The Role of Music Therapy in Supporting Intellectually Disabled Youth in Senegal

Introduction: Music therapy is a practice for helping and supporting people with intellectual and relational difficulties. This study illustrated the benefits of music therapy for young people living with intellectual disabilities (YLID) in an African context. Methodology: This study investigated six young individuals with intellectual disabilities who had undergone three years of music therapy. They were participants in the inclusive non-academic training program at the National School of Arts in Dakar from 2017 to 2019. Data collection utilized individual interviews with the youths, evaluation grids from teachers and psychiatrists. Guardians provided informed consent along with the assent of the young participants. Results: The six young were aged between 18 and 30 years old, with an average age of 24.6 years. Four of the YLID were male. Three young people with intellectual disabilities had delayed psychomotor development. Observations revealed the beneficial influence of music therapy on the health and well-being of young individuals. Music played a role in alleviating stress and anxiety among youth with intellectual disabilities (YLID), enhancing their mood and mental health. It assisted in navigating challenging situations and heightened alertness among YLID. Additionally, music therapy contributed to improvements in dyslexia, fine and gross motor skills, and memory development among intellectually disabled youth, ultimately facilitating their integration into society. Conclusion: In light of our results, music therapy makes a major contribution to the empowerment of YLID. Engaging in musical activities helps young people connect with others through instrumental expression and a sense of accomplishment. By facilitating music therapy, it becomes possible to combat discrimination and stigmatization, thus promoting the social inclusion of intellectually disabled youth. Therefore, it is important to promote music therapy in Senegal to meet the needs of YLID.

Associated Factors of Dental Caries among Intellectually Disabled Persons in Specialized Centers of Ouagadougou

Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated with it, we conducted a study in specialized centers welcoming subjects with intellectual disabilities in Ouagadougou (Burkina Faso). Objectives: The objective of this study was to identify the factors associated with it among intellectually disabled in the specialized centers of Ouagadougou. Methods: The study was cross-sectional analytical. The survey took place between November 2020 and January 2021 among people with intellectual disabilities in reception centers receiving a grant from the Ministry of Women, National Solidarity, Family and Humanitarian Action. Data collection was done with a questionnaire adapted from the World Health Organization (WHO) and dental caries was recorded according to WHO criteria in decayed, missing or filled teeth generating a DMF index. Logistic regression was used to identify factors associated with the presence of dental caries. Results: A total of 193 participants were included in the study with an average age of 12.4 years ± 7.9. The overall prevalence of caries measured with the DMF index was 58.6% 95% CI [51.2 - 65.8]. It was significantly associated with female gender (OR = 4.2;95% CI [1.4 - 12.5], p = 0,01), the clinical form of mental illness (epilepsy OR = 3.8 95%;CI [1.2 - 12.7], p = 0,02, trisomy OR = 5.0;95% CI [1.1 - 22.9], p = 0,03, motor autonomy OR = 0.2 95%;CI [0.1 - 0.7], p = 0,01) and at use of toothpaste OR = 9.33;95% CI [1.05 - 82.7], p = 0,04. Conclusion: Dental caries remains a very present pathology in most people living with an intellectual disability. Also, it is necessary to put in place prevention strategies to reduce its prevalence and improve access to oral care for these people.

Understanding Behavioral Manifestations of Obsessive-Compulsive Disorder in People with Intellectual Disabilities—A Qualitative Study

Background: There is limited knowledge about obsessive-compulsive disorder (OCD) in people with intellectual disabilities (IDs). This paper describes the manifestation of compulsive behaviors associated with OCD at the behavioral level in people with ID in institutionalized settings. The aim was to gain nuanced insight into appropriate understanding and classification in this specific context, and derive implications for research and practice. Methods: Individual cases of people with ID (n = 7) were studied to assess compulsive symptoms through two days of on-site observation of the person with ID within the institution, guided group discussions (n = 28), and semi-structured interviews with key informants and caregivers of the person with ID (n = 20). Caregiver ratings of the compulsive behavior checklist were compiled. Data were analyzed using qualitative content analysis. Results: All forms of OCD were present. Characteristics of compulsive behaviors in people with ID at the behavioral level included less complex and more obvious compulsive acts, immediate responses, signs of tension, motor restlessness, facial expression changes, repetition, need for predictability, time-consuming behaviors, and aggressive reactions when these acts were interrupted. Some of the compulsive behaviors corresponded to the ICD-11 OCD code 6B20, and others to compulsions as a psychological symptom (MB23.4). Conclusions: OCD may manifest atypically at the behavioral level in people with ID, posing significant challenges for accurate classification due to symptom ambiguity. Follow-up differential diagnostic studies are needed to more accurately identify and differentiate OCD symptoms in people with ID. Further, disorder-specific guidelines for recognizing OCD in people with ID are needed for institutionalized settings without psychiatric-psychotherapeutic expertise.

Assessment of Quality of Life, Family Function and Family Empowerment for Families Who Provide Home Care for a Child with Severe Motor and Intellectual Disabilities in Japan

Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.

Family empowerment and associated factors in Japanese families raising a child with severe motor and intellectual disabilities

Objectives:Family caregivers raising children with severe motor and intellectual disabilities(SMID)experience the enormous burden of care.The concept of family empowerment is one of the important assessment indexes of family nursing from the perspective of providing comprehensive support for these families.The objective of this study was to identify the factors associated with the empowerment of families raising a child with SMID in Japan.Methods:We conducted a nationwide questionnaire survey involving 1659 primary caregivers raising a child with SMID through 89 special schools.We assessed the main outcomes using the Family Empowerment Scale(FES).We then conducted a multiple linear regression analysis to reveal the factors associated with family empowerment.Results:In total,1362 primary caregivers were included in our study.Our results show that factors contributing to high FES scores are higher age of the primary caregiver,higher education,greater recognition of regional support,lower childcare burden,higher utilization of home visit services,higher usage of a childcare institution,higher household income,and stronger family bonding.Conclusion:Healthcare professionals should carefully assess the state of family empowerment of the primary caregivers who are younger and those who have low education,low household income,high childcare burden,and fragile bonding with the family.Second,they should encourage such families to use regional support resources for childcare.That is,policy makers should consider ways to promote home visits and institutional services for the care of children with SMID,aiming especially for the provision of well-coordinated care and services.

Neuromuscular fatigue and recovery profiles in individuals with intellectual disability

Purpose: This study aimed to explore neuromuscular fatigue and recovery profiles im individuals with intellectual disability(ID) after exhausting submaximal contraction.Methods: Ten men with ID were compared to 10 men without ID. The evaluation of neuromuscular function consisted in brief(3 s) isometric maximal voluntary contraction(IMVC) of the knee extension superimposed with electrical nerve stimulation before, immediately after, and during33 min after an exhausting submaximal isometric task at 15% of the IMVC. Force, voluntary activation level(VAL), potentiated twitch(Ptw), and electromyography(EMG) signals were measured during IMVC and then analyzed.Results: Individuals with ID developed lower baseline IMVC, VAL, Ptw; and RMS/M_(max) ratio(root-mean-square value normalized to the maximal peak-to-peak amplitude of the M-wave) than controls(p < 0.05). Nevertheless, the time to task failure was significantly longer in ID vs. controls(p < 0.05). The 2 groups presented similar IMVC decline and recovery kinetics after the fatiguing exercise. However. individuals with ID presented higher VAL and RMS/M_(max) ratio declines but lower Ptw decline compared to those without ID. Moreover, individuals with ID demonstrated a persistent central fatigue but faster recovery from peripheral fatigue.Conclusion: These differences in neuromuscular fatigue profiles and recovery kinetics should be acknowledged when prescribing training programs for individuals with ID.

Empirical Study on the Empowerment of Families Raising Children with Severe Motor and Intellectual Disabilities in Japan: The Association with Positive Feelings towards Child Rearing

Background: “Children with severe motor and intellectual disabilities” refers to children with markedly limited activity due to severe overlapping of physical and intellectual disabilities. The physical and mental burden placed on families raising severely disabled children, particularly the primary caregivers, is great in home settings. For families to effectively utilize services and over-come child rearing problems, the families themselves need the “strength” to cooperate with others for the purpose of raising a severely disabled child. The ultimate goal of family support is to enable such families to achieve satisfaction and self-growth in child rearing. Methods: We used a questionnaire to survey 75 primary caregivers to empirically elucidate the empowerment and positive feelings towards child rearing of families raising children with severe motor and intellectual disabilities and the related factors. The t-test and Spearman’s rank correlation coefficient were used to examine the association with bivariates. A multiple regression analysis was conducted for empowerment and positive feelings. Results: Results revealed that life events, livelihood, awareness of social support and the child’s sleep problems were factors related to empowerment. Of these, awareness of social support from outside of the family was found to contribute the most to empowerment. Furthermore, improvement and maintenance of positive feelings towards child rearing reaffirmed the existence of empowerment in addition to reducing negative feelings towards child rearing and ensuring social support. Conclusions: Raising children with severe motor and intellectual disabilities requires specialist knowledge and skills. Support from professionals to empower the entire family is therefore important in order to strengthen positive feelings towards child rearing.

The influence of environment, predisposing, enabling and need variables on personal health choices of adults with intellectual disability

Attention to disease and risk factor management is increasingly a feature of people with intellectual disability (ID) as an augmented life expectancy also exposes a growing number of age-related diseases. An additional concern is little attention to date to physical activity, nutrition, access to social support and other personal health choices and to environmental issues such as the impact of access to social support and the implications of individual’s living arrangements. Method: Using a sample of 753 persons with ID from the intellectual disability supplement to the Irish longitudinal study on ageing (IDS-TILDA), forty three variables were grouped into environmental, predisposing, enabling, need and personal health choices clusters and hierarchical ordinary least squares regression examined the contribution of environmental, enabling, predisposing, need and all combinations of the sets of variables to personal health choices. Findings: Almost 32% of variance was explained primarily by need variables. Most significant relationships were with meeting up with family and friends (environmental), age, rating of health and worries about getting older (predisposing), having public health insurance and nursing who come into the home (enabling) and presence of stroke, chronic constipation, functional limitations, high assistance needs with activities of daily living (need). Discussion: Taken together, the groupings of variables from the Anderson Model explained a modest amount of variance in the pursuit of positive personal health choices by people with ID. More work is clearly needed in developing evidence-based interventions and strategies, and in understanding the relationship between positive personal health choices of people with ID and health outcomes.

Chronic Diseases of Childhood and the International Classification of Functioning, Disability, and Health: A Systematic Review

The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and Health (ICF) results from the need to implement new explanatory evaluative and therapeutic models. Thus, the present systematic review aims to identify published studies on the use of the ICF in chronic childhood diseases. As a secondary objective, to map the themes that have already been studied in the area to support the discussion on the expansion of the use of this classification in health services. The systematic review followed the PRISMA protocol, and the model was the PICO acronym, where Population was children and adolescents with chronic diseases, Intervention/Exposure was evaluation based on ICF concepts, Comparator was any tool, instrument, or intervention, and outcome was direct or indirect use of the ICF. We selected eight articles, five of which used the ICF as a conceptual tool and three as a classification system, divided into the following themes: quality of life, evaluation of patients (without using coding) and mapping the inclusion of the activity’s results and participation in clinical trials. Thus, use of the ICF in clinical practice is still incipient, although it has been recommended in guidelines. Further studies are necessary to expand the number of contributions by the ICF and to develop the necessary approaches for understanding the classification’s use.

Osteoporosis and People with Down Syndrome: A Preliminary Descriptive Examination of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing Wave 1 Results

Background: People with Down syndrome (DS) are a high “at risk” group to develop osteoporosis. Increased morbidity associated with older age, higher prevalence of Alzheimer dementia, hypotonia, hypogonadism, and thyroid disease, are all features of DS and predispose this cohort to musculoskeletal complications. Methods: The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA) is a representative study of the aging of adults with intellectual disability in Ireland. The sample (N = 753) included 147 people with DS. Data was gathered on participants’ health status, behavioural health, health screenings and activities of daily living. The prevalence of osteoporosis and related risk factors among people with DS was specifically examined. Findings: Of the 147 participants with DS, 9.4% reported a doctor’s diagnosis of osteoporosis;a much lower figure than prevalence of risk factors would suggest. Predisposing factors identified included higher than general population rates of thyroid disease (37.4%), epilepsy (19.3%), sedentary lifestyle (51.7%) and the majority of the females reporting having experienced menopause (61%). Bone health screening was low at (8%) despite the presence of such high levels of risk factors in this population. Conclusion: Given the risk factor findings and the hidden nature of osteoporosis, underreported incidence among people with Down syndrome seems probable. Further investigations and systematic screening are required.

Exercises and sports participation in healthy older adults with intellectual disability—A pilot study

Background: Many adults with intellectual disabilities (ID) have low physical activity (PA). Lack of PA is a risk factor for metabolic and cardiovascular diseases, and some types of cancer. The objective of this study was to investigate the rate of PA in healthy older adults with ID. Methods: A cross-sectional analysis of baseline data. Participants were caregivers of persons with ID who were over 50 years old and living in a residential care center. A PA questionnaire and a daily rapport form were used to gather information about the type and rate of daily PA of persons with ID for 12 consecutive days. The Katz Index of Independence in Activities of Daily Living (ADL) was used to assess functional dependency. Results: Healthy older adults with ID do not engage in adequate regular PA as recommended by the US Department of Health and Human Services. Conclusion: The low participation in PA for persons with ID may be related to lack of appreciation of the benefits of PA, lack of support from their caregivers and difficulty finding experienced personnel to train them.

Effectiveness of Music Therapy on Social Skill Growth in Educable Intellectual Disability Boys

Social skills include the ability to establish interpersonal relationships with others in a way that is acceptable in terms of norms of society and it should be beneficial to society and have mutual interest. Method: Sample was taken from especial elementary school for educable intellectual disability children in Mashhad, Iran. The sample was boys between 9 - 11 years. After the initial selection of students, they were randomly assigned to two groups of twenty (experimental and control groups). 7 sessions of music therapy were performed for each one in the experimental group whereas no sessions were applied for anyone in the control group. Winelend Social Growth Scale was used to measure their social skill before and after intervention. Result: The mean difference in social skill between the two groups were statistically less than the 0.01 which is highly significant (P-value = 0.0005). This shows that art and music therapy are effective on the growth of social skills in educable intellectual disability children. Conclusion: This research shows that music therapy is effective for improvement of social skills in educable intellectual disability children.

The Differences in the Attitudes of Students With and Without Learning Disabilities Towards Including Students With Mild Intellectual Disability in Elementary Regular Schools in Bahrain

The purpose of this study was to investigate the differences in the attitudes of the students with and without learning disabilities(LD)towards including the learners with mild intellectual disability in regular elementary schools.Participants were 120 elementary boys and girls in Bahraini elementary schools.A survey was used here to identify the students’attitudes towards the inclusion of the children with mild intellectual disability in regular schools.The results indicated that:(1)There was a positive attitude among elementary students towards including the children with mild intellectual disability in regular schools;(2)there were statistically significant differences among the students with and without learning disabilities in their attitudes towards including the children with mild intellectual disability in regular elementary schools in favour of the typically developing group;and(3)there were statistically significant differences among the male and female students with and without learning disabilities in their attitudes towards including the children with mild intellectual disability in regular schools in favour of females.

Processes through Which the Grandparents of a Child with Severe Motor and Intellectual Disabilities (SMID) May Become Involved in Raising the Child

In Japan, it is common practice to involve grandparents in the care of children with severe motor and intellectual disabilities (SMID), as it may be difficult for nuclear families to handle such children by themselves. This study aimed to explore and describe the process through which the grandparents of children with SMID may be involved in their upbringing. Data were obtained via semi-structured interviews with 13 grandparents who had a grandchild with SMID. The collected data were examined using Yasuhito Kinoshita’s modified grounded theory approach. Altogether, 11 categories were identified from 29 themes. The results revealed two broad patterns concerning the nature of the grandparents’ involvement and their definition of grandparenthood in the context of raising a grandchild with SMID. In one process, grandparents supported the child’s family. They also learned to relate to the child and their family, despite experiencing a lack of responsiveness from the child initially. This ultimately resulted in them being inspired by their grandchild. In the other process, the grandparents left the care of their grandchild to the child’s family and chose to monitor the child’s welfare indirectly. In both the processes, the level of involvement was determined by the extent to which the family chose to ask grandparents for help. The study’s findings can be used to identify the kind of support that grandparents of children with SMID require while highlighting the role of considering the needs and intentions of the children’s families.

Neurobiology of Neuronal Network Alteration in Intellectual Disability Related to Fetal Alcohol Spectrum Disorders

The molecular and cellular mechanisms by which alcohol produces its deleterious effects on neuronal networks are only now beginning to be understood. This review focused on alcohol-induced neurobiological alterations on neuronal network components underlying information processing, for further understanding of intellectual disability related to FASD. Abnormal neurodevelopmental events related to alcohol-damaged fetal brain included neurogenesis inhibition, aberrant migration, impaired differentiation, exacerbated apoptosis, impaired axon outgrowth and branching altering synaptogenesis and synaptic plasticity, abnormal GABAergic interneurons triggering synaptic inhibitory/excitatory imbalance, reduced myelinogenesis causing injured white matter in prefrontal lobe and atrophied corpus callosum compromising interhemispheric information transfer, the whole compromising neuronal network scaffolding which may lead to biased information processing with deficits in executive function. What added to these abnormalities are smaller gray matter and reduced hippocampus, resulting in cognition and memory failures. As a whole, these developmental disorders may underlie intellectual disability related to FASD. In rodents, these neuronal network components matured mainly during the second and third trimesters equivalents of human gestation. Transferability of results from animal to human was also discussed. It was hoped that the understanding of alcohol-induced neuronal networks failure mechanisms during the developing brain may lay a foundation for prospective new treatments and interventions.

Empirically supported psychological treatments:The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability

This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability(ID)at all stages of their life.We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population,along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems.We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID.The review is structured around the three generations of therapies:Applied behavior analysis(e.g.,positive behavior support),cognitive behavioral therapies(e.g.,mindfulness-based cognitive therapy),and contextual therapies(e.g.,dialectical behavior therapy).We conclude with some recommendations for professional practice in the fields of ID and psychiatry.

Students With Intellectual Disability Learn How to Write With Motivation and Joy

Reading and writing can be seen as two sides of the same coin but have different demands for the writer and the reader to handle.The aim of this article is to focus on writing,how to create texts when students have intellectual disabilities and how students with intellectual disabilities have improved their writing skills through an intervention study.Writing will be highlighted from different perspectives,mostly about how writing can be supported through a structural way of working.When it comes to reading and reading difficulties,many studies have been done from different aspects of these topics.Most of these studies are among students with typical intellectual development.Studies about writing development and difficulties are fewer in number than studies about reading,but these are also mostly about children with typical development.When it comes to students with intellectual disability,studies about reading are rare and even rarer when it comes to writing.With this article,we will shed light on how writing difficulties can occur in general development and also when students have intellectual disability.The intervention study presented in this article will give some examples of how teachers can support every student’s writing development.

Submicroscopic 11p13 deletion including the elongator acetyltransferase complex subunit 4 gene in a girl with language failure, intellectual disability and congenital malformations: A case report

BACKGROUND We described the main features of an infant diagnosed with facial dysmorphic,language failure,intellectual disability and congenital malformations to strengthen our understanding of the disease.Currently,treatment is only rehabilitation and surgery for cleft lip and palate.CASE SUMMARY The proband was a 2-years-8-months-old girl.Familial history was negative for congenital malformations or intellectual disability.The patient had microcephaly,upward-slanting palpebral fissures,depressed nasal bridge,bulbous nose and bilateral cleft lip and palate.Brain magnetic resonance imaging showed cortical atrophy and band heterotopia.Her motor and intellectual development is delayed.A submicroscopic deletion in 11p13 involving the elongator acetyltransferase complex subunit 4 gene(ELP4)and a loss of heterozygosity in Xq25-q26.3 were detected.CONCLUSION There is no treatment for the ELP4 deletion caused by a submicroscopic 11p3 deletion.We describe a second case of deletion of the ELP4 gene without aniridia,which confirms the association between ELP4 gene with several defects and absence of this ocular defect.Additional clinical data in the deletion of the ELP4 gene as cleft palate,facial dysmorphism,and changes at level brain could be associated to this gene or be part of the effect of the recessives genes involved in the loss of heterozygosity region of Xq25-26.3.

Depressive symptoms, social support, cognitive function, and stigma: predictors of resilience in caregivers of children with intellectual disabilities

Objective:Family plays an important role in taking care of children with intellectual disabilities(IDs).Resilience supports coping strategies for caregivers with their children caring.However,factors influencing the resilience of caregivers with ID in Thailand are yet to be identified.Therefore,the aim of this study was to identify the predictors of resilience in caregivers of children with moderate to severe ID.Methods:A cross-sectional study was implemented in caregivers of children with ID aged 18 years and older who had children diagnosed with ID aged 6–18 years and classified as moderate to severe ID.Descriptive statistic and multiple linear regression were used for data analysis.Results:The study sample consisted of 85 caregivers who took care of their children older than 5 years(95.30%).Depression,social support,cognitive function,and stigma could predict the resilience(F[4,80]=26.79,P<0.001)and explain the variability of resilience by 57.3%.Conclusions:Caregivers have to take care of their children for a long period,which could develop a burden to the caregivers.The resilience and influencing factors should be monitored and managed by developing a campaign to promote caregivers’health and well-being.