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The mental health of young children with intellectual disabilities or borderline intellectual functioning

Social Psychiatry and Psychiatric Epidemiology volume 45, pages 579–587 (2010)Cite this article

Abstract

Objective

To determine within a nationally representative sample of young Australian children: (1) the association amongst intellectual disability, borderline intellectual functioning and the prevalence of possible mental health problems; (2) the association amongst intellectual disability, borderline intellectual functioning and exposure to social disadvantage; (3) the extent to which any between-group differences in the relative risk of possible mental health problems may be attributable to differences in exposure to disadvantageous social circumstances.

Methods

The study included a secondary analysis of a population-based child cohort of 4,337 children, aged 4/5 years, followed up at age 6/7 years. The main outcome measure was the scoring within the ‘abnormal’ range at age 6/7 years on the parent-completed Strengths and Difficulties Questionnaire.

Results

When compared to typically developing children, children identified at age 4/5 years as having intellectual disability or borderline intellectual functioning: (1) showed significantly higher rates of possible mental health problems for total difficulties and on all five SDQ subscales at age 6/7 years (OR 1.98–5.58); (2) were significantly more likely to be exposed to socio-economic disadvantage at age 4/5 and 6/7 years. Controlling for the possible confounding effects of exposure to socio-economic disadvantage (and child gender) significantly reduced, but did not eliminate, between-group differences in prevalence.

Conclusions

Children with limited intellectual functioning make a disproportionate contribution to overall child psychiatric morbidity. Public health and child and adolescent mental health services need to ensure that services and interventions fit to the purpose and are effective for children with limited intellectual functioning, and especially those living in poverty, as they are for other children.

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References

  1. Einfeld S, Tonge BJ (1996) Population prevalence of psychopathology in children and adolescents with intellectual disability. I. Epidemiological findings. J Intellect Disabil Res 40:99–109

    Article  PubMed  Google Scholar 

  2. Emerson E, Hatton C (2007) The mental health of children and adolescents with intellectual disabilities in Britain. Br J Psychiatry 191:493–499

    Article  PubMed  Google Scholar 

  3. Rutter M et al (1976) Research report: Isle of Wight studies 1964–1974. Psychol Med 6:313–332

    Article  CAS  PubMed  Google Scholar 

  4. Cooper SA et al (2007) Mental ill-health in adults with intellectual disabilities: prevalence and associated factors. Br J Psychiatry 190:27–35

    Article  PubMed  Google Scholar 

  5. Zetlin A, Murtaugh M (1990) Whatever happened to those with borderline IQ? Am J Ment Retard 94:463–469

    CAS  PubMed  Google Scholar 

  6. Seltzer MM et al (2005) Life course impacts of mild intellectual deficits. Am J Ment Retard 110:451–468

    Article  PubMed  Google Scholar 

  7. Hassiotis A et al (2008) Psychiatric morbidity and social functioning among adults with borderline intelligence living in private households. J Intellect Disabil Res 52(2):95–106

    CAS  PubMed  Google Scholar 

  8. Maughan B, Collishaw S, Pickles A (1999) Mild mental retardation: psychosocial functioning in adulthood. Psychol Med 29:351–366

    Article  CAS  PubMed  Google Scholar 

  9. Valliant GE, Davis JT (2000) Social/emotional intelligence and midlife resilience in schoolboys with low tested intelligence. Am J Orthopsychiatry 70:215–222

    Article  Google Scholar 

  10. Douma J et al (2007) Antisocial and delinquent behaviors in youths with mild or borderline disabilities. Am J Ment Retard 112(3):207–220

    Article  PubMed  Google Scholar 

  11. Douma J et al (2006) Self-reports on mental health problems of youth with moderate to borderline intellectual disabilities. J Am Acad Child Adolesc Psychiatry 45:1224–1231

    Article  PubMed  Google Scholar 

  12. Seltzer MM et al (2005) Life course impacts of mild intellectual deficits. Am J Ment Retard 110(6):451–468

    Article  PubMed  Google Scholar 

  13. Hassiotis A et al (1999) Prevalence and characteristics of patients with severe mental illness and borderline intellectual functioning. Report from the UK700 randomised controlled trial of case management. Br J Psychiatry 175:135–140

    Article  CAS  PubMed  Google Scholar 

  14. Einfeld S, Emerson E (2009) Intellectual disability, in Rutter’s child and adolescent psychiatry. In: Rutter M et al (eds). Blackwell, Oxford

  15. Hayes SC (2004) Interaction with the criminal justice system. In: Emerson E et al (eds) International handbook of methods for research and evaluation in intellectual disabilities. Wiley, Chichester, pp 479–494

    Google Scholar 

  16. Llewellyn G, McConnell D, Ferronato L (2003) Prevalence and outcomes for parents with disabilities and their children in an Australian court sample. Child Abuse Negl 27:235–251

    Article  PubMed  Google Scholar 

  17. Emerson E (2007) Poverty and people with intellectual disability. Ment Retard Dev Disabil Res Rev 13:107–113

    Article  PubMed  Google Scholar 

  18. Stancliffe RJ, Lakin KC (2007) Independent living. In: Odom SL et al (eds) Handbook on developmental disabilities. Guilford Publications, New York, pp 429–448

    Google Scholar 

  19. Rydell A-M (2009) Family factors and children’s disruptive behaviour: an investigation of links between demographic characteristics, negative life events and symptoms of ODD and ADHD. Soc Psychiatry Psychiatr Epidemiol (in press)

  20. Ford T, Goodman R, Meltzer H (2004) The relative importance of child, family, school and neighbourhood correlates of childhood psychiatric disorder. Soc Psychiatry Psychiatr Epidemiol 39:487–496

    Article  PubMed  Google Scholar 

  21. Reijneveld SA et al (2005) Area deprivation and child psychosocial problems: a national cross-sectional study among school-aged children. Soc Psychiatry Psychiatr Epidemiol 40:18–23

    Article  PubMed  Google Scholar 

  22. Fryers T, Melzer D, Jenkins R (2003) Social inequalities and the common mental disorders: a systematic review of the evidence. Soc Psychiatry Psychiatr Epidemiol 38:229–237

    Article  PubMed  Google Scholar 

  23. Amone-P’Olak K et al (2009) Socioeconomic position and mental health problems in pre- and early adolescents: the TRAILS study. Soc Psychiatry Psychiatr Epidemiol 44:231–238

    Article  PubMed  Google Scholar 

  24. Collishaw S, Maughan B, Pickles A (2004) Affective problems in adults with mild learning disability: the roles of social disadvantage and ill health. Br J Psychiatry 185:350–351

    Article  PubMed  Google Scholar 

  25. Australian Institute of Family Studies (2006) The Longitudinal Study of Australian Children: 2005–2006 annual report. Australian Institute of Family Studies, Melbourne

  26. Australian Institute of Family Studies (2005). The Longitudinal Study of Australian Children: 2004 annual report. Australian Institute of Family Studies, Melbourne

  27. Australian Institute of Family Studies (2008) The Longitudinal Study of Australian Children: 2006–2007 annual report. Australian Institute of Family Studies, Melbourne

  28. Australian Institute of Family Studies (2008) The Longitudinal Study of Australian Children: data user’s guide. Australian Institute of Family Studies, Melbourne

    Google Scholar 

  29. Soloff C, Lawrence D, Johnstone R (2005) LSAC technical paper no. 1: sample design. Australian Institute of Family Studies, Melbourne

  30. Mission S, Sipthorpe M (2007) Wave 2 weighting and non-response: LSAC technical paper no. 5. Australian Institute of Family Studies, Melbourne

  31. Sanson A et al (2005) LSAC technical paper #2: summarising children’s wellbeing—the LSAC outcome index. Australian Institute of Family Studies, Melbourne

  32. Rothman S (2004) Peabody Picture Vocabulary Test: LSAC Australian short-form. Australian Council for Educational Research, Melbourne

  33. Dunn LM, Dunn LM (1997) Peabody Picture Vocabulary Test—third edition. Technical specifications. American Guidance Services, Circle Pines

    Google Scholar 

  34. Australian Council for Educational Research, Who Am I? (1999). ACER, Camberwell

  35. Doig B (2005) Developing formal mathematical assessment for 4- to 8-year-olds. Math Educ Res J 16:100–119

    Google Scholar 

  36. de Lemos M (2002) Patterns of young children’s development: an international comparison of development as assessed by Who Am I? Human Resources Development, Canada

  37. Janus M (2007) The early development instrument: a tool for monitoring children’s development and readiness for school. In: Young ME, Richardson LM (eds) Early child development—from measurement to action. A priority for growth and equity. World Bank, Washington, pp 141–155

    Google Scholar 

  38. Goodman R (1999) The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 40:791–801

    Article  CAS  PubMed  Google Scholar 

  39. Goodman R (2001) Psychometric properties of the Strengths and Difficulties Questionnaire (SDQ). J Am Acad Child Adolesc Psychiatry 40:1337–1345

    Article  CAS  PubMed  Google Scholar 

  40. Goodman R et al (2000) Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry 177:534–539

    Article  CAS  PubMed  Google Scholar 

  41. Hawes DJ, Dadds MR (2004) Australian data and psychometric properties of the Strengths and Difficulties Questionnaire. Aust N Z J Psychiatry 38:644–651

    PubMed  Google Scholar 

  42. Mathai J, Anderson P, Bourne A (2004) Comparing psychiatric diagnoses generated by the Strengths and Difficulties Questionnaire with diagnoses made by clinicians. Aust N Z J Psychiatry 38:639–643

    PubMed  Google Scholar 

  43. Emerson E (2005) Use of the Strengths and Difficulties Questionnaire to assess the mental health needs of children and adolescents with intellectual disabilities. J Intellect Dev Disabil 49(Pt 1):16–24

    CAS  Google Scholar 

  44. Shaw M et al (2007) The handbook of inequality and socioeconomic position: concepts and measures. Policy Press, Bristol

    Google Scholar 

  45. Trewin D (2003) Socioeconomic indexes for areas: Australia 2001. Australian Bureau of Statistics, Canberra

    Google Scholar 

  46. Soloff C et al (2006) LSAC technical paper no. 3: wave 1 weighting and non-response. Australian Institute of Family Studies, Melbourne

  47. Deville JC, Särndal CE (1992) Calibration estimators in survey sampling. J Am Stat Assoc 87:376–382

    Article  Google Scholar 

  48. Oakes JM, Johnson PJ (2006) Propensity score matching for social epidemiology. In: Oakes JM, Kaufman JS (eds) Methods in social epidemiology. San Francisco, Josey Bass

    Google Scholar 

  49. Blackford J (2007) Statistical issues in developmental epidemiology and developmental disabilities research: confounding variables, small sample size, and numerous outcome variables in developmental epidemiology of mental retardation and developmental disabilities. In: Urbano R, Hodapp R (eds) Developmental epidemiology of mental retardation and developmental disabilities. Academic Press, New York, pp 93–120

  50. Sturmer T et al (2006) A review of the application of propensity score methods yielded increasing use, advantages in specific settings, but not substantially different estimates compared with conventional multivariable methods. J Clin Epidemiol 59:437–447

    Article  PubMed  Google Scholar 

  51. Shah BR et al (2005) Propensity score methods gave similar results to traditional regression modeling in observational studies: a systematic review. J Clin Epidemiol 58:550–559

    Article  PubMed  Google Scholar 

  52. Martens EP et al (2008) Systematic differences in treatment effect estimates between propensity score methods and logistic regression. Int J Epidemiol 37:1142–1147

    Article  PubMed  Google Scholar 

  53. Leuven E, Sianesi B (2003) PSMATCH2: stata module to perform full Mahalanobis and propensity score matching, common support, graphing and covariate inbalance testing V3.0.0. Stata Corp, College Station

    Google Scholar 

  54. Einfeld S et al (2006) Psychopathology in young people with intellectual disability. J Am Med Assoc 296(16):1981–1989

    Article  CAS  Google Scholar 

  55. Einfeld S, Ellis L, Emerson E (under review) Comorbidity of intellectual disability and mental disorder: a systematic review

  56. Einfeld S, Emerson E (2008) Intellectual disability. In: Rutter M et al (eds) Rutter’s child and adolescent psychiatry. Blackwell, Oxford

    Google Scholar 

  57. Leonard H, Wen X (2002) The epidemiology of mental retardation: challenges and opportunities in the new millennium. Ment Retard Dev Disabil Res Rev 8:117–134

    Article  PubMed  Google Scholar 

  58. Emerson E (2009) Intellectual and physical disability, social mobility, social inclusion and health. Centre for Disability Reserach, Lancaster University, Lancaster

    Google Scholar 

  59. World Health Organisation (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on the Social Determinants of Health. World Health Organisation, Geneva

  60. Marmot M, Wilkinson G (eds) (2006) Social determinants of health, 2nd edn. Oxford University Press, Oxford

    Google Scholar 

  61. Wilkinson RG, Pickett KE (2009) The spirit level: why more equal societies almost always do better. Penguin, London

    Google Scholar 

  62. Emerson E, Hatton C (2007) The contribution of socio-economic position to the health inequalities faced by children and adolescents with intellectual disabilities in Britain. Am J Ment Retard 112(2):140–150

    Article  PubMed  Google Scholar 

  63. Emerson E, Hatton C (2007) Poverty, socio-economic position, social capital and the health of children and adolescents with intellectual disabilities in Britain: a replication. J Intellect Disabil Res 51(11):866–874

    Article  CAS  PubMed  Google Scholar 

  64. BMA Board of Science (2006) Child and adolescent mental health: a guide for healthcare professionals. BMA, London

    Google Scholar 

  65. Costello EJ et al (2003) Relationships between poverty and psychopathology: a natural experiment. JAMA 290:2023–2029

    Article  CAS  PubMed  Google Scholar 

  66. Goodman R, Ford T, Richards H (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 41:645–656

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This paper uses a confidentialised unit record file from the Longitudinal Study of Australian Children (LSAC). The LSAC Project was initiated and is funded by the Commonwealth Department of Families, Community Services and Indigenous Affairs and is managed by the Australian Institute of Family Studies. The findings and views reported in this paper, however, are those of the author and should not be attributed to either FaCSIA or the Australian Institute of Family Studies.

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Authors and Affiliations

  1. Centre for Disability Research, Lancaster University, Lancaster, LA1 4YT, UK

    Eric Emerson

  2. Brain and Mind Research Institute, University of Sydney, P.O. Box 170, Lidcombe, NSW, 1825, Australia

    Stewart Einfeld

  3. Faculty of Health Sciences, University of Sydney, P.O. Box 170, Lidcombe, NSW, 1825, Australia

    Eric Emerson, Stewart Einfeld & Roger J. Stancliffe

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  1. Eric Emerson
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  2. Stewart Einfeld
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Correspondence to Eric Emerson.

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Emerson, E., Einfeld, S. & Stancliffe, R.J. The mental health of young children with intellectual disabilities or borderline intellectual functioning. Soc Psychiat Epidemiol 45, 579–587 (2010). https://doi.org/10.1007/s00127-009-0100-y

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