Assessment & Research

Instruments assessing anxiety in adults with intellectual disabilities: a systematic review.

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

Glasgow Anxiety Scale and ADAMS general anxiety subscale are the front-runners for measuring anxiety in adults with ID, but they still need more replication.

✓ Read this if BCBAs working with adults with intellectual disability in day programs or residential settings
✗ Skip if Clinicians who only serve typically developing clients or children under 12

01Research in Context

01

What this study did

Hermans et al. (2011) hunted for anxiety tests made for adults with intellectual disability. They read every paper they could find and kept only the studies that checked if the tests really work.

The team looked at how long each test takes, what it costs, and if staff can give it without special gear.

02

What they found

Two tools came out on top: the Glasgow Anxiety Scale and the ADAMS general anxiety subscale. Both were built for people with ID and show early signs of reliability.

Still, only a handful of studies exist for each tool, and most are small or weak in design.

03

How this fits with other research

Wouters et al. (2017) did the same kind of sweep for fitness tests in youth with ID. Like Heidi, they found only a few tools with solid numbers behind them. Together, the reviews show that ID assessment is still a skinny evidence base no matter the domain.

Older preference studies such as Hamilton et al. (1978) and Willemsen-Swinkels et al. (1998) prove you can make valid tools for adults with severe ID when you keep the format simple. Their success hints that brief, concrete item sets may also help anxiety measures.

None of the neighbor papers contradict Heidi, but they widen the lens: if you want to screen mood or preference in ID, expect slim pickings and pilot your own data.

04

Why it matters

If you serve adults with ID, you now know which two anxiety scales have the best early backing. Start with the Glasgow or ADAMS general subscale, collect your own reliability numbers, and share them. Every new data set thickens the thin evidence base and moves the field toward better mental-health care for this often-overlooked group.

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Pick either the Glasgow or ADAMS general subscale, give it to one client this week, and chart the score alongside your ABC data to see if it tracks observed worry behaviors.

02At a glance

Intervention
not applicable
Design
systematic review
Population
intellectual disability
Finding
not reported

03Original abstract

BACKGROUND: In the last decades several instruments measuring anxiety in adults with intellectual disabilities have been developed. AIM: To give an overview of the characteristics and psychometric properties of self-report and informant-report instruments measuring anxiety in this group. METHOD: Systematic review of the literature. RESULTS: Seventeen studies studying 14 different instruments were found. Methodological quality as measured with the Quality Assessment of Diagnostic Accuracy Studies checklist was insufficient for four studies, sufficient for seven, and good for six. For self-report, the Glasgow Anxiety Scale for people with a learning disability appears most promising, with good internal consistency (a = 0.96), high test-retest reliability (r = 0.95), sensitivity (100%) and specificity (100%). For informant-report, the general anxiety subscale of the Anxiety, Depression and Mood Scale may be promising, with good internal consistency (a = 0.83 and a = 0.84) and excellent test-retest reliability (ICC = 0.78 and ICC = 0.92), but poor interrater reliability (ICC = 0.39). CONCLUSIONS: Two instruments appear promising. However, these instruments have only been studied once or twice, whereas the methodological quality of these studies was varying.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.01.034