Emotional and behavioural problems in adolescents with intellectual disability with and without chronic diseases.
ID teens with chronic diseases—especially mental health ones—show far more emotional and behaviour problems, so behaviour plans need medical partnership and mindset work.
01Research in Context
What this study did
Bailey et al. (2010) asked Dutch special-school teens with intellectual disability about their health.
They compared kids who also had long-term medical or mental conditions with kids who did not.
Parents filled out a short checklist on feelings, tantrums, hyperactivity and peer problems.
What they found
Teens with a chronic disease showed far more emotional and behaviour trouble.
The jump was biggest when the chronic disease was a mental health diagnosis.
The authors say the risk can be four to eight times higher than for ID teens without extra illness.
How this fits with other research
Bailey et al. (2010) used the same schools and year to look at mild autism-like signs. They also saw more of those signs when chronic disease was present, so the two papers back each other up.
Bailey et al. (2010) then checked who actually reports the diseases. Teachers missed many mental health diagnoses that parents listed. This extends the warning: if you only ask the teacher you may under-count risk factors.
Verberg et al. (2019) moved the lens from disease to mindset. They found that teens who believe emotions cannot change had more mental health problems. Together the studies say: watch both medical history and the teen’s own beliefs.
Why it matters
For BCBAs this means a standard behaviour plan may fall short when medical or mental chronic disease is in the mix. Ask about diagnoses at intake, then loop in medical or mental-health partners. Track data separately for days when health flares up; you may see patterns that explain spikes in SIB or non-compliance. Build growth-mindset lessons around emotion regulation to hit the risk factor Fenneke highlighted.
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02At a glance
03Original abstract
BACKGROUND: Adolescents with intellectual disability (ID) (ID-adolescents) and adolescents with chronic diseases are both more likely to have emotional and behavioural problems. The aim of this study was to assess the association between chronic diseases in ID-adolescents and emotional and behavioural problems in a large school-based sample. METHODS: We obtained data on 1044 ID-adolescents, aged 12-18 years, attending secondary schools in the Netherlands. Parents of the adolescents completed the Dutch version of the Strengths and Difficulties Questionnaire and questions about chronic diseases in their child and about the background of the child. RESULTS: Prevalence rates of emotional and behavioural problems were generally high in ID-adolescents with chronic diseases (45%), compared with ID-adolescents without chronic diseases (17%). The likelihood of emotional and behavioural problems was high in ID-adolescents with two [odds ratios (OR) 4.47; 95% CI: 2.97-6.74] or more than two chronic diseases (OR 8.01; 95% CI: 5.18-12.39) and for ID-adolescents with mental chronic diseases (OR 4.56; 95% CI: 3.21-6.47). Also ID-adolescents with somatic chronic diseases had a high likelihood of emotional and behavioural problems (OR 1.99; 95% CI: 1.33-2.99), in particular in the combination of somatic and mental chronic diseases (OR 5.16; 95% CI: 3.46-7.71). CONCLUSIONS: The current study showed that chronic diseases in ID-adolescents, in particular mental chronic diseases, largely increase the likelihood of emotional and behavioural problems. This should be taken in the provision and planning of care for ID-adolescents.
Journal of intellectual disability research : JIDR, 2010 · doi:10.1111/j.1365-2788.2009.01231.x