Seizure disorders in people with intellectual disability: an analysis of differences in social functioning, adaptive functioning and maladaptive behaviours.

Researchers compared two groups of adults with severe or profound intellectual disability.

One group also had epilepsy. The other group did not.

They measured social skills, daily living skills, and problem behaviors in both groups.

The epilepsy group scored much lower on social and daily living skills.

Both groups showed the same amount of aggression, self-injury, and other problem behaviors.

Seizures hurt adaptive skills but did not create extra behavior problems.

Balboni et al. (2020) extends these findings. They found that in severe ID, better adaptive skills can actually pair with more challenging behavior when many conditions overlap.

Drijver et al. (2025) gives you a newer tool. Their DIAB measure fixes the floor effects that made the 1999 adaptive scores hard to interpret.

Keintz et al. (2011) adds another layer. They show low mood—not seizures—drives challenging behavior behavior in severe ID. This helps explain why the epilepsy group had typical behavior levels.

When you assess a client with severe ID plus epilepsy, expect big gaps in social and self-care skills. Plan extra teaching time for dressing, eating, and peer interaction. Do not assume seizures will cause more hitting or yelling. Instead, screen for mood issues like Balboni et al. (2020) and Keintz et al. (2011) suggest. Use the new DIAB tool from Drijver et al. (2025) to get clearer adaptive scores and track small gains over time.