Assessment & Research

ADHD and other associated developmental problems in children with mild mental retardation. The use of the "Five-To-Fifteen" questionnaire in a population-based sample.

Lindblad et al. (2011) · Research in developmental disabilities 2011
★ The Verdict

Use the Five-to-Fifteen parent form as a fast first sweep; most kids with mild ID will light up in several domains and need fuller assessment.

✓ Read this if BCBAs who evaluate or write plans for school-age children with mild intellectual disability.
✗ Skip if Clinicians working only with severe ID or adult populations.

01Research in Context

01

What this study did

Lindblad et al. (2011) asked 39 Swedish parents of kids with mild intellectual disability to fill out the Five-to-Fifteen (FTF) parent form. The team wanted to see how many children also had ADHD, autism, language, motor, or memory problems. They used the FTF because it covers all these areas in one short booklet.

02

What they found

Every child scored in the trouble range for learning. More than half hit the cutoff for ADHD, autism, and social skills problems. Language, motor, and memory domains were also flagged for most kids. In short, the FTF showed that comorbid issues are the rule, not the exception, in mild ID.

03

How this fits with other research

Lambek et al. (2015) later repeated the work with a whole country sample and added teacher ratings. Their bigger study kept the six FTF domains and proved the same tool works across informants, so the 2015 paper now sets the standard you should cite.

Bhaumik et al. (2008) used the shorter SDQ and also found sky-high mental-health rates in kids with ID, backing up the ‘comorbidity is common’ message with a different questionnaire.

Tyler et al. (2021) swapped the FTF for CBCL/TRF forms and still saw the same pattern: kids with ID pile up internalising and externalising problems, and you need both parent and teacher to catch them.

04

Why it matters

If you assess a child with mild ID, plan on extra conditions. Start with the parent FTF; it takes ten minutes and gives you a road map for referrals. When parents flag several domains, follow up with teacher FTF or CBCL/TRF to see which problems show up across settings. This quick screen keeps you from missing ADHD, autism, or language delays that can hide behind cognitive scores.

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Hand the FTF parent form to the caregiver at intake and pre-score the six domains before the next meeting.

02At a glance

Intervention
not applicable
Design
case series
Sample size
39
Population
intellectual disability
Finding
not reported

03Original abstract

The aim was to examine the rates and types of parent reported neuropsychiatric problems in children and adolescents with mild mental retardation (MMR) (mild intellectual disability/UK) using the Five-To-Fifteen questionnaire (FTF). The target group comprised all pupils with clinically diagnosed MMR, aged between 7 and 15 years, attending the special schools for children with MMR in two municipalities in a region in the South-West of Sweden. The FTF is a 181-item parent questionnaire with age and gender specific Swedish norms covering eight domains, including the phenomenology of early symptomatic syndromes eliciting neurodevelopmental examinations (ESSENCE), including ADHD, autism, tic syndromes, and various kinds of language, memory, and learning problems. Parents of 63% (39/62) of the eligible target group completed the FTF. After scrutiny of the medical records, 6 of the 39 children were found not to meet criteria for MR. Scores exceeding the 90th centile of the norm group were considered indicative of neuropsychiatric problems. Such high scores are strongly associated with clinically valid ESSENCE/neuropsychiatric disorders. All the examined children with validated MR were reported by their parents to have learning problems. There were very high rates of problems reported in all the other seven FTF domains: perception (88%), language (79%), social skills/autism (76%), memory (67%), emotional problems (58%), motor skills (55%) and executive functions/ADHD (55%). School age children with MMR are all in need of a comprehensive work-up covering not only general cognitive abilities, but also many other areas, including motor skills, executive function/attention, social and emotional/behavioural symptoms/functioning. Such broad assessment (including child screening by parent report with the FTF) will enable a better basis for understanding their special needs of support through life.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.05.026