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BEST Project Rapid Review:

Modifications and implementation of mental health therapy interventions for adolescents and young adults with I/DD

Sarah Weldy, IL LEND Trainee-Occupational Therapy

Magdelene Thebaud, IL LEND Trainee- Social Work

Ellie Renz, IL LEND

Trainee- Self-Advocacy

Annanda Batista, IL LEND Trainee- Nursing

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Background and Purpose

Additional mental health problems are substantially increased amongst people with neurodevelopmental disorders”

  • 70% of kids with ASD have at least one mental health disorder
  • 41% to 50% of kids have two or more mental health conditions
  • Anxiety affects about half of those with ASD who have a mental health condition

But: CBT is commonly used treatment for these mental health disorders such as depression anxiety, but sometimes it doesn’t translate well to the ND community.

King, Bryan H. Psychiatric comorbidities in neurodevelopmental disorders, Current Opinion in Neurology: April 2016 - Volume 29 - Issue 2 - p 113-117 doi: 10.1097/WCO.0000000000000299; beckinstitute.org; kcl.ac.uk​

Research Question

  • How can psychotherapy for anxiety and depression be modified/adapted for adolescents and young adults with intellectual or developmental disabilities?​

Collaborations

  • The Department of Pediatrics,
  • CHECK program,
  • IL Division of Specialized Care for Children, Wellesley College
  • University of Chicago
  • University of California – Los Angeles
  • Division of Specialized Care for Children
  • Dr. Berg

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Methods

Rapid Review

Lorem 3

Each article was analyzed individually and entered into a matrix. Additional articles were excluded. After full reading, 18 articles met the inclusion criteria.

These articles were summarized and analyzed for identification of themes, adaptations/modifications to curriculum, and implementation outcomes.

Lorem 1

The team identified subject headings and key terms for the rapid review. We entered the search terms into the following databases: EMBASE; PsychINFO; PubMed; and CINAHL. The initial search yielded 4,193 articles.

Lorem 2

The team de-duplicated the initial 4,193 articles. Following de-duplication, there were 3,146 articles.

Then articles were analyzed with the inclusion and exclusion criteria. 107 articles were selected.

Review and Analysis

Search

Inclusion/Exclusion

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Keywords

KEYWORDS

(I/DD Terms)

KEYWORDS (Age Terms)

KEYWORDS (Mental health conditions terms)

KEYWORDS (Interventions Terms)

developmental disability

intellectual disability

cerebral palsy

spina bifida

blind*

visual impairment

hearing

deaf

developmental delay

muscular dystrophy

cystic fibrosis

sickle cell anemia

learning disability

ASD

autism

ADHD

attention deficit hyperactivity disorder

attention deficit disorder

autism spectrum disorder

stutter*

epilepsy

seizure

young people

young person

youth

adolescence

adolescent

adolescents

young adult

Depression

anxiety

CBT

cognitive-behavioral therapy

behavioral therapy

behavioural therapy

cognitive-behavioural therapy

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Inclusion and Exclusion Criteria

Inclusion Criteria

Exclusion Criteria

Population

Youth and young adults aged 13-25 with comorbid I/DD and depression and/or anxiety

< 13 years of age

> 25 years of age

Intervention Targets

Depression and/or anxiety

Non-mental health symptoms as primary intervention targets or outcomes

Outcomes

Examined implementation outcomes

Did not examine implementation outcomes

Study Design

Randomized control trials

Quasi-experimental

Pre-post trials

>10 participants

Non-experimental design

Treatment

Cognitive intervention

Behavioral intervention

Cognitive-behavioral intervention

Non cognitive, behavioral, or cognitive-behavioral interventions

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Results

Studies included: 18

Demographic of studies: 16 about ASD, 2 about ADHD

-Sample size varied 7-159 (pooled sample: N=594)

-mean age: 14.7

-sex/gender: 75% male

All articles covered CBT interventions

CBT adaptations:

-Facing your Fears (n=3)

-Behavioral Interventions for Anxiety in Children with Autism (BIACA) (n=4)

-Multimodal Anxiety and Social Skills Intervention (MASSI) (n=3)

-other CBT interventions (n=8)

-modularized intervention delivery

-visual supports

-language adaptation

-specific skills training

-parent involvement and incorporation of youth interests

14 studies showed positive outcomes

4 null findings

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Conclusion