Prevalence and risk markers of behavior problems among adults with intellectual disabilities: a total population study in Örebro County, Sweden.
Check for autism, sleep problems, and sensory hypersensitivity in any adult with ID—these three signs predict behavior problems best.
01Research in Context
What this study did
Lundqvist (2013) counted every adult with intellectual disability (ID) living in one Swedish county.
The team asked carers to complete a short behavior checklist.
They also recorded each person’s diagnosis, sleep habits, and sensory issues.
What they found
Six out of ten adults with ID showed clear behavior problems.
Risk was highest when the person also had autism, poor sleep, or sensory hypersensitivity.
Adults with Down syndrome had fewer behavior problems than other groups.
How this fits with other research
Bellon-Harn et al. (2020) later studied older Irish adults with ID and found that sleep problems also predicted anxiety and depression.
Their data extend the Swedish finding: poor sleep is a red flag across countries and age bands.
Faso et al. (2016) looked at U.S. adults with Down syndrome and reported more behavior problems when dementia or psychopathology was present.
This seems to clash with Lars-Olov’s protective effect for Down syndrome, but the U.S. sample was already showing clinical decline, while the Swedish study counted everyone, healthy or not.
The papers agree: Down syndrome alone lowers risk; add dementia and risk rises.
Why it matters
When you intake an adult with ID, screen for autism, sleep trouble, and sensory issues first. These three markers flag the highest behavior risk. If the person has Down syndrome and no dementia, you can breathe a little easier, but still watch for early cognitive change. Use this quick triage to decide who needs a full functional assessment first.
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02At a glance
03Original abstract
The aim of the present study was to investigate the prevalence of behavior problems among people with administratively defined intellectual disability (ID) and identify possible risk markers for behavior problems using the Behavior Problems Inventory (BPI). Sixty-two percent of the ID population (n=915) had a behavior problem (self-injurious, stereotyped, or aggressive/destructive behavior) and 18.7% had a behavior problem identified as challenging behavior, resulting in a prevalence of 80.3 per 100,000 in the base population. The most pronounced risk markers for behavior problems were severity of ID, autism, night sleep disturbances, sensory hypersensitivity, communication dysfunction, social deficits, psychiatry involvement, and psychotropic medication. About 50% of people with behavior problems were on psychotropic drugs. Protective markers were Down's syndrome and, to some extent, cerebral palsy. The results were largely consistent with those reported in previous studies. Findings not previously reported were that prevalence of aggressive/destructive behavior peaked among those ≥70 years. Highlighting groups within a population at particular risk has implications for management and treatment of individuals with behavior problems.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.01.010