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.

Family Support Situation and Educational Strategies for Primary School Children with Intellectual Disabilities Learning in Regular Class

This paper aims to verify the family support situation for primary school children with intellectual disabilities learning in regular class and to explore various educational strategies to promote their development.A self-made questionnaire was used in this survey,and the parents of 380 intellectual disabled students were the subjects of this survey.It turns out that the overall family support for intellectual disabled children learning in regular class in China is good,but it is affected by the degree of obstacles.Factors such as grade,gender,and parental education had no significant effect on family support.It is the shared responsibility of the government,schools,and parents to promote the level of family support.Governments at all levels must implement family support projects,schools must carry out family education guidance to impart scientific parenting knowledge,and parents must take note of their own responsibilities,so as to promote the physical and mental development of children with intellectual disabilities.

Curriculum Adaptation in Special Schools for Students with Intellectual Disabilities(SID):A Case Study of Project Learning in One SID School in Hong Kong

Using a qualitative case study approach,the authors analyzed the curriculum adaptation process for one project learning activity in School K,which is a SID school in the context of school-university collaboration.Multiple sources of data were collected for triangulation,including interviews,documents and observations.Curriculum adaptation strategies in this study were analyzed from five perspectives:instructional goals,instructional content,instructional strategies,instructional settings,and student behavioral needs.It was found that curriculum adaptation efforts could help students with ID develop potential at their own level through project learning activates and teachers could also gain professional development during the university-school collaboration process.As for future studies,enlarging the sample size,involving teachers’past orientations and motivations in the project learning process,and collecting quantitative data could all be taken into account.

A Novel MYCN Variant Associated with Intellectual Disability Regulates Neuronal Development

The V-MYC avian myelocytomatosis viral-related onco- gene, a neuroblastoma-derived gene （MYCN, MIM： 164840） located on chromosome 2p24, was previously found to be associated with Feingold syndrome 1 （FGLDS1, MIM： 164280） [1]. FGLDS1 is an autosomal dominant disorder characterized by variable combinations of microcephaly, limb malformations, esophageal and duodenal atresias, and learning disabilities. Cardiac and renal malformations, vertebral anomalies, and deafness have also been described in a minority of patients [2]. Despite the involvement of intellectual disability in FGLDS1, the molecular mechanisms of the MYCN gene in regulating brain development remain largely unclear.Some truncated mutations in the N terminus of the MYCN have been identified in FGLDS1 [1, 3].

THE WAY WALKED WITH CHILDREN： MEDICAL TREATMENT AND REHABILITATION

Due to obstacles in expression and communication, as well as a societal lack of humanitarian spirit and deficiencies in system design, children with intellectual disabilities are confronted with various problems when seeking medical treatment. The dilemma of medical treatment seriously restricts the survival and development of disabled groups. By reviewing the way in which a mother accompanied her disabled child for 28 years together, this article analyzed the reasons for the dilemmas of medical treatment, and appealed to improve the living conditions of persons with intellectual disabilities to guarantee their rights for rehabilitation. In addition, by introducing the recreational and sports activities that parents＇ spontaneous organization created for children with intellectual disabilities, it put forward the proposal to prevent in advance the possible deterioration of conditions caused by social isolation, which is definitely a preferable remedy for persons with disabilities.