Physical conditions and challenging behaviour in people with intellectual disability: a systematic review
Background Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour. Methods A literature search was cond...
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Veröffentlicht in: | Journal of intellectual disability research 2011-07, Vol.55 (7), p.675-698 |
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description | Background Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour.
Methods A literature search was conducted in PubMed and the Cochrane systematic review database for empirical studies published between 1990 and 2008. The quality of all the studies that met the inclusion criteria was assessed using the SIGN‐50 methodology checklists.
Results The search identified 45 studies, which looked at general medical conditions, motor impairment, epilepsy, sensory impairment, gastrointestinal disease, sleep disorders, dementia and others. There were four high‐quality observational studies, seven well‐conducted observational studies, 21 observational studies of low methodological quality and 13 non‐analytical studies. There were significant and independent associations between challenging behaviours and urinary incontinence, pain related to cerebral palsy and chronic sleep problems, and between self‐injurious behaviour and visual impairment. No association was found with hearing impairment, bowel incontinence, mobility impairment or epilepsy. Many other physical conditions were not addressed at all.
Conclusion Medical conditions can play a role in challenging behaviour, and this should be evaluated in the clinical setting. So far, the level of evidence is generally low, and longitudinal studies are completely lacking. We recommend a systematic approach to research examining the role of physical conditions in challenging behaviour, the ultimate aim being to establish a basis for the development of clinical guidelines. |
doi_str_mv | 10.1111/j.1365-2788.2011.01390.x |
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Methods A literature search was conducted in PubMed and the Cochrane systematic review database for empirical studies published between 1990 and 2008. The quality of all the studies that met the inclusion criteria was assessed using the SIGN‐50 methodology checklists.
Results The search identified 45 studies, which looked at general medical conditions, motor impairment, epilepsy, sensory impairment, gastrointestinal disease, sleep disorders, dementia and others. There were four high‐quality observational studies, seven well‐conducted observational studies, 21 observational studies of low methodological quality and 13 non‐analytical studies. There were significant and independent associations between challenging behaviours and urinary incontinence, pain related to cerebral palsy and chronic sleep problems, and between self‐injurious behaviour and visual impairment. No association was found with hearing impairment, bowel incontinence, mobility impairment or epilepsy. Many other physical conditions were not addressed at all.
Conclusion Medical conditions can play a role in challenging behaviour, and this should be evaluated in the clinical setting. So far, the level of evidence is generally low, and longitudinal studies are completely lacking. We recommend a systematic approach to research examining the role of physical conditions in challenging behaviour, the ultimate aim being to establish a basis for the development of clinical guidelines.</description><identifier>ISSN: 0964-2633</identifier><identifier>EISSN: 1365-2788</identifier><identifier>DOI: 10.1111/j.1365-2788.2011.01390.x</identifier><identifier>PMID: 21366751</identifier><identifier>CODEN: JIDREN</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult and adolescent clinical studies ; Aggression ; Attention Deficit and Disruptive Behavior Disorders - epidemiology ; Behavior ; Behavior Problems ; Biological and medical sciences ; Cerebral Palsy ; Challenging behaviour ; Child clinical studies ; Correlation analysis ; Dementia ; Developmental disorders ; Epilepsy ; Fecal Incontinence - epidemiology ; Hearing Impairments ; Humans ; Intellectual deficiency ; intellectual disability ; Intellectual Disability - epidemiology ; Learning disabilities ; Learning disabled people ; Longitudinal Studies ; Medical conditions ; Medical sciences ; Mental disorders ; Mental Retardation ; Motor Skills Disorders - epidemiology ; Observational research ; Pain ; Physical Disabilities ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Self Destructive Behavior ; Self-Injurious Behavior - epidemiology ; self-injurious behaviour ; Sleep ; Sleep disorders ; Systematic review ; Urinary Incontinence - epidemiology ; Visual Impairments</subject><ispartof>Journal of intellectual disability research, 2011-07, Vol.55 (7), p.675-698</ispartof><rights>2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd</rights><rights>2015 INIST-CNRS</rights><rights>2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.</rights><rights>Copyright Blackwell Publishing Ltd. Jul 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6310-b149d214cf0328629bfd0209eb1c9c92a2b8061e76c7a4d529adbe584dbd7bf13</citedby><cites>FETCH-LOGICAL-c6310-b149d214cf0328629bfd0209eb1c9c92a2b8061e76c7a4d529adbe584dbd7bf13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2788.2011.01390.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2788.2011.01390.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,30978,30979,45553,45554</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ929161$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24254064$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21366751$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Winter, C. F.</creatorcontrib><creatorcontrib>Jansen, A. A. C.</creatorcontrib><creatorcontrib>Evenhuis, H. M.</creatorcontrib><title>Physical conditions and challenging behaviour in people with intellectual disability: a systematic review</title><title>Journal of intellectual disability research</title><addtitle>J Intellect Disabil Res</addtitle><description>Background Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour.
Methods A literature search was conducted in PubMed and the Cochrane systematic review database for empirical studies published between 1990 and 2008. The quality of all the studies that met the inclusion criteria was assessed using the SIGN‐50 methodology checklists.
Results The search identified 45 studies, which looked at general medical conditions, motor impairment, epilepsy, sensory impairment, gastrointestinal disease, sleep disorders, dementia and others. There were four high‐quality observational studies, seven well‐conducted observational studies, 21 observational studies of low methodological quality and 13 non‐analytical studies. There were significant and independent associations between challenging behaviours and urinary incontinence, pain related to cerebral palsy and chronic sleep problems, and between self‐injurious behaviour and visual impairment. No association was found with hearing impairment, bowel incontinence, mobility impairment or epilepsy. Many other physical conditions were not addressed at all.
Conclusion Medical conditions can play a role in challenging behaviour, and this should be evaluated in the clinical setting. So far, the level of evidence is generally low, and longitudinal studies are completely lacking. We recommend a systematic approach to research examining the role of physical conditions in challenging behaviour, the ultimate aim being to establish a basis for the development of clinical guidelines.</description><subject>Adult and adolescent clinical studies</subject><subject>Aggression</subject><subject>Attention Deficit and Disruptive Behavior Disorders - epidemiology</subject><subject>Behavior</subject><subject>Behavior Problems</subject><subject>Biological and medical sciences</subject><subject>Cerebral Palsy</subject><subject>Challenging behaviour</subject><subject>Child clinical studies</subject><subject>Correlation analysis</subject><subject>Dementia</subject><subject>Developmental disorders</subject><subject>Epilepsy</subject><subject>Fecal Incontinence - epidemiology</subject><subject>Hearing Impairments</subject><subject>Humans</subject><subject>Intellectual deficiency</subject><subject>intellectual disability</subject><subject>Intellectual Disability - epidemiology</subject><subject>Learning disabilities</subject><subject>Learning disabled people</subject><subject>Longitudinal Studies</subject><subject>Medical conditions</subject><subject>Medical sciences</subject><subject>Mental disorders</subject><subject>Mental Retardation</subject><subject>Motor Skills Disorders - epidemiology</subject><subject>Observational research</subject><subject>Pain</subject><subject>Physical Disabilities</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Self Destructive Behavior</subject><subject>Self-Injurious Behavior - epidemiology</subject><subject>self-injurious behaviour</subject><subject>Sleep</subject><subject>Sleep disorders</subject><subject>Systematic review</subject><subject>Urinary Incontinence - epidemiology</subject><subject>Visual Impairments</subject><issn>0964-2633</issn><issn>1365-2788</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkktv1DAUhSMEotPCP0DIQkJlk-B3bCQWqCpDS1UeBXVp2Y7T8ZBJhjjpTP49TjMMEguoN7F1v3N0c-9JEoBghuJ5vcwQ4SzFuRAZhghlEBEJs-2DZLYvPExmUHKaYk7IQXIYwhJCyBHlj5MDHCmeMzRL_OfFELzVFbBNXfjON3UAui6AXeiqcvWNr2-AcQt965u-Bb4Ga9esKwc2vlvEZ-ciZbs-GhQ-aOMr3w1vgAZhCJ1b6c5b0Lpb7zZPkkelroJ7uvseJd_fn347-ZBefJqfnby7SC0nCKYGUVlgRG0JCRYcS1MWEEPpDLLSSqyxEfE3XM5trmnBsNSFcUzQwhS5KRE5So4n33Xb_Oxd6NTKBxvb1LVr-qCE5CiXkpL_kwJxySS5h2eO4qgRzyP56p8kEgRjStkd-uIvdBlHXMfZRD_KcgbJ2KOYINs2IbSuVOvWr3Q7KATVmAW1VOPK1bhyNWZB3WVBbaP0-c6_NytX7IW_lx-BlztAh5iAstW19eEPRzGjkNPIPZs413q7L5-eSywRH23eTuWNr9xw7_7U-dnX8Rb16aT3MTHbvV63P1ScUs7U9eVcXX78Iq7m8FpdkV_32OeI</recordid><startdate>201107</startdate><enddate>201107</enddate><creator>de Winter, C. F.</creator><creator>Jansen, A. A. C.</creator><creator>Evenhuis, H. M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>201107</creationdate><title>Physical conditions and challenging behaviour in people with intellectual disability: a systematic review</title><author>de Winter, C. F. ; Jansen, A. A. C. ; Evenhuis, H. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6310-b149d214cf0328629bfd0209eb1c9c92a2b8061e76c7a4d529adbe584dbd7bf13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult and adolescent clinical studies</topic><topic>Aggression</topic><topic>Attention Deficit and Disruptive Behavior Disorders - epidemiology</topic><topic>Behavior</topic><topic>Behavior Problems</topic><topic>Biological and medical sciences</topic><topic>Cerebral Palsy</topic><topic>Challenging behaviour</topic><topic>Child clinical studies</topic><topic>Correlation analysis</topic><topic>Dementia</topic><topic>Developmental disorders</topic><topic>Epilepsy</topic><topic>Fecal Incontinence - epidemiology</topic><topic>Hearing Impairments</topic><topic>Humans</topic><topic>Intellectual deficiency</topic><topic>intellectual disability</topic><topic>Intellectual Disability - epidemiology</topic><topic>Learning disabilities</topic><topic>Learning disabled people</topic><topic>Longitudinal Studies</topic><topic>Medical conditions</topic><topic>Medical sciences</topic><topic>Mental disorders</topic><topic>Mental Retardation</topic><topic>Motor Skills Disorders - epidemiology</topic><topic>Observational research</topic><topic>Pain</topic><topic>Physical Disabilities</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Self Destructive Behavior</topic><topic>Self-Injurious Behavior - epidemiology</topic><topic>self-injurious behaviour</topic><topic>Sleep</topic><topic>Sleep disorders</topic><topic>Systematic review</topic><topic>Urinary Incontinence - epidemiology</topic><topic>Visual Impairments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Winter, C. F.</creatorcontrib><creatorcontrib>Jansen, A. A. C.</creatorcontrib><creatorcontrib>Evenhuis, H. 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F.</au><au>Jansen, A. A. C.</au><au>Evenhuis, H. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ929161</ericid><atitle>Physical conditions and challenging behaviour in people with intellectual disability: a systematic review</atitle><jtitle>Journal of intellectual disability research</jtitle><addtitle>J Intellect Disabil Res</addtitle><date>2011-07</date><risdate>2011</risdate><volume>55</volume><issue>7</issue><spage>675</spage><epage>698</epage><pages>675-698</pages><issn>0964-2633</issn><eissn>1365-2788</eissn><coden>JIDREN</coden><abstract>Background Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour.
Methods A literature search was conducted in PubMed and the Cochrane systematic review database for empirical studies published between 1990 and 2008. The quality of all the studies that met the inclusion criteria was assessed using the SIGN‐50 methodology checklists.
Results The search identified 45 studies, which looked at general medical conditions, motor impairment, epilepsy, sensory impairment, gastrointestinal disease, sleep disorders, dementia and others. There were four high‐quality observational studies, seven well‐conducted observational studies, 21 observational studies of low methodological quality and 13 non‐analytical studies. There were significant and independent associations between challenging behaviours and urinary incontinence, pain related to cerebral palsy and chronic sleep problems, and between self‐injurious behaviour and visual impairment. No association was found with hearing impairment, bowel incontinence, mobility impairment or epilepsy. Many other physical conditions were not addressed at all.
Conclusion Medical conditions can play a role in challenging behaviour, and this should be evaluated in the clinical setting. So far, the level of evidence is generally low, and longitudinal studies are completely lacking. We recommend a systematic approach to research examining the role of physical conditions in challenging behaviour, the ultimate aim being to establish a basis for the development of clinical guidelines.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21366751</pmid><doi>10.1111/j.1365-2788.2011.01390.x</doi><tpages>24</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult and adolescent clinical studies Aggression Attention Deficit and Disruptive Behavior Disorders - epidemiology Behavior Behavior Problems Biological and medical sciences Cerebral Palsy Challenging behaviour Child clinical studies Correlation analysis Dementia Developmental disorders Epilepsy Fecal Incontinence - epidemiology Hearing Impairments Humans Intellectual deficiency intellectual disability Intellectual Disability - epidemiology Learning disabilities Learning disabled people Longitudinal Studies Medical conditions Medical sciences Mental disorders Mental Retardation Motor Skills Disorders - epidemiology Observational research Pain Physical Disabilities Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Self Destructive Behavior Self-Injurious Behavior - epidemiology self-injurious behaviour Sleep Sleep disorders Systematic review Urinary Incontinence - epidemiology Visual Impairments |
title | Physical conditions and challenging behaviour in people with intellectual disability: a systematic review |
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