Factors affecting the risk of behaviour problems in children with severe intellectual disability.
For kids with severe ID, daily-living skill gaps drive self-injury, sleep, and destruction problems more than aggression.
01Research in Context
What this study did
Chadwick et al. (2000) looked at kids with severe intellectual disability. They asked which daily-living gaps go with behavior problems.
The team used a one-time survey in special schools. They checked walking, dressing, feeding, sleep, and problem behaviors.
What they found
Kids who could walk showed more behavior issues than kids who could not. Poor daily-living skills predicted sleep trouble, overactivity, self-injury, destruction, and autistic traits.
Aggression and tantrums did not link to skill deficits. Only self-care skills mattered for the other problems.
How this fits with other research
Balboni et al. (2020) seems to flip the story. In adults with severe ID living in institutions, higher adaptive skills went with more challenging behavior. The gap is age and setting: kids in school versus adults with many diagnoses under one roof.
Libero et al. (2016) followed kids over time and found that high repetitive behavior and overactivity forecast later self-injury, aggression, and destruction. O et al. saw the same behaviors but only in a snapshot.
Staddon et al. (2002) gave numbers to the sleep link: one in six children with ID has severe sleep problems, and those kids also show more daytime behavior issues. O et al. flagged the link first; R et al. sized it.
Why it matters
When you see self-injury, destruction, or sleep issues in a child with severe ID, first check daily-living skills, not just communication. Teaching dressing, feeding, and toileting may drop these problems faster than tackling aggression head-on. Track sleep and repetitive movements early; they are red flags for bigger trouble later.
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02At a glance
03Original abstract
In order to examine the importance of a range of potential risk factors for behaviour problems in children with severe intellectual disability, a sample was identified by the administration of a screening version of the Vineland Adaptive Behaviour Scales (VABS) to the parents of children aged 4-11 years attending six special needs schools in three adjacent inner London boroughs. Parents whose children had a VABS standard score of < or = 50 were interviewed using the Disability Assessment Schedule and both parents and teachers completed the Aberrant Behaviour Checklist. Most behaviour problems were more common in ambulant children, but problems less dependent on the ability to walk, such as sleeping difficulties, screaming and self-injury, were equally common in ambulant and non-ambulant children. Among ambulant children, there were few significant associations between the severity of the child's behaviour problems and the age or sex of the child, the presence or absence of epilepsy, and various indices of socio-economic disadvantage. Sleeping difficulties, overactivity, self-injury, destructive behaviour and autistic features, such as social withdrawal and stereotypies, were strongly associated with skills deficits, but aggression, temper tantrums and general disruptive behaviour were not. Limitations in daily living skills were better predictors of behaviour problems than were poor communication skills.
Journal of intellectual disability research : JIDR, 2000 · doi:10.1046/j.1365-2788.2000.00255.x