symptoms using the Edinburgh Postnatal Depression Scale is recommended for all women. Despite this, screening is not routinely implemented and little is known about barriers and enablers to implementation for women of refugee background. METHODS: Semi-structured interviews were conducted with a range of health professionals (n=28: midwives, obstetricians, perinatal mental health and refugee health experts, interpreters) and women of refugee background (n=9). Themes generated from thematic analysis were examined in relation to the Theoretical Domains Framework and Cultural Competence Conceptual Framework, followed by identification of effective behaviour change techniques to address the barriers and enablers identified by participants. These techniques formed the basis of recommendations to inform sustainable implementation of screening and referral. RESULTS: Almost all participants perceived perinatal mental health screening to be necessary and most recognised the importance of post-traumatic stress disorder (PTSD) screening. Barriers and enablers were identified and related to eight domains: knowledge, skills, professional roles, beliefs about capabilities and consequences, environmental context, social influences and behavioural regulation. CONCLUSIONS: This research clarifies how mental health screening may be integrated into routine antenatal care for women of refugee background, in order to improve provision of recommended care. These theory-informed recommendations include an inter-disciplinary approach, coordinating care within and across services, addition of PTSD screening, and effective communication with women.

This paper aims to synthesise the literature on attachment in children with Autism Spectrum Disorder (ASD), highlighting gaps in current research and applications for clinical practice. The research databases PsycINFO, Ovid Medline, and the Cochrane Library were searched for the terms "autism" and "attachment". Forty papers investigating attachment in children with ASD were identified and narratively reviewed. Seven samples were identified that reported attachment classifications using the Strange Situation Paradigm, with an average of 47% of children with ASD classified as secure (n = 186). With research to date concluding that children with ASD can form secure attachments, studies are now looking at risk and protective factors in the development of attachment, correlates of attachment, attachment disorders in children with ASD, and attachment-based interventions for children with ASD. Many of these studies are preliminary investigations with contradictory findings reported, highlighting important directions for future research.Copyright © 2016

Objective: Oxidative stress, inflammation and heavy metals have been implicated in the aetiology of autistic disorder. N-acetyl cysteine has been shown to modulate these pathways, providing a rationale to trial N-acetyl cysteine for autistic disorder. There are now two published pilot studies suggesting efficacy, particularly in symptoms of irritability. This study aimed to explore if N-acetyl cysteine is a useful treatment for autistic disorder. Method(s): This was a placebo-controlled, randomised clinical trial of 500 mg/day oral N-acetyl cysteine over 6 months, in addition to treatment as usual, in children with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnosis of autistic disorder. The study was conducted in Victoria, Australia. The primary outcome measures were the Social Responsiveness Scale, Children's Communication Checklist-Second Edition and the Repetitive Behavior Scale-Revised. Additionally, demographic data, the parent-completed Vineland Adaptive Behavior Scales, Social Communication Questionnaire and clinician-administered Autism Diagnostic Observation Schedule were completed. Result(s): A total of 102 children were randomised into the study, and 98 (79 male, 19 female; age range: 3.1-9.9 years) attended the baseline appointment with their parent/guardian, forming the Intention to Treat sample. There were no differences between N-acetyl cysteine and placebo-treated groups on any of the outcome measures for either primary or secondary endpoints. There was no significant difference in the number and severity of adverse events between groups. Conclusion(s): This study failed to demonstrate any benefit of adjunctive N-acetyl cysteine in treating autistic disorder. While this may reflect a true null result, methodological issues particularly the lower dose utilised in this study may be confounders.Copyright © The Royal Australian and New Zealand College of Psychiatrists.

There has been limited study of the relationship between child attachment and caregiver wellbeing amongst children with autism spectrum disorder (ASD). This study examined self-reported child attachment quality alongside caregivers' report of their own psychological distress, parenting stress and attachment style, amongst 24 children with high-functioning autism or Asperger's disorder (ASD; aged 7-14 years) and 24 typically developing children (aged 7-12 years), and their primary caregiver. Children with ASD were no less secure, but their caregivers were more stressed and reported more attachment-related anxiety, compared to typically developing dyads. Child attachment security was related to caregiver psychological distress and attachment style, but only amongst typically developing children. Impacts of emotion processing impairments on caregiver-child relationships in ASD are discussed.Copyright © 2016, Springer Science+Business Media New York.

Changes to the DSM-5 Autism Spectrum Disorder (ASD) criteria raised concerns among parents and practitioners that the criteria may exclude some children with Pervasive Developmental Disorder (PDD). Few studies have examined DSM-5 sensitivity and specificity in children less than 5 years of age. This study evaluated 185 children aged 20-55 months with DSM-IV PDD or developmental delay. Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) data was assigned to DSM-5 subdomains. Children displaying the required symptomatology were classified with DSM-5 ASD. DSM-IV clinical diagnoses were compared to DSM-5 classifications. Using combined ADI-R/ADOS information, sensitivity was.84 and specificity was.54. Comorbid behaviour and emotional problems were significantly lower in children with PDD that did not meet DSM-5 criteria.Copyright © 2016, Springer Science+Business Media New York.

Longitudinal research has demonstrated that social outcomes for adults with autism are restricted, particularly in terms of employment and living arrangements. However, understanding of individual and environmental factors that influence these outcomes is far from complete. This longitudinal study followed a community sample of children and adolescents with autism into adulthood. Social outcomes in relation to community inclusion and living skills were examined, including the predictive role of a range of individual factors and the environment (socio-economic disadvantage). Overall, the degree of community inclusion and living skills was restricted for the majority, and while childhood IQ was an important determinant of these outcomes, it was not the sole predictor. The implications of these findings in relation to interventions are discussed.Copyright © 2014, Springer Science+Business Media New York.

The literature on the association between behavioural and emotional problems and ageing in adults with Down syndrome (DS) without dementia is limited and has generally not reported on a wide range of behavioural and emotional problems. This research aimed to extend the field by examining the associations between age and a wide spectrum of behavioural and emotional problems in adults with DS without dementia. A preliminary analysis of the association between potential covariates and behavioural and emotional problems was also undertaken. Parents and caregivers completed a questionnaire on behavioural and emotional problems for 53 adults with DS aged between 16 and 56 years. Twenty-eight adults with DS and their caregivers were part of a longitudinal sample, which provided two time points of data approximately four years apart. Additionally, 25 participants with DS and their caregivers were from a cross sectional sample, which provided one time point of data. Random effects regression analyses were used to examine the patterns in item scores for behavioural and emotional problems associated with age.No significant associations between age and the range or severity of any behavioural and emotional items were found. This suggested a more positive pattern for ageing adults with DS than has been previously described. Given that behavioural and emotional problems were not associated with age, investigation into other factors that may be associated with the behavioural and emotional difficulties for adults with DS is discussed. © 2014 Elsevier Ltd.

This study investigated the relationship between structural language skills, and communication skills, adaptive behavior, and emotional and behavior problems in pre-school children with autism. Participants were aged 3-5 years with autism (n = 27), and two comparison groups of children with developmental delay without autism (n = 12) and typically developing children (n = 20). The participants were administered standardised tests of structural language skills, and parents completed the Vineland Adaptive Behavior Scales and the Developmental Behaviour Checklist. Results indicated that for children with autism, communication skills, and in particular receptive communication skills, were associated with social and daily living skills, and behavior problems. Receptive structural language skills were associated with expressive communication skills. There were no associations found between structural language skills and social or daily living skills, nor behavior problems. The results of this study suggest that communication skills are more closely linked to functional and behavioral outcomes in autism than structural language skills. © 2012 Springer Science+Business Media, LLC.

Purpose of review: This review examines an eclectic selection of publications from the past 12 months under the broad heading of 'assessment in intellectual disability'. Being unable to cover all possible publications the authors have concentrated on the assessment of pain (in those with severe intellectual disability), psychopathology, risk assessment and offending, autism, preference and choice, and dementia. Recent findings: Research into assessment has generally taken the form of developing new instruments, or adapting existing ones, or comparing the performance of a range of scales in a certain area. Researchers are using increasingly sophisticated psychometric analyses and refining the nature and purpose of tools for a range of clinical purposes. Summary: The result of recent effort in this area is better instruments, often developed by experienced researchers who have been working in their chosen area of speciality for some years. It has been a very worthwhile period of extension and consolidation. © 2005 Lippincott Williams & Wilkins.

This study examined whether repetitive behaviours were a differentiating feature of autism in children aged less than 51 months. The study also examined the relationship between age (chronological and developmental) and repetitive behaviours in young children with autism. Standardised developmental and diagnostic assessments were conducted on 55 children aged between 22 and 51 months, consisting of 40 developmentally delayed children with DSM-IV-TR Autistic Disorder and 15 developmentally delayed children without Autistic Disorder. Results indicated that several measures of repetitive behaviour, particularly more complex high-level ones, were significantly positively associated with the probability of receiving a diagnosis of autism. No significant relationships were found between developmental age and the presence of repetitive behaviours in children with autism, but younger chronological age was associated more with simple or low-level repetitive behaviours. © Steinkopff Verlag 2006.

Autism is characterized by impairments in three areas: (i) reciprocal social interaction; (ii) communication; and (iii) repetitive and stereotyped patterns of interest and behaviour. Despite the finding that parents notice abnormalities and problems with their child's development at a very early age, research shows that diagnoses are often made at an age beyond that recommended for the commencement of early intervention. This paper reviews the range of studies that have sought to elucidate the early features of autism in young, preschool children. Impairments in the capacity for reciprocal social interaction involving preverbal, verbal and non-verbal communication, and play and symbolic behaviour are the key features indicative of autism in infants and preschool children.

The aim of the current study was to investigate the manifestation of repetitive behaviour profiles in young children with a Pervasive Developmental Disorder. The sample consisted of 137 developmentally delayed children with a DSM-IV-TR Pervasive Developmental Disorder (PDD) and 61 developmentally delayed children without a PDD. An exploratory factor analytic investigation using 12 ADI-R repetitive behaviour items from parent report of children with a PDD reported the emergence of two factors. The first factor consisted of higher-level, "insistence on sameness" behaviours, and the second of lower-level, repetitive "sensory-motor" behaviours. This factor structure was also applicable to a more general group of young children with developmental delay, regardless of their diagnosis. Correlational analyses highlighted contrasting relationships between developmental variables and the different repetitive behaviour factors. These relationships were different for children with a PDD and those without a PDD. The findings have potential implications for the early assessment and diagnosis of PDDs in young children. © 2009 Springer Science+Business Media, LLC.

Purpose of review: This review examines papers published in the last 12 months in the area of mental health problems in children and adolescents with intellectual disability. The research is organized into the following sections: mental health investigations, specific syndromes, family/carer-related papers, treatment findings and theoretical papers. Recent findings: Significant findings are presented on the nature and prevalence of psychopathology in young people with intellectual disability and some specific syndrome groups. Summary: Whilst much progress has been made recently in defining the nature of mental health problems in children and adolescents with intellectual disability, further information is needed on the development of psychopathology in this population. It is now essential that more research be undertaken in developing efficacious treatments for these children and their families. © 2004 Lippincott Williams & Wilkins.

This study aimed to determine whether there were differences in behavioural and emotional disturbance (psychopathology) between children and adolescents with high-functioning autism and Asperger syndrome. Subjects consisted of 75 children and adolescents with high-functioning autism and 52 with Asperger's disorder (DSM-IV diagnoses). Psychopathology was measured using the Developmental Behaviour Checklist. Analysis of covariance (ANCOVA) controlling for the effects of age and cognitive level was used to determine whether the groups differed in their levels of psychopathology. It was found that children and adolescents with Asperger's disorder presented with higher levels of psychopathology than those with high-functioning autism, were more disruptive, antisocial and anxious, and had more problems with social relationships. The implications of these findings are discussed.

Few studies have focused on the validity of the ADI-R and ADOS in the assessment of preschool children with developmental delay. This study aimed to evaluate the diagnostic validity of the ADI-R and the ADOS in young children. Two-hundred and nine children aged 20-55 months participated in the study, 120 of whom received a diagnosis of autism. ADI-R and ADOS diagnostic classifications were compared to consensus clinical diagnoses. Children with a clinical diagnosis of autism scored significantly higher on all algorithm domains of the ADI-R and ADOS. The ADOS performed better than the ADI-R in comparison to consensus clinical diagnosis. Characteristics of the ADI-R and ADOS false positive and false negative cases are explored. Further research is recommended in terms of examining which items of the ADI-R best predict a diagnosis of autism for very young children with developmental problems. © 2007 Springer Science+Business Media, LLC.

Sums of responses to behaviour checklist items are commonly used as outcome measures. We argue for the use of mean scores. For sets of responses registering absence and presence at different levels of intensity of behaviours we also show that mean scores may usefully be 'decomposed' into separate measures of the range and the intensity of problematic behaviours. These separate measures are the proportion of items positively endorsed and the 'intensity index' - the proportion of positive scores that are above one. We illustrate their use with primary outcome scores from the Developmental Behaviour Checklist (DBC) in the Australian Child to Adult Development Study. The low mean scores of young people with profound intellectual disability are shown to be a function of the narrow range of behaviours they display rather than of the level of intensity of these behaviours, which is relatively high. Change over time in mean scores is shown to be attributable to change in both the range and the intensity of behaviours as young people age in the study. We show how the technique of measuring these two separate strands contributing to mean scores may be applied to checklists with sets of responses longer than the zero, one, two of the DBC. Copyright © 2008 John Wiley & Sons, Ltd.

The ability to identify children who require specialist assessment for the possibility of autism at as early an age as possible has become a growing area of research. A number of measures have been developed as potential screening tools for autism. The reliability and validity of one of these measures for screening for autism in young children with developmental problems was evaluated. The parents of 207 children aged 20-51 months completed the Developmental Checklist-Early Screen (DBC-ES), prior to their child undergoing assessment. Good interrater agreement and internal consistency was found, along with significant correlations with a clinician completed measure of autism symptomatology. High sensitivity was found, with lower specificity for the originally proposed 17-item screening tool and a five-item version. © 2007 Springer Science+Business Media, LLC.

A 24-item short form of the 96-item Developmental Behaviour Checklist was developed to provide a brief measure of Total Behaviour Problem Score for research purposes. The short form Developmental Behaviour Checklist (DBC-P24) was chosen for low bias and high precision from among 100 randomly selected item sets. The DBC-P24 was developed from epidemiological data in the first three waves of the Australian Child to Adult Development study, and cross validated for groups with autism, fragile X, Prader-Willi, and Williams in this longitudinal study and in cross sectional Dutch, English, and Finnish samples of young people with intellectual disability. The DBC-P24 has low bias and high precision in cross-validation samples and achieves high sensitivity and specificity to full DBC-P based caseness decisions. © American Association on Mental Retardation.