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Article
Publication date: 5 July 2021

Michelle Heyman, Megan Ledoux Galligan, Giselle Berenice Salinas, Elizabeth Baker, Jan Blacher and Katherine Stavropoulos

Professionals working with community populations are often presented with complicated cases where it is difficult to determine which diagnosis or diagnoses are…

Abstract

Purpose

Professionals working with community populations are often presented with complicated cases where it is difficult to determine which diagnosis or diagnoses are appropriate. Differentiating among neurodevelopmental disorders such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder and intellectual disability can be a complex process, especially, as these disorders have some overlapping symptoms and often co-occur in young children. This series of case studies aims to present commonly overlapping symptoms in children who present to clinics with developmental concerns.

Design/methodology/approach

This paper presents three case studies that were completed at a free community ASD screening clinic in Southern California.

Findings

The case studies have common presenting behaviors and symptoms (e.g. social communication difficulties) that often co-occur across diagnoses; explanations for the final diagnoses are given in each case.

Research limitations/implications

Conclusions from these three cases cannot generalize to all children being seen in clinics for neurodevelopmental concerns.

Practical implications

This series of case studies highlights commonly overlapping symptoms in children who present for differential diagnosis with social and/or behavioral concerns. Implications for educational placement and intervention are discussed.

Social implications

These cases highlight the challenges involved in the differential and dual diagnostic process for young children with developmental concerns. Diagnostic considerations can affect later educational placement and opportunities for socialization.

Originality/value

This series of case studies provide practical information for clinicians about how to effectively differentiate between commonly occurring neurodevelopmental disorders, particularly given recent changes to the Diagnostic and Statistical Manual, 5th edition (DSM-5).

Details

Advances in Autism, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-3868

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Article
Publication date: 24 January 2011

Raja Mukherjee, Michael Layton, Evan Yacoub and Jeremy Turk

Associations between fetal alcohol syndrome (FAS) and other conditions have been reported, but the links between FAS and autistic spectrum disorders (ASD) remain unclear…

Abstract

Associations between fetal alcohol syndrome (FAS) and other conditions have been reported, but the links between FAS and autistic spectrum disorders (ASD) remain unclear. This study explored the relationship between FAS and ASD in individuals attending a specialist diagnostic clinic. Consecutive referrals over 24 months to a specialist neurodevelopmental clinic were evaluated using gold standard methods for FAS diagnosis and ASD. The first 18‐month cohort who met criteria for ASD were compared with controls attending the same clinic but who had not experienced prenatal alcohol exposure (nested data). Data for the whole group were also collected. Twenty‐one fetal alcohol spectrum disorder (FASD) individuals were assessed and 16 (72%) met ICD‐10 criteria for childhood autism. Further significant differences between the prenatally exposed and non‐exposed group with ASD were found in the nested study. The research shows an association between heavy prenatal alcohol exposure and ASD. As this is a small sample in a specialist clinic, the study suggests that a larger, more population‐based study of those exposed to heavy prenatal alcohol is warranted.

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Article
Publication date: 7 September 2015

Marco O. Bertelli

The purpose of this paper is to provide a critical overview of some main implications of the neurodevelopmental perspective for the field of the mental health in…

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268

Abstract

Purpose

The purpose of this paper is to provide a critical overview of some main implications of the neurodevelopmental perspective for the field of the mental health in intellectual disability and autism spectrum disorders.

Design/methodology/approach

A discussion surrounding the importance of integrating different approaches in the neurodevelopmental perspective, drawing on sources from the paper proposals to the 10th International Congress of the European Association in Mental Health and Intellectual Disability (EAMHID), and the literature.

Findings

At present, the neurodevelopmental perspective seems to be the most appropriate and valued conceptual framework to support multi-level, interdisciplinary approaches in understanding the aetiologies of mental health problems as well as when and how to intervene. It inherently exemplifies a dimensional approach, which can capture variations between individuals, their developmental time course, brain-behaviours associations and functional significance better than categorical approaches, and diagnostic measures.

Originality/value

This editorial outlines a special issue that offers a comprehensive and varied collection of papers from the contributions to the 10th International Congress of the EAMHID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 9 no. 5
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 4 January 2016

Marco O. Bertelli, Kerim Munir, James Harris and Luis Salvador-Carulla

The debate as to whether intellectual disability (ID) should be conceptualized as a health condition or as a disability has intensified as the revision of World Health…

Abstract

Purpose

The debate as to whether intellectual disability (ID) should be conceptualized as a health condition or as a disability has intensified as the revision of World Health Organization’s (WHO’s) International Classification of Diseases (ICD) is being finalized. Defining ID as a health condition is central to retaining it in ICD, with significant implications for health policy and access to health services. The purpose of this paper is to include some reflections on the consensus document produced by the first WHO Working Group on the Classification of MR (WHO WG-MR) and on the process that was followed to realize it. The consensus report was the basis for the development of official recommendations sent to the WHO Advisory Group for ICD-11.

Design/methodology/approach

A mixed qualitative approach was followed in a series of meetings leading to the final consensus report submitted to the WHO Advisory group. These recommendations combined prior expert knowledge with available evidence; a nominal approach was followed throughout with face-to-face conferences.

Findings

The WG recommended a synonym set (“synset”) ontological approach to the conceptualisation of this health condition underlying a clinical rationale for its diagnosis. It proposed replacing MR with Intellectual Developmental Disorders (IDD) in ICD-11, defined as “a group of developmental conditions characterized by a significant impairment of cognitive functions, which are associated with limitations of learning, adaptive behaviour and skills”. The WG further advised that IDD be included under the parent category of neurodevelopmental disorders, that current distinctions (mild, moderate, severe and profound) be continued as severity qualifiers, and that problem behaviours removed from its core classification structure and instead described as associated features.

Originality/value

Within the ID/IDD synset two different names combine distinct aspects under a single construct that describes its clinical as well as social, educational and policy utilities. The single construct incorporates IDD as a clinical meta-syndrome, and ID as its functioning and disability counterpart. IDD and ID are not synonymous or mirror concepts as they have different scientific, social and policy applications. New diagnostic criteria for IDD should be based on a developmental approach, which accounts for the complex causal factors known to impact the acquisition of specific cognitive abilities and adaptive behaviours. The paper focuses on a new clinical framework for the diagnosis of IDD that also includes and complements the existing social, educational and policy components inherent in ID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 10 no. 1
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 1 September 2007

Ron Gray and Raja Mukherjee

Foetal alcohol spectrum disorders describes a group of disorders caused by the consumption of prenatal alcohol. The range of outcomes and the clinical management of these…

Abstract

Foetal alcohol spectrum disorders describes a group of disorders caused by the consumption of prenatal alcohol. The range of outcomes and the clinical management of these disorders vary in both the complexity of their presentations, associated disorders and management outcomes. This article seeks to review the literature around some of the more difficult areas associated with the condition and present some insights into possible ways of managing the psychiatric and neurodevelopmental disorders seen in the context of the UK system and the NHS.

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Article
Publication date: 4 January 2016

Marco O. Bertelli

– The purpose of this paper is to provide a summary of main outcomes of the 10th EAMHID International Congress and a critical overview of some key contributions.

Abstract

Purpose

The purpose of this paper is to provide a summary of main outcomes of the 10th EAMHID International Congress and a critical overview of some key contributions.

Design/methodology/approach

A discussion on the impact of the neurodevelopmental perspective on mental health care achievements and failures in the field of intellectual disability (ID) and autism spectrum disorders (ASD).

Findings

The considerable progress in the field of mental health care for people with ID that has been made in the last 30 years and that is reflected through the 350 papers presented in this Congress represents the continuation of the work of great pioneers, such as Frank Menolascino, Felix Platter or William I. Gardner, who have been honoured by the EAMHID in the naming of the congress rooms, and the dedication of the poster award. The neurodevelopmental perspective was confirmed to be the current most valued conceptual framework to explain relations across systems and to support multi-level, transnosographic, life-long, interdisciplinary approaches in the production of aetiological insight and good-quality intervention for mental health problems; on the other hand it might determine a premature abandonment of the traditional nosology and the appearance of very broad spectrum conditions covering the full range of psychopathology. Also psychopharmacology was extensively considered, with the explicit aim to raise the attention of researchers and clinicians on this neglected topic. Unfortunately, adults with ID/ASD are still deprived of the right to receive treatments that are based on strong evidence, as it is for the general population.

Originality/value

This editorial outlines the second part of a special issue that offers a comprehensive and varied collection of papers from the contributions to the 10th International Congress of the EAMHID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 10 no. 1
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 1 January 2013

Lisa Underwood, Andrew Forrester, Eddie Chaplin and Jane McCarthy

The purpose of this paper is to review the evidence on providing services to people with neurodevelopmental disorders in prisons, with a focus on those prisoners with…

Abstract

Purpose

The purpose of this paper is to review the evidence on providing services to people with neurodevelopmental disorders in prisons, with a focus on those prisoners with autism spectrum disorder (ASD).

Design/methodology/approach

Electronic databases were used to search for literature specifically on ASD in prisons. The literature was supplemented with the authors’ experiences of carrying out research on ASD in prison.

Findings

The searches only identified four articles and therefore the broader literature on people with ASD and other developmental disorders was reviewed in relation to the prison context.

Originality/value

The paper highlights the current limited evidence base on prisoners with autism spectrum disorders.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 4 no. 1/2
Type: Research Article
ISSN: 2050-8824

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Article
Publication date: 1 January 2014

C. Ellie Wilson, Ged Roberts, Nicola Gillan, Chris Ohlsen, Dene Robertson and Janneke Zinkstok

This paper aims to provide an overview of the recent National Institute for Health and Clinical Excellence (NICE) clinical guidance for diagnosis and treatment of adults…

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1136

Abstract

Purpose

This paper aims to provide an overview of the recent National Institute for Health and Clinical Excellence (NICE) clinical guidance for diagnosis and treatment of adults with Autism Spectrum Disorder (ASD) and to discuss clinical and practical implications.

Design/methodology/approach

This is a summary and discussion of the NICE guidance for adults with autism. This includes discussion of relevant related guidance, the need for transition services for young people with ASD, education of professionals, applicability of the guidance to people with intellectual disabilities and challenges related to implementation of the guidance in a changing National Health Service.

Findings

The guidance provides an excellent overview of current and state-of-the-art strategies for diagnosis and treatment of ASD-related behaviours, and their level of evidence. In terms of diagnosis, the main recommendation for clinicians is to carry out a comprehensive assessment for adults with suspected autism, taking into account co-morbid mental health problems and potential unmet needs. In addition, NICE makes recommendations regarding pharmacological and psychological interventions and these are discussed. The guidance also makes specific recommendations regarding service design, for example the formation of Autism Strategy Groups. This will hopefully support the development of specialist adult autism services.

Originality/value

This paper provides new insights into the implications of the recently published NICE clinical guidance for autism in adults, relevant for health care professionals, service managers and service users.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 8 no. 1
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 11 January 2021

Christine Wee, Trixie Mottershead, Sarah Wright, Sujeet Jaydeokar and Mahesh Odiyoor

This paper aims to improve community care for people with intellectual disabilities (ID) and/or autism. Lack of coordination between agencies leads to children and young…

Abstract

Purpose

This paper aims to improve community care for people with intellectual disabilities (ID) and/or autism. Lack of coordination between agencies leads to children and young people with the most complex needs falling between services. The North West Operational Delivery Network (ODN) for learning disability and autism set out to develop a model of care for mental health services for children and young people with ID and/or autism in North West England that would improve coordination between services and lead to better community care.

Design/methodology/approach

The ODN held a series of good practice events and consultations with stakeholders in North West England to look at gaps in service provision, national guidelines and agree on a pathway for services.

Findings

The ODN decided to use the THRIVE framework as the basis for a specific model of care. Interventions were mapped against the THRIVE groupings, including pathways and team specifications for assessment and support for children with autism, and models for child and adolescent mental health service support for ID and/or autism, for keeping children and young people with behaviour that challenges in the community and transition.

Originality/value

This model aims to provide the North West England region with a clear multi-agency approach for supporting the needs of this population and supports multi-agency commissioning, gap analysis, earlier intervention and improving health outcomes for this population.

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Book part
Publication date: 9 November 2020

Kristen Gillespie-Lynch, Patrick Dwyer, Christopher Constantino, Steven K. Kapp, Emily Hotez, Ariana Riccio, Danielle DeNigris, Bella Kofner and Eric Endlich

Purpose: We critically examine the idea of neurodiversity, or the uniqueness of all brains, as the foundation for the neurodiversity movement, which began as an autism…

Abstract

Purpose: We critically examine the idea of neurodiversity, or the uniqueness of all brains, as the foundation for the neurodiversity movement, which began as an autism rights movement. We explore the neurodiversity movement's potential to support cross-disability alliances that can transform cultures.

Methods/Approach: A neurodiverse team reviewed literature about the history of the neurodiversity movement and associated participatory research methodologies and drew from our experiences guiding programs led, to varying degrees, by neurodivergent people. We highlight two programs for autistic university students, one started by and for autistics and one developed in collaboration with autistic and nonautistic students. These programs are contrasted with a national self-help group started by and for stutterers that is inclusive of “neurotypicals.”

Findings: Neurodiversity-aligned practices have emerged in diverse communities. Similar benefits and challenges of alliance building within versus across neurotypes were apparent in communities that had not been in close contact. Neurodiversity provides a framework that people with diverse conditions can use to identify and work together to challenge shared forms of oppression. However, people interpret the neurodiversity movement in diverse ways. By honing in on core aspects of the neurodiversity paradigm, we can foster alliances across diverse perspectives.

Implications/ Values: Becoming aware of power imbalances and working to rectify them is essential for building effective alliances across neurotypes. Sufficient space and time are needed to create healthy alliances. Participatory approaches, and approaches solely led by neurodivergent people, can begin to address concerns about power and representation within the neurodiversity movement while shifting public understanding.

Details

Disability Alliances and Allies
Type: Book
ISBN: 978-1-83909-322-7

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