Support Professionals and Students in the
Field of Developmental Disabilities

Journal on Developmental Disabilities

The Journal on Developmental Disabilities is a peer-reviewed journal with a growing regional and international readership.

Volume 17 Number 2 – General Issue


Perceived Parental Stress: The Relative Contributions of Child and Parent Characteristics
Karen Auyeung, Julie Burbidge, Patricia Minnes

Normative demands often associated with raising a child can be intensified for parents of children with intellectual disabilities (ID). The purpose of this study was to explore the experiences of stress reported by parents of individuals with ID in two age groups: high school students and adults. We also investigated this issue with respect to the type of disability experienced (i.e., Down syndrome or ID due to an unknown cause). One hungred and five parents completed the Family Stress and Coping Interview IFSCI) which provides a profile of stressful issues related to caring for a person with ID. Significant differences were found in indvidual issues reported by parents across age groups and type of disability. Implications and directions for future research are discussed.

Stress in Parents of Children with Developmental Disabilities over Time
Anne M. Ritzema, Ingrid E. Sladeczek

Stress levels of parents whose children have developmental disabilities (DD) are significantly higher than those of parents with typically developing children. However, few studies have looked at the effects of child characteristics on parent stress over time. The aim of the present study is to assess whether changes in child behaviour problems or adaptive functioning affect parent stress. Using data from the National Early Intervention Research Initiative, predictors and correlates of stress were examined in parents of children with developmental disabilities who attend early intervention (EI) program (n=21). Families participated in two rounds of data collection, approximately two and a half years apart. At Time 1 child behaviour problems significantly predicted parent stress (β = .71, t(53) = 7.47, p<.0001). Between Time 1 and Time 2 child behaviour problems decreased significantly (t(19) = 2.13, p<.05), as did parent stress (t(19) = 3.58, p=.002). At Time 2, child behaviour problems were significantly related with parent stress (r(19) - .74, p<.0001), and so was child adaptive functioning (r(19) = -.53, p<.05), although adaptive function did not change significantly between Time 1 and Time 2. The results are discussed in the context of current EI practice and policy in Canada.

Perspectives of Support Workers on Supporting Persons with intellectual Disability and Pica
Melody Ashworth and Lynn Martin

The purpose of this paper was to determine the support needs of adults with intellectual disability (ID) and pica (the ingestion of inedibles). Through two focus groups, the perspectives of staff from institutional and community settings in Ontario were examined. Qualitative data revealed that three categories of intervention underpinned reduction in pica (i.e., preventative measures, formal supports and familiarity with the individual), and that staff in both settings tended to be isolated in managing this complex behaviour. Further, inadequate resources, the lower functioning level of the individual, and lack of knowledge acted as barriers to implementing strategies to reduce the impact of pica on the person's life. This study provides important information on the barriers and successes experienced by support workers, and the service needs and recommendations for additional services for adults with ID and pica.


Brief Reports

Occurrence of Metabolic Syndrome in Inpatients with Intellectual Disability Treated with Atypical Antipsychotics
Kousha Azimi, Poonam Raina, and Yona Lunsky

Metabolic syndrome occurs at higher rates among adults with serious mental illness. Atypical antipsychotics have been shown to increase the susceptibility to cardio-metabolic problems, but despite their high usage among individuals with intellectual disability, metabolic syndrome has not been well studied in this group. This study examined the prevalence of metabolic syndrome and its risk factors among 23 psychiatric inpatients with intellectual disability prescribed atypical antipsychotics. Three out of four patients were classified as either obese or pre-obese and over one third were flagged for metabolic syndrome. The need for enhanced metabolic monitoring in adults with intellectual disability is discussed.

Antipsychotic Prescription Patterns in Adults with Developmental Disability with and without Psychotic Disorder
Mohamad Abbass and Yona Lunsky

Individuals with developmental disabilities are commonly over-prescribed antipsychotic medication. Although it is advised that antipsychotics should be prescribed primarily for psychotic disorders, they are commonly prescribed for other reasons, including behavioural issues. This study aimed to characterize individuals prescribed antipsychotics with no psychosis by comparing them to individuals prescribed antipsychotics with psychosis, presumably medicated for that reason. Overall, the two groups were similar demographically and clinically. However, individuals with no psychosis were more likely to be diagnosed with a mood disorder, and were reported to have higher ratings of hyperactivity and noncompliance and lower ratings of psychosis.

Emergency Department Assessment and Outcomes in Individuals with Autism Spectrum Disorders
Ami Tint, Suzanne Robinson, and Yona Lunsky

Individuals with autism spectrum disorders (ASD) have complex care needs and may face unique challenges in the emergency department (ED). A review of ED chart audits was conducted on a sample of 24 individuals with ASD who had visited the ED for a psychiatric or medical crisis. These individuals had a combined total of 39 visits, 30 of which were for psychiatric crises and 9 for medical crisis. The majority of ED visits were a result of physical or verbal aggression episodes. The care received, ED dispositions and implications for community resources and ED staff training are discussed.

Professional Support and Postive Gain for Mothers of Children with ASD
Jennifer MacMullin, Ami Tint, and Jonathan Weiss

Though raising a child with autism spectrum disorder (ASD) is often associated with stress, many parents report positive aspects as well. Access to professional supports may be related to positive gain, given that professional supports are related to decreased levels of stress. The purpose of this study was to investigate the relationship between professional support and positive gain for mothers of children with ASD. Participants included 132 mothers of children diagnosed with ASD aged 4 - 21 years. Professional support and behaviour problems were found to be significant predictors of positive gain in mothers of children with ASD. The clinical implications of these results are discussed

Experiences of Families of Individuals with Intellectual Disability and Psychiatric Disorder
Maisha Syeda, Jonathan Weiss, and Yona Lunsky

Caring for individuals with intellectual disability often results in stressful experiences for family caregivers, even leading to crisis in some cases. This paper uses the Brief Family Distress Scale (BFDS) to assess the subjective experience of crisis in a clinical sample of 29 families of individuals with intellectual disability and psychiatric disorder. Our analyses determined that 58% of the families rated themselves as 6 or above on the BFDS, indicative of approaching crisis or worse. An analysis of the BFDS correlation with related constructs and stressors, and families need for certain resources and services are further discussed.

Describing Clincial Profiles of Individuals with Dual Diagnosis in Specialized Care Treatment Beds
Poonam Raina, Yona Lunsky, and Barry Isaacs

The purpose of this study was to describe the clinical profiles of 53 individuals with dual diagnosis in community-based specialized treatment beds. Staff assessed individuals using the Reiss Screen for Maladaptive Behavior (RSMB) and the Behavior Problems Inventory (BPI). Overall, individuals in the sample were young and primarily male. The most common clinical diagnoses were autism spectrum disorder and mood disorder, and 67% were prescribed two or more psychotropic medications. The majority exhibited challenging behaviour, with aggressive behaviour more common than self injurious behaviour. The findings are discussed in the context of other individuals with a dual diagnosis in various treatment settings.

Interventions for Inappropriate Handling of Feces in Adults with Autism Spectrum Disorders
Jessica Case and M. Mary Konstantareas

Among the behaviours that professionals in the field of Autism Spectrum Disorder (ASD) are faced with, has been how some of the individuals deal with feces. A Functional Behavioural Assessment (FBA) was employed to identify the function of maladaptive behaviours related to feces. The results of the FBA concluded that the factors influencing the behaviours varied for each participant in the study. Individualized behaviour modification programs were developed to introduce functional replacement behaviours in each domain. The results of this study indicate that the frequency of behaviours can be decreased when interventions are developed, targeting the specific variables maintaining behaviour.

Knowledge as Coping in Parents of Children with Autism
Nidhi Luthra and Adrienne Perry

The purpose of this study was to explore knowledge as a possible factor influencing the positive and negative outcomes of parents of children with autism. A sample of 94 families was included in this study. Child severity data was collected using file review, and the parents completed a brief questionnaire about parenting stress, positive impact, actual knowledge about autism and intensive behavioural intervention, and perceived knowledge. A moderate positive correlation was found between actual and perceived knowledge. In addition, perceived knowledge (but not actual knowledge) was a significant predictor of positive impacts, but not negative impact.


Media Reviews

Tying Your Own Shoes
Ann Fudge Schormans

Tying Your Own Shoes One Film, Four Perspectives - Ann Fudge Schormans Tying Your Own Shoes - Shira Avni An Insider's Review - Petra Tolley A Review - Chris Tolley Raising a Son with Down Syndrome: Drawing Inspiration from Four Artists and Their Expression of "Special Needs" - Adele Iannantuono

A Critical Review of Ian Brown's The Boy in the Moon
Lisa Watt

This paper is a review of the book: The Boy in the Moon. It is a memoir written by Ian Brown, a Canadian author and journalist, about his journay of raising he son, Walker, who was born with an impossibly rare genetic mutation called cardiofaciocutaneous (CFC) syndrome.