Biomedical subjects

Richard P Hastings

Publications and source records attributed to Richard P Hastings.

At least 19 recordsLinked to original sources

PubMed2006

Longitudinal relationships between sibling behavioral adjustment and behavior problems of children with developmental disabilities.

Siblings of children with developmental disabilities were assessed twice, 2 years apart (N = 75 at Time 1, N = 56 at Time 2). Behavioral adjustment of the siblings and their brother or sister with developmental disability was assessed. Comparisons of adjustment for siblings of children with autism, Down syndrome, and mixed etiology mental retardation failed to identify group differences. Regression analysis showed that the behavior problems of the child with developmental disability at Time 1, but not the change in their behavior over time, predicted sibling adjustment over 2 years. There was no evidence that this putative temporal relationship operated bidirectionally: sibling adjustment did not appear to be related to the behavior problems of the children with developmental disabilities over time.

Adaptation, Psychological↗

PubMed2006

Maternal distress and expressed emotion: cross-sectional and longitudinal relationships with behavior problems of children with intellectual disabilities.

Mothers of children with intellectual disability were assessed at two time points, 2 years apart (n = 75 at Time 1, n = 56 at Time 2). Data were gathered on maternal distress, mental health, expressed emotion, and the child's internalizing and externalizing behavior problems. Consistent with previous research with families of children who have intellectual disability, maternal distress and children's behavior problems entered into a bidirectional relationship over time. This relationship was found to be specific to externalizing problems. Exploratory analyses also suggest that maternal distress and depression had a bidirectional longitudinal relationship. In terms of maternal expressed emotion, criticism and not emotional over-involvement was cross-sectionally but not longitudinally related to children's externalizing behavior problems and to maternal distress.

Adolescent↗

PubMed2005

Care staff attributions about challenging behaviors in adults with intellectual disabilities.

A number of researchers have explored the attributions that care staff make about challenging behavior. The expectation, based on behavioral and cognitive models, is that these attributions may help predict why staff inadvertently reinforce challenging behavior. Two studies of staff attributions about challenging behavior are reported. In the first, a high level of consistency in attributions across staff was found. In a second quasi-experimental study, staff made attributions about two known clients' behavior. Analysis of these data showed that attributions varied in a manner broadly consistent with the hypothesized functions of the behaviors. The weight of the evidence suggests that staff may be sensitive to the causes of challenging behavior. The practical implications of these data are discussed.

Adult↗

PubMed2005

Early intensive behavioral intervention for children with autism: therapists' perspectives on achieving procedural fidelity.

The variability in outcomes observed in home-based early intensive behavioral intervention for children with autism is likely in part to be the result of the quality of therapist performance. Therapist behavior in this context, however, is poorly understood. To achieve such an understanding, it will be necessary to specify how factors such as therapist, child and intervention program characteristics, as well as supervision and training provision, influence therapists' interactions with children. This study identified facilitating factors and barriers that therapists considered to influence their capacity to deliver early intensive behavioral intervention to young children with autism. Nineteen therapists associated with various service providers in the South of England were interviewed. In general, responses represented opposite poles of the same construct. For example, child factors such as compliance and competence were considered to facilitate instruction, whereas challenging behavior and lack of progress were perceived to hinder it. These issues are considered in the light of previous research on staff behavior in related contexts. The factors identified suggest specific avenues for questionnaire and experimental research to validate these findings, have implications for routine service provision and may help improve the outcomes of children receiving early intensive behavioral intervention.

Adult↗

PubMed2005

Systems analysis of stress and positive perceptions in mothers and fathers of pre-school children with autism.

Systemic analyses of psychological functioning in families of children with autism have typically shown that parents report different experiences (e.g., stress) and that siblings may also be affected. The purpose of the present research was more explicitly to address relationships between child, partner, and parent variables. Parents of 48 children with autism (41 mother-father pairs) reported on child characteristics, and their own stress and mental health. Mothers were found to report both more depression and more positive perceptions than fathers. Regression analyses revealed that paternal stress and positive perceptions were predicted by maternal depression; maternal stress was predicted by their children's behavior problems (not adaptive behavior or autism symptoms) and by their partner's depression. The future testing of the mechanisms underlying these results is discussed. In addition, the need is emphasized for more systemic analyses to understand the psychological functioning of children with autism and their siblings and parents.

Adult↗

PubMed2005

Dimensional phenotypic analysis and functional categorisation of mutations reveal novel genotype-phenotype associations in Rett syndrome.

We aimed to improve the understanding of genotype-phenotype correlations in Rett syndrome (RS) by adopting a novel approach to categorising phenotypic dimensions - separating typicality of presentation, outcome severity and age of onset - and by classifying MECP2 mutations strictly by predicted functional attributes. MECP2 mutation screening results were available on 190 patients with a clinical diagnosis of RS (140 cases with classic RS, 50 with atypical RS). 135 cases had identified mutations. Of the 140 patients, 116 with classic RS (82.9%) had an identified mutation compared with 19 of 50 patients (38%) with an atypical presentation. Cases with early onset of regression and seizures, and those with clinical features that might indicate alternative aetiologies, were less likely to have mutations. Individuals with late truncating mutations had a less typical presentation than cases with missense and early truncating mutations, presumably reflecting greater residual function of MECP2 protein. Individuals with early truncating mutations had a more severe outcome than cases with missense and late truncating mutations. These findings held when restricting the analysis to cases over 15 years of age and classic cases only. Previous findings of variation in severity among the common mutations were confirmed. The approach to phenotypic and genotypic classification adopted here allowed us to identify genotype-phenotype associations in RS that may aid our understanding of pathogenesis and also contribute to clinical knowledge on the impact of different types of mutations.

Adolescent↗

PubMed2005

Evidence-based practices in intellectual disability and behaviour disorders.

PURPOSE OF REVIEW: To critically review the most recently published studies on the treatment of challenging behaviours/behaviour disorders for individuals with intellectual disability. RECENT FINDINGS: Literature published in the review period was from three traditions: applied behaviour analysis, psychopharmacology, and service evaluation. Applied behaviour analysis treatments have a large evidence base, and recent research has focused on refining issues such as dealing with low rate behaviours, improving generalization, the effects of choice-making, and setting event variables that may affect treatment outcomes. Recent interest in risperidone as a treatment for behaviour disorder has dominated the literature on pharmacological interventions. Several empirical studies support the use of risperidone in children, although a recent review is more sceptical of the quality of the evidence to date. A small number of service evaluation studies suggest in particular that applied behaviour analysis technologies can be scaled up to benefit large numbers of patients. SUMMARY: Applied behaviour analysis methods for the assessment and treatment of behaviour disorders continue to be the focus of research, and continue to result in positive outcomes. Recent data show the value of using applied behaviour analysis technologies as a service model for people with behaviour disorders. Pharmacological treatments, especially risperidone, also have a developing evidence base despite a lack of understanding of their mechanisms of action. A number of questions about behaviour disorders remain unanswered, especially whether early intervention may be effective and their putative relationship with psychiatric conditions.

Journal Article↗

PubMed2005

Use of the questionnaire on resources and stress (QRS-F) with parents of young children with autism.

The Questionnaire on Resources and Stress (Friedrich, short form: QRS-F) has been used widely with parents of children with disabilities. However, its psychometric properties in parents of young children with autism have not been established. Here, 174 mothers and 43 fathers of children under 6 years with autism spectrum disorder were studied by two independent research teams. Each parent completed a 31-item version of the QRS-F. Factor analysis of the mothers' scores on these items failed to identify an expected two- or three-factor structure. Thus, the properties of a total stress score were explored. Analyses revealed evidence of good reliability, and expected associations with social support, coping and autism severity. These analyses lend preliminary support to the convergent validity of the scale. Overall, the data support the use of a total stress score from the 31-item version of the QRS-F in research with parents of young children with autism.

Adaptation, Psychological↗

PubMed2005

Coping strategies in mothers and fathers of preschool and school-age children with autism.

Despite the theoretical and demonstrated empirical significance of parental coping strategies for the wellbeing of families of children with disabilities, relatively little research has focused explicitly on coping in mothers and fathers of children with autism. In the present study, 89 parents of preschool children and 46 parents of school-age children completed a measure of the strategies they used to cope with the stresses of raising their child with autism. Factor analysis revealed four reliable coping dimensions: active avoidance coping, problem-focused coping, positive coping, and religious/denial coping. Further data analysis suggested gender differences on the first two of these dimensions but no reliable evidence that parental coping varied with the age of the child with autism. Associations were also found between coping strategies and parental stress and mental health. Practical implications are considered including reducing reliance on avoidance coping and increasing the use of positive coping strategies.

Adaptation, Psychological↗

PubMed2005

Positive contributions made by children with an intellectual disability in the family: mothers' and fathers' perceptions.

The aims of this article were to test the psychometric properties of the Positive Contributions Scale (PCS), and to compare perceptions of positive contributions reported by mothers and fathers. Participants were 140 mothers and 60 fathers of children with intellectual disabilities. Results supported the reliability and construct validity of the PCS. Internal consistency was good for all subscales bar one, and the PCS total score was associated with scores on the Positive Affect Scale. There were differences on PCS scales for mothers and fathers, with mothers generally reporting more positive contributions than fathers. The PCS is a reasonably robust measure and its use in future research should help to address questions about the nature and function of parental positive perceptions. The PCS might also be used in applied settings to help balance the effects of asking families about their difficulties and support needs.

Adult↗

PubMed2004

Symptoms of ADHD and their correlates in children with intellectual disabilities.

Existing research suggests that children with intellectual disabilities are at increased risk for ADHD, and that the symptoms of the disorder might successfully be treated with stimulant drugs. However, there has been little exploration of ADHD symptoms and their correlates in children with intellectual disabilities. Analyses of three samples of children with intellectual disabilities are presented (total N=338). Correlational analyses showed that younger children, and those with a diagnosis of Autism were rated as having more ADHD/hyperactivity symptoms. There was little evidence of a sex difference, and no strong associations with domains of adaptive behavior (socialization, communication, and daily living skills). However, there was a small but significant negative association between mental age and ratings of symptoms. Finally, an increased prevalence of ADHD/hyperactivity symptoms was confirmed in the children with intellectual disabilities compared to their siblings. This effect remained after controlling for chronological and mental age differences between the siblings. These findings support those from previous research and suggest that ADHD/Hyperkinesis may be a valid psychiatric diagnosis for children with intellectual disabilities. However, a great deal more research is needed to explore the phenomenology of ADHD in intellectual disability and to develop an evidence base for psychosocial intervention.

Adolescent↗

PubMed2004

Practitioner review: stress intervention for parents of children with intellectual disabilities.

BACKGROUND: Parents of children with intellectual disabilities are at increased risk for stress and other mental health problems. The purpose of the present review is to consider the evidence base for psychological intervention to remediate stress in these parents. METHODS: A selective review of interventions designed to reduce stress in parents of children with intellectual disabilities, with a focus on group interventions that incorporate various cognitive behavioural techniques. RESULTS: Research evidence suggests that standard service models (e.g., respite care, case management) probably help to reduce parental stress. The strongest evidence base is for cognitive behavioural group interventions, especially for the reduction of stress in mothers. Some data also indicate the potential value of parent-led support networks. CONCLUSIONS: More research and clinical development are needed to establish a firmer evidence base for stress interventions with parents of children with intellectual disabilities. There are also a number of potential practical implications of reducing parental stress for maximising the efficacy of general parent training interventions and also behavioural programmes for children's challenging behaviours.

Adult↗

PubMed2003

Brief report: Behavioral adjustment of siblings of children with autism.

Existing research studies have shown mixed results relating to the impact upon children of having a sibling with a disability. However, siblings of children with autism may be more at risk than siblings of children with other disabilities. In the present study, data were gathered on 22 siblings of children with autism. These children were rated by their mothers as having more behavior problems and fewer prosocial behaviors than a normative sample. Analysis of variables predicting sibling behavioral adjustment revealed that boys with siblings who have autism, and also those younger than their sibling with autism, engaged in fewer prosocial behaviors. Psychological adjustment of mothers (stress) and the child with autism (behavior problems) were not predictive of sibling behavioral adjustment.

Adolescent↗

PubMed2003

Behavioral adjustment of siblings of children with autism engaged in applied behavior analysis early intervention programs: the moderating role of social support.

There have been few studies of the impact of intensive home-based early applied behavior analysis (ABA) intervention for children with autism on family functioning. In the present study, behavioral adjustment was explored in 78 siblings of children with autism on ABA programs. First, mothers' ratings of sibling adjustment were compared to a normative sample. There were no reported increases in behavioral adjustment problems in the present sample. Second, regression analyses revealed that social support functioned as a moderator of the impact of autism severity on sibling adjustment rather than a mediator or compensatory variable. In particular, siblings in families with a less severely autistic child had fewer adjustment problems when more formal social support was also available to the family. The implications of these data for future research and for practice are discussed.

Adaptation, Psychological↗

PubMed2003

Features of autism in Rett syndrome and severe mental retardation.

It has long been recognized that there is phenotypic overlap between Rett syndrome (RS) and autism. Advances in our clinical and genetic understanding of RS over the past decade have made clear that the cause and course of RS and autism are distinct (except perhaps in a few cases). Despite this, further delineation of the phenotypic overlap between RS and autism is warranted to enhance clinical decision-making and to further understanding of neuropathological development in both disorders. The present study measured autistic symptoms using the Autism Behavior Checklist (ABC) in a sample of girls with RS and a comparison group of girls with severe and profound mental retardation (SMR). Controlling for developmental level and motor ability, girls with RS scored more highly than those with SMR on the Sensory and Relating subscales. In contrast, there were no group differences on the Body and Object use, Language and Social and Self-help subscales. Further work on the characterisation of the behavioral phenotype of genetic disorders such as RS and autism may aid in identifying the neuropathogenic processes that lead from gene-to-brain-to-behavior.

Adolescent↗

PubMed2003

Staff reactions to self-injurious behaviours in learning disability services: attributions, emotional responses and helping.

OBJECTIVES: The aim of the study was to explore an amended version of Weiner's (e.g. Weiner, 1980) helping behaviour model potentially more specific to the context of care staff working with people with learning disabilities and challenging behaviours. DESIGN: Key elements of the helping model (causal attributions, affective responses, and helping behaviour) were assessed using self-report questionnaires. In contrast to previous research, helping behaviour was conceptualized as behaviour more or less likely to reinforce challenging behaviours rather than as willingness to expend extra effort in helping. Furthermore, dimensions of positive and negative affect associated with challenging behaviour were used. METHOD: A total of 123 care staff in adult services viewed one of two videos depicting a person with learning disabilities engaging in self-injurious behaviour. Information about the behaviour's function was manipulated in order to assess reinforcing staff helping responses. Staff completed self-report scales immediately after viewing the video material. RESULTS: There was very little evidence for the predicted associations between causal attributions and both positive and negative affect, and only one significant association between affect and reinforcing helping responses. Given this lack of association, we did not fully test Weiner's prediction that affect would mediate the impact of causal attributions on helping. CONCLUSIONS: We found no evidence that Weiner's helping model can be amended to account for staff working with challenging behaviour. Close examination of previous studies also reveals very few supportive data of Weiner's original formulation. Therefore, we discuss the potential utility of alternative models in addition to methodological and conceptual issues.

Adult↗

PubMed2003

Towards a behavioral phenotype for Rett syndrome.

Despite considerable interest in Rett syndrome, there have been few studies of associated behavioral and emotional problems. In the present study, 143 girls with Rett syndrome were compared on the Developmental Behavior Checklist with 85 girls with severe to profound mental retardation of mixed etiologies. After controlling for the effects of physical disabilities, we found that the girls with Rett syndrome presented more "autistic-relating" and fewer antisocial behaviors. A subsample of children with autism was also compared to the girls with Rett syndrome on autistic-relating behaviors, revealing that the Rett syndrome group did not present with classic autistic behavioral features The implications of these results for the identification of a Rett syndrome behavioral phenotype are discussed.

Child↗

PubMed2002

Facilitating factors and barriers to the implementation of intensive home-based behavioural intervention for young children with autism.

BACKGROUND: Although international interest in intensive home-based early behavioural intervention for children with autism is increasing, there is little or no published research on the experiences of families conducting these programmes. METHODS: One hundred and forty-one UK parents conducting Lovaas-style interventions with their young child with autism were asked to identify factors that acted as facilitative factors and barriers to the implementation of these programmes. Parents responded to written questions contained within a questionnaire survey, and their responses were subjected to a content analysis procedure. RESULTS: Several of the facilitative factors and barriers were found to be similar. For example, a supportive therapy team was the most frequently cited facilitative factor, and problems recruiting and maintaining a suitable team was the most frequently reported barrier. Other factors seemed to be more independent constructs. For example, an important barrier was the lack of time and personal energy, but plenty of time and energy was not cited as a facilitative factor. CONCLUSIONS: The practical implications of these results for families and for services supporting families engaged in intensive early behavioural intervention are discussed. In addition, more general implications for the designers of behavioural intervention programmes are identified.

Adult↗