Behavior problems: differences among intellectually disabled adults with co-morbid autism spectrum disorders and epilepsy.
Among adults with ID, those carrying both autism and epilepsy show the sharpest behavior problems, so double your assessment efforts when you see the triple combo.
01Research in Context
What this study did
The researchers compared behavior problems in adults with intellectual disability. They split the adults into three groups: ID only, ID plus autism, and ID plus autism plus epilepsy.
Each person filled out standard behavior checklists. The team then looked for small but real score differences between the groups.
What they found
Adults who had all three conditions—ID, autism, and epilepsy—earned the highest behavior-problem scores. The rise was small yet statistically clear.
Scores did not jump equally on every subscale. Some behavior areas stayed flat, showing the effect is real but not sweeping.
How this fits with other research
Gaynor et al. (2008) saw no extra psychopathology when adults with ID had epilepsy alone. Busch et al. (2010) now show the trouble appears only when autism joins the mix, updating the earlier picture.
Bao et al. (2017) found epilepsy in 70% of adults with severe ID and motor problems. Their high rate supports the idea that seizures are common in this wider field, giving context to the triple-comorbidity group.
Storch et al. (2012) reported more tantrums in toddlers with seizures. That might seem to clash, but the kids were very young and did not all have ID. Age and diagnosis explain the gap.
Why it matters
If you serve adults with ID plus both autism and epilepsy, plan for a bump in challenging behavior. Screen these clients for pain, side effects, or environmental triggers more often. Share the higher-risk profile with residential staff and medical partners so you can act early instead of reacting late.
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02At a glance
03Original abstract
Behavior problems such as aggression, property destruction, stereotypy, self-injurious behavior, and other disruptive behavior are commonly observed among adults with intellectual disabilities (ID), autism spectrum disorders (ASD), and epilepsy residing at state-run facilities. However, it is unknown how these populations differ on behavior problem indicies. Assessment of behavior problems were made with the ASD-behavior problems-adult version battery. One hundred participants with ID were matched and compared across four equal groups comprising 25 participants with ID, 25 participants with epilepsy, 25 participants with ASD, and 25 participants with combined ASD and epilepsy. When controlling for age, gender, race, level of ID, and hearing and visual impairments, significant differences were found among the four groups, Wilks's Lambda=.79, F(12, 246)=1.93, p<.05. The multivariate eta2 based on Wilks's Lambda was .08. A one-way ANOVA was conducted for each of the four subscales of the ASD-BPA as follow-up tests to the MANOVA. Groups differed on the aggression/destruction subscale, F(3, 96)=.79, p>.05, eta2=.03, and stereotypy subscale, F(3, 96)=2.62, p>.05, eta2=.08. No significant differences were found on the self-injury subscale and disruptive behavior subscale. Trend analysis demonstrated that individuals with ID expressing combined co-morbid ASD and epilepsy were significantly more impaired than the control group (ID only) or groups containing only a single co-morbid factor with ID (ASD or epilepsy only) on these four subscales. Implications of these findings in the context of known issues in ID, epilepsy, and ASD, current assessment practices among these populations and associated challenges are discussed.
Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2010.04.003