University of Reno Intellectual and Developmental Disorders Response

There are 2 discussion listed below. Please respond to each student discussion board.

1. (EM) Ptomey, L. T., Walpitage, D. L., Mohseni, M., Dreyer Gillette, M. L., Davis, A. M., Forseth, B., Dean, E. E., Waitman, L. R. (2020). Weight status and associated comorbidities in children and adults with down syndrome, autism spectrum disorder and intellectual and developmental disabilities. Journal of Intellectual Disability Research, 64, 725-737.

• Key definitions
  • Obesity- abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 25 is considered overweight, and over 30 is obese.
  • Comorbidity- the simultaneous presence of two or more diseases or medical conditions in a patient.
  • Down Syndrome (DS)- a congenital condition characterized by a distinctive pattern of physical characteristics including a flattened skull, pronounced folds of skin in the inner corners of the eyes, large tongue, and short stature, and by some degree of limitation of intellectual ability and social and practical skills. It usually arises from a defect involving chromosome 21, usually an extra copy (trisomy-21).
  • Autism Spectrum Disorder (ASD)- is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person.
  • Intellectual and developmental disabilities (IDD)– disorders that are usually present at birth and that negatively affect the trajectory of the individual’s physical, intellectual, and/or emotional development. Many of these conditions affect multiple body parts or systems.
  • Congenital Heart Defect- one or more problems with the heart’s structure that exist since birth
  • Sleep Apnoea- potentially serious sleep disorder in which breathing repeatedly stops and starts.
  • Type 2 diabetes- a condition in which cells cannot use blood sugar (glucose) efficiently for energy. This happens when the cells become insensitive to insulin and the blood sugar gradually gets too high.
  • Dementia- the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.
  • Hypothyroidism- abnormally low activity of the thyroid gland, resulting in retardation of growth and mental development in children and adults.
  • Hypertension- abnormally high blood pressure.
• Key findings / “takeaways”

• Down Syndrome

• Children
  • 27% were Overweight (OW)
  • 22% were Obese (OB)
  • No difference in BMI with race or male/female
  • Most common comorbidities were congenital heart disease, hypothyroid, and sleep apnoea.
• Adults
  • 27.3 % were Overweight (OW)
  • 53.8% were Obese (OB)
  • No difference in BMI with race
  • OW/OB was significantly higher in females
  • Most common comorbidities were hypothyroidism, sleep apnoea, and congenital heart disease.
• OW/OB was associated with increased risk of sleep apnoea and type 2 diabetes.

• Autism Spectrum Disorder

• Children
  • 17.5 % were OW
  • 24.4% were OB
  • No difference in BMI between males and females or race
  • Most common comorbidities were sleep apnoea, hypertension, and congenital heart disease.
• Adults
  • 24.3% were OW
  • 37.8% were OB
  • No difference in BMI between males and females or race
  • Most common comorbidities were hypertension, hypothyroidism, and type 2 diabetes.
• OW/OB were associated with an increased risk of sleep apnoea, and type 2 diabetes.

• Intellectual and developmental disorder

• Children
  • 11.8% were OW
  • 21.7 were OB
  • OW/OB was significantly higher in females
  • No significant difference in race
  • The ONLY prevalent comorbidity was congenital heart disease.
• Adults
  • 21% were OW
  • 41.4% were OB
  • OW/OB was significantly higher in females
  • No significant difference in race
  • Most common comorbidities were hypertension, type 2 diabetes, and hypothyroidism.
• OW/OB were associated with an increased risk of sleep apnoea, type 2 diabetes, and hypertension.
• What do the findings mean for students with an ID?
  • Both children and adults with DS have the highest rates of OW/OB compared to those with ASD or IDD.
  • Female participants are more likely to be classified as OB.
  • Female adults with DS and IDD had higher rates of obesity than males.
  • There were no differences in obesity rates for different races in children and adults.
  • Children with IDD had fewer comorbidities than their peers with DS or ASD.
• What are potential implications for practice / educational programming?
  • Government agencies and professional organizations have recommended efforts to reduce the prevalence of OW/OB and obesity related chronic diseases in individuals with IDD.
  • It is critical to identify strategies to improve or maintain healthy weight status in adults with IDD.
  • Research in the future should focus on developing weight management interventions for those with IDD but really a focus for weight management/weight gain for those with DS(
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  • (ND) 2. Key Definitions:
    • Intellectual Disabilities (ID)- involves problems with general mental abilities that affect functioning in two areas: intellectual functioning (such as learning, problem-solving, judgement) adaptive functioning (activities of daily life such as communication and independent living) (www.psychiatry.org) (Links to an external site.)
    • Multi-morbidity– two or more conditions additional to intellectual disabilities
    • Physical Health– measured through a person’s physical strength, endurance and flexibility; covers nutrition, exercise, medical care, and appropriate use of medical systems.
    • Mental Health– a person’s condition with regard to their psychological and emotional well-being. (Oxford dictionary)
    • Inequalities– inequalities in health are the unjust and avoidable differences in people’s health across the population and between specific population groups. (http://www.healthscotland.scot)
    • Deprivation– can be defined as the consequence of a lack of income and other resources, which cumulatively can be seen as living in poverty (www.nottinghaminsight.org.uk ) (Links to an external site.)

    Key Findings/”Takeaways”:The research article written by Cooper, McLean, Guthrie, McConnachie, Mercer, Sullivan and Morrison, “Multiple physical and mental health comorbidity in adults with intellectual disabilities: a population-based cross-sectional analysis”, discussed adults with ID experience death at an earlier age compared to that of the general population. They also endure additional health inequalities that may lead to a shorter life span. One of the contributing factors explored were individuals with disabilities and multimorbidity who lived in low-income, socio-economically deprived areas due to lack of resources, low-income, health understanding, inadequate medical treatment, misunderstanding medications and proper treatment, which could have potentially affected longevity. Physical and mental health conditions with individuals with disabilities were more prevalent as the deprivation increased in neighborhoods.The research also indicated that ID also caused physical and/or mental health issues, as Down Syndrome was commonly associated with a thyroid disorder and sensory impairments. Also, adults with ID were more likely not to eat healthily, exercise, had mobility issues, obesity, and approximately a quarter took antipsychotic drugs, which may have attributed to the above conditions. Unfortunately, this population was more likely to be prescribed drugs that lead to health side effects, and they may not have the full capacity to understand how to communicate the adverse effects or be able to notice related health issues that could have been onset by the medication(s).Adults who experienced multi-morbidity with ID compared to the general public experienced this between the ages of 20-25 versus the GP aged 50-54. To effectively create change there are many factors that need to be addressed, quality care/healthcare, medical understanding and overseeing medications, resources that enable mobility, healthy lifestyles, and ensuring care facilities hire trained staff members that require background checks, etc. *In this Scottish research, the general population practices created a data system of people with ID and since receiving a pay-for-performance, ID is a lifetime diagnosis, as it’s coded at birth or during childhood, and remains on their medical record indefinitely. (interesting fact)What do the findings mean for students with an ID?Students with ID need to learn self-advocacy skills to ensure they understand how to lead a healthy lifestyle, understand their diagnoses to ensure proper care and treatment, and how to receive resources necessary to live healthily. Students who are not able to do this on their own will need to have their parents, guardian, and caregivers understand the importance of these statistics to support and be made aware of what can happen to start with lifestyle habits as a child that may lead to unhealthy living circumstances.What are potential implications for practice/educational programming?There needs to be great understanding and patience with students who live with multi-morbidity. Students could be feeling unwell, experience pain, discomfort, etc., which may come across as being defiant or unwilling to engage in activities. If communication is limited these are important issues that need to be known by the teacher and staff members to ensure quality instruction and allow for a positive work environment. Ensuring that observations are recorded, thorough IEP data is continually kept, assistive technology assessment is conducted if necessary, a behavior plan is implemented if necessary, and positive, and consistent correspondence is routine with parents to ensure a smooth transition between home and school to create the best life possible for the student.