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Studiens syfte var att beskriva hur Alternativ och Kompletterande Kommunikation (AKK) används av lärare i den anpassade skolan för att främja elevers arbete med ämnesinnehåll, språkutveckling och kognition. Studien utgick från det sociokulturella perspektivet. En kvalitativ intervjustudie genomfördes och data analyserades i en tematisk analys. Urvalet bestod av åtta lärare i den anpassade skolan. Resultatet visade att lärare använder AKK i stor utsträckning för att möjliggöra arbete med ämnesinnehåll. Användandet av AKK gynnade elevernas språkutveckling och kognition, då lärarna möjliggjorde arbete i den proximala utvecklingszonen. Både empirisk och teoretisk generalisering låg till grund för arbetet med ämnesinnehåll, och vi fann exempel på lärare som arbetade liknade en learning activity. Lärarna önskade utveckla arbetet med att tolka elevernas deltagande i ämnesarbetet, samt att få mer stöd i form av färdigutvecklade lektionsstrukturer. Eleverna utmanades att fördjupa sitt kunnande vilket också kan gynna dem i ett samhällsperspektiv på lång sikt. Resultatet av studien kan användas av lärare i det didaktiska planeringsarbetet., The aim of the study was to describe how Alternative and Augmentative Communication (AAC) is used by teachers in special schools to promote students' work with subject content, language development and cognition. The study was based on the sociocultural perspective. A qualitative interview study was conducted and the data was analyzed in a thematic analysis. The sample consisted of eight teachers in special schools. The results showed that teachers use AAC to a large extent to enable work with subject content. The use of AAC benefited the students' language development and cognition, as the teachers enabled work in the zone of proximal development. Both empirical and theoretical generalization was the basis for the work with subject content, and we found examples of teachers whose work was similar to a learning activity. The teachers also wanted to develop the interpretation of the students' participation in the subject work, as well as to receive more support in the form of fully developed lesson structures. The students were challenged to deepen their knowledge, which can also have long term societal benefits for students. The results of the study can be used by teachers in didactic planning work.

Studiens syfte var att beskriva hur Alternativ och Kompletterande Kommunikation (AKK) används av lärare i den anpassade skolan för att främja elevers arbete med ämnesinnehåll, språkutveckling och kognition. Studien utgick från det sociokulturella perspektivet. En kvalitativ intervjustudie genomfördes och data analyserades i en tematisk analys. Urvalet bestod av åtta lärare i den anpassade skolan. Resultatet visade att lärare använder AKK i stor utsträckning för att möjliggöra arbete med ämnesinnehåll. Användandet av AKK gynnade elevernas språkutveckling och kognition, då lärarna möjliggjorde arbete i den proximala utvecklingszonen. Både empirisk och teoretisk generalisering låg till grund för arbetet med ämnesinnehåll, och vi fann exempel på lärare som arbetade liknade en learning activity. Lärarna önskade utveckla arbetet med att tolka elevernas deltagande i ämnesarbetet, samt att få mer stöd i form av färdigutvecklade lektionsstrukturer. Eleverna utmanades att fördjupa sitt kunnande vilket också kan gynna dem i ett samhällsperspektiv på lång sikt. Resultatet av studien kan användas av lärare i det didaktiska planeringsarbetet., The aim of the study was to describe how Alternative and Augmentative Communication (AAC) is used by teachers in special schools to promote students' work with subject content, language development and cognition. The study was based on the sociocultural perspective. A qualitative interview study was conducted and the data was analyzed in a thematic analysis. The sample consisted of eight teachers in special schools. The results showed that teachers use AAC to a large extent to enable work with subject content. The use of AAC benefited the students' language development and cognition, as the teachers enabled work in the zone of proximal development. Both empirical and theoretical generalization was the basis for the work with subject content, and we found examples of teachers whose work was similar to a learning activity. The teachers also wanted to develop the interpretation of the students' participation in the subject work, as well as to receive more support in the form of fully developed lesson structures. The students were challenged to deepen their knowledge, which can also have long term societal benefits for students. The results of the study can be used by teachers in didactic planning work.

El presente trabajo pretende analizar la situación y obstáculos que se encuentran las personas excarceladas con discapacidad intelectual -leve y moderada-, con el objetivo de crear un programa postpenitenciario para este colectivo. Es bien cierto que podemos intuir a las dificultades que se encontrarán las personas una vez salgan de la privación de libertad en centros penitenciarios, pero, ¿somos conscientes de los impedimentos y objeciones que se encuentran los sujetos doblemente discriminados, que padecen de discapacidad intelectual? Para ello, se realizará un recorrido para comprender la discapacidad intelectual, sus escalas de grados, la epidemiologia, delictogenesis, comorbilidad y el entorno penitenciario. Una vez comprendido esto, se aproximará a los obstáculos que se encuentran las personas con discapacidad intelectual una vez son puestas en libertad, además, se pondrán de manifiesto los diferentes programas que se han llevado a cabo a lo largo del tiempo. Una vez comprendidas las esferas más teóricas del campo a estudiar, se abordará el planteamiento de un innovador programa postpenitenciario para las personas excarceladas con discapacidad intelectual., This paper aims to analyze the situation and obstacles encountered by people released from prison with intellectual disabilities - mild and moderate-, with the aim of creating a postpenitentiary program for this group. It is true that we can intuit the difficulties that people will encounter once they leave the deprivation of liberty in prisons, but are we aware of the impediments and objections that are doubly discriminated subjects, who suffer from intellectual disabilities? To this end, a journey will be made to understand intellectual disability, its scales of degrees, epidemiology, criminogenesis, comorbidity and the prison environment. Once this is understood, we will approach the obstacles encountered by people with intellectual disabilities once they are released, in addition, we will highlight the different programs that have been carried out over time. Once the more theoretical spheres of the field to be studied have been understood, the approach of an innovative post-penitentiary program for released persons with intellectual disabilities will be addressed.

Background Long-term use of antiseizure drugs is associated with a low bone mineral density (BMD) and an increased fracture risk. The literature regarding institutionalised children on chronic antiseizure drugs is limited. Therefore, the aim of this cross-sectional study is to evaluate the prevalence of low BMD and the history of fractures in institutionalised children with epilepsy and intellectual disability (ID). Methods A dual-energy X-ray absorptiometry of lumbar spine (L1-L4) and hip was performed in 24 children, residing in a long-stay care facility in the Netherlands. Additionally, serum concentrations of albumin, calcium and 25-hydroxyvitamin D were determined. Data on fractures were retrospectively extracted from the medical files. Results Ages of the children (14 male and 10 female) ranged from 5 to 17 years with a mean age of 13.0 (+/- 3.2). The criteria of the International Society for Clinical Densitometry (ISCD) were used for classification of bone mineral disorders. Eight (33.3%) children had a normal BMD (Z-score > - 2.0). Of the 16 children with a low BMD (Z-score <= - 2.0), three were diagnosed as osteoporotic, based on their fracture history. Ten children (41.7%) were reported to have at least one fracture in their medical history. Serum concentrations of albumin-corrected calcium (2.28-2.50 mmol/L) and (supplemented) vitamin D (16-137 nmol/L) were within the normal range. Conclusions This study demonstrated that 67% of institutionalised children with epilepsy and ID had low BMD and 42% had a history of at least one fracture, despite supplementation of calcium and vitamin D in accordance with the Dutch guidelines.

This essay consists of a review of 34 scientific articles. The aim is to describe and compile current research about students with intellectual disability (ID) and neurodevelopmental disorder (NDD). The research questions focus on what challenges for learning and teaching the diagnoses imply, if there are any differences between girls and boys, and how the learning environment may be adapted for these students. The theoretical framework in this study consists of gender theory and social constructions. The results show that many students with ID also have diagnoses within NDD and that it affects the students’ executive, adaptive and social abilities. Girls show other symptoms than boys, but there tends to be fewer differences when the students have a severe ID. Girls are often quieter than boys and seem to have better social skills, while boys more frequently have challenging behaviour. The differences contribute to boys receiving more support in school and that they are referred to neuropsychiatric assessment at an earlier age. Girls however are more difficult to discover, which causes that girls often receive a diagnosis later than boys. Considerably more boys than girls get a diagnosis within NDD; research has for many years focused on boys’ symptoms, which has affected the formation of the diagnostic tools. The result shows that there is a huge need of adapting the education to each student’s ability and level of knowledge with help from a clear structure in a calm setting with few disturbances. The students need support in developing their executive, adaptive and social skills. Early interventions have shown to be of great importance. Regardless of cognitive level, pedagogues need to have high expectations on the students, encourage them and give them the support they need. The students may for example need longer time, rehearsal or that the exercises are divided into smaller parts. The result indicates that students with disabilities have the best opportunity f, Den här forskningsöversikten består av en granskning av 34 vetenskapliga artiklar. Syftet är att beskriva och sammanställa aktuell forskning om elever som har IF och NPF. Frågeställningarna fokuserar på vilka utmaningar för lärande och undervisning diagnoserna innebär, om det förekommer några skillnader mellan flickor och pojkar samt hur lärmiljön kan anpassas för dessa elever. Det teoretiska ramverket i studien utgörs av genusteori och sociala konstruktioner. Resultatet visar att många elever med IF har diagnoser inom NPF och att det påverkar elevernas exekutiva, adaptiva och sociala förmågor. Flickor uppvisar ofta andra symtom än pojkar, men skillnaderna tenderar att vara mindre vid svår eller grav IF. Flickor är i regel tystare än pojkar och verkar ofta ha en högre social kompetens, medan pojkar i högre utsträckning är utåtagerande. Skillnaderna bidrar till att pojkar ofta får mer stöd i skolan och att de utreds i ett tidigare skede. Flickor är däremot svårare att upptäcka, vilket bidrar till att flickor ofta får diagnos senare än pojkar. Betydligt fler pojkar än flickor får diagnos inom NPF; forskning har i många år utgått från pojkars symtom, vilket har påverkat utformandet av utredningsverktygen. Resultatet visar att det finns ett stort behov av att individanpassa undervisningen utifrån elevernas förmågor och kunskapsnivå med hjälp av tydlig struktur i en lugn miljö med få störande moment. Eleverna behöver stöd för att utveckla sina exekutiva, adaptiva och sociala förmågor. Tidiga insatser har visat sig vara av stor betydelse. Oavsett kognitiv nivå krävs att pedagoger möter eleverna med höga förväntningar och uppmuntran samt ger dem det stöd de behöver. Exempelvis kan det handla om att få längre tid på sig, repetition eller att uppgifterna delas upp i mindre delar. Resultatet indikerar att elever med funktionsnedsättningar har störst möjlighet att utvecklas tillsammans med elever inom reguljär skola.

Background Long-term use of antiseizure drugs is associated with a low bone mineral density (BMD) and an increased fracture risk. The literature regarding institutionalised children on chronic antiseizure drugs is limited. Therefore, the aim of this cross-sectional study is to evaluate the prevalence of low BMD and the history of fractures in institutionalised children with epilepsy and intellectual disability (ID). Methods A dual-energy X-ray absorptiometry of lumbar spine (L1-L4) and hip was performed in 24 children, residing in a long-stay care facility in the Netherlands. Additionally, serum concentrations of albumin, calcium and 25-hydroxyvitamin D were determined. Data on fractures were retrospectively extracted from the medical files. Results Ages of the children (14 male and 10 female) ranged from 5 to 17 years with a mean age of 13.0 (+/- 3.2). The criteria of the International Society for Clinical Densitometry (ISCD) were used for classification of bone mineral disorders. Eight (33.3%) children had a normal BMD (Z-score > - 2.0). Of the 16 children with a low BMD (Z-score <= - 2.0), three were diagnosed as osteoporotic, based on their fracture history. Ten children (41.7%) were reported to have at least one fracture in their medical history. Serum concentrations of albumin-corrected calcium (2.28-2.50 mmol/L) and (supplemented) vitamin D (16-137 nmol/L) were within the normal range. Conclusions This study demonstrated that 67% of institutionalised children with epilepsy and ID had low BMD and 42% had a history of at least one fracture, despite supplementation of calcium and vitamin D in accordance with the Dutch guidelines.

This essay consists of a review of 34 scientific articles. The aim is to describe and compile current research about students with intellectual disability (ID) and neurodevelopmental disorder (NDD). The research questions focus on what challenges for learning and teaching the diagnoses imply, if there are any differences between girls and boys, and how the learning environment may be adapted for these students. The theoretical framework in this study consists of gender theory and social constructions. The results show that many students with ID also have diagnoses within NDD and that it affects the students’ executive, adaptive and social abilities. Girls show other symptoms than boys, but there tends to be fewer differences when the students have a severe ID. Girls are often quieter than boys and seem to have better social skills, while boys more frequently have challenging behaviour. The differences contribute to boys receiving more support in school and that they are referred to neuropsychiatric assessment at an earlier age. Girls however are more difficult to discover, which causes that girls often receive a diagnosis later than boys. Considerably more boys than girls get a diagnosis within NDD; research has for many years focused on boys’ symptoms, which has affected the formation of the diagnostic tools. The result shows that there is a huge need of adapting the education to each student’s ability and level of knowledge with help from a clear structure in a calm setting with few disturbances. The students need support in developing their executive, adaptive and social skills. Early interventions have shown to be of great importance. Regardless of cognitive level, pedagogues need to have high expectations on the students, encourage them and give them the support they need. The students may for example need longer time, rehearsal or that the exercises are divided into smaller parts. The result indicates that students with disabilities have the best opportunity f, Den här forskningsöversikten består av en granskning av 34 vetenskapliga artiklar. Syftet är att beskriva och sammanställa aktuell forskning om elever som har IF och NPF. Frågeställningarna fokuserar på vilka utmaningar för lärande och undervisning diagnoserna innebär, om det förekommer några skillnader mellan flickor och pojkar samt hur lärmiljön kan anpassas för dessa elever. Det teoretiska ramverket i studien utgörs av genusteori och sociala konstruktioner. Resultatet visar att många elever med IF har diagnoser inom NPF och att det påverkar elevernas exekutiva, adaptiva och sociala förmågor. Flickor uppvisar ofta andra symtom än pojkar, men skillnaderna tenderar att vara mindre vid svår eller grav IF. Flickor är i regel tystare än pojkar och verkar ofta ha en högre social kompetens, medan pojkar i högre utsträckning är utåtagerande. Skillnaderna bidrar till att pojkar ofta får mer stöd i skolan och att de utreds i ett tidigare skede. Flickor är däremot svårare att upptäcka, vilket bidrar till att flickor ofta får diagnos senare än pojkar. Betydligt fler pojkar än flickor får diagnos inom NPF; forskning har i många år utgått från pojkars symtom, vilket har påverkat utformandet av utredningsverktygen. Resultatet visar att det finns ett stort behov av att individanpassa undervisningen utifrån elevernas förmågor och kunskapsnivå med hjälp av tydlig struktur i en lugn miljö med få störande moment. Eleverna behöver stöd för att utveckla sina exekutiva, adaptiva och sociala förmågor. Tidiga insatser har visat sig vara av stor betydelse. Oavsett kognitiv nivå krävs att pedagoger möter eleverna med höga förväntningar och uppmuntran samt ger dem det stöd de behöver. Exempelvis kan det handla om att få längre tid på sig, repetition eller att uppgifterna delas upp i mindre delar. Resultatet indikerar att elever med funktionsnedsättningar har störst möjlighet att utvecklas tillsammans med elever inom reguljär skola.

Background: The current lack of knowledge about intellectual disability (ID) in forensic psychiatric contexts can compromise the legal certainty of these individuals during the medico-legal process. To address ambiguous results in previous literature, the aim of the current study was to estimate the prevalence of ID in a pre-trial forensic psychiatric settings. Moreover, as little is known about the characteristics of offenders with ID, we conducted a clinical characterization of individuals with and without ID being subject to forensic psychiatric assessment. Methods: Using data from several Swedish national registers, we conducted a population-based retrospective observational study on 8,442 individuals being subject to pre-trial forensic psychiatric assessments in Sweden in 1997–2013. We performed univariate analyses to compare the characteristics of individuals with (n = 537) and without ID (n = 7,905). Results: The prevalence of ID was 6.4% in the Swedish pre-trial forensic psychiatric context during the observational period. Compared with individuals without ID, individuals with ID were younger at the time of assessment, had a lower educational level, and had less frequently started families. ID was associated with lower frequency of diagnosed psychotic and bipolar disorders. However, a similar prescription rate of antipsychotics, and a comparable rate of previous inpatient care was observed among individuals with and without ID. Individuals with ID had more often been prescribed anti-libidinal treatments often used for treating sexual disorders, although did not present a higher prevalence of sexual disorder. Conclusions: The prevalence of ID among pre-trial individuals being subject to forensic psychiatric assessment was more than twice as high as assumed in the general population. Our results suggest that individuals with ID received pharmacotherapy without clear indication. Remaining challenges in the clinical management of individuals with ID were indicat, Funding Agency:Stiftelsen Savstaholm

Autism spectrum disorder (ASD) frequently co-occurs with intellectual disability (ID) and often remains undiagnosed until adulthood. The Social Communication Questionnaire (SCQ) is a widely used measure to screen for ASD. To improve the utility of the SCQ for adults with ID, the aim of this study was to develop an ID-specific and adult appropriate algorithm for the SCQ using a core set of valid items. These items were identified in one sample (N = 226) and further cross-validated in a second, independent sample (N = 225) from Germany, England and the U.S. The newly developed algorithm has 24 items compared with the 40 items in the original instrument. The reduced item core set yielded similar diagnostic validity as the original algorithm with good sensitivity values (0.81–0.89) and low specificity values (0.62–0.72). Overall, these results suggest that the removed items may not carry diagnostically relevant information in adults with ID; thus, excluding these items may result in a more efficient and age-appropriate screening measure for this population. However, due to the low specificity values, a comprehensive assessment is essential for a final diagnostic assignment.

Autism Spectrum Disorders (ASD) are complex neurodevelopmental conditions characterized by delays in social interactions and communication as well as displays of restrictive/repetitive interests. DNA copy number variants have been identified as a genomic susceptibility factor in ASDs and imply significant genetic heterogeneity. We report a 7-year-old female with ADOS-G and ADI-R confirmed autistic disorder harbouring a de novo 4 Mb duplication (18q12.1). Our subject displays severely deficient expressive language, stereotypic and repetitive behaviours, mild intellectual disability (ID), focal epilepsy, short stature and absence of significant dysmorphic features. Search of the PubMed literature and DECIPHER database identified 4 additional cases involving 18q12.1 associated with autism and/or ID that overlap our case: one duplication, two deletions and one balanced translocation. Notably, autism and ID are seen with genomic gain or loss at 18q12.1, plus epilepsy and short stature in duplication cases, and hypotonia and tall stature in deletion cases. No consistent dysmorphic features were noted amongst the reviewed cases. We review prospective ASD/ID candidate genes integral to 18q12.1, including those coding for the desmocollin/desmoglein cluster, ring finger proteins 125 and 138, trafficking protein particle complex 8 and dystrobrevin-alpha. The collective clinical and molecular features common to microduplication 18q12.1 suggest that dosage-sensitive, position or contiguous gene effects may be associated in the etiopathogenesis of this autism-ID-epilepsy syndrome., P. Wang, P. Carrion and K. Calli contributed equally to this study.

Objective and Hypothesis: This research will focus on how it influences the level of autonomy of adult people with intellectual disabilities (ID) in their employment. Also It will analyze whether sex, age, level of intelligence and workplace influence the autonomy in people with ID. Instrument: We use “The Arc‘s Self-Determination Scale (Adult Version) by Michael Wehmeyer. Method: We used a sample of 38 adults with ID (20 women represented a 52.63% of the sample and 18 men with the 47.37%, average age was 33 (age range 20 to 53 years). They were divided into six centers, staffed by people with Intellectual Disabilities, located at the following locations in Extremadura: Don Benito, Cáceres, Badajoz, Jerez de los Caballeros, Azuaga and Villafranca de los Barros. Conclusions: The sex is not an important variable in the degree of autonomy of people with ID; in terms of age, persons under 45 years are slightly more autonomous than the older of this age; with reference to the workplace, in the Occupational Centers (OC) can be found most of the sample and there are not significant differences in the degree of autonomy, while the Sheltered Employment (SE), there are nearly twice workers with a high autonomy than with a low autonomy. Finally, in regard to the level of intelligence, the greater the degree of severity of disability lowers the level of autonomy of the individual., Objetivo e Hipótesis: El presente trabajo de investigación versará sobre cómo influye el nivel de autonomía de las personas con discapacidad intelectual (DI) adultas con respecto a su empleo. Se va a analizar, además, si el sexo, la edad, el nível de inteligencia y el centro de trabajo influyen en la autonomia en las personas con DI. Instrumento: Se utilizo “The Arc’s Self-Determination Scale” (Version para adultos) de Michael Wehmeyer. Método: Para ello se utilizó una muestra de 38 personas adultas con DI (20 mujeres con un 52,63% y 18 varones con un 47,37%, siendo la edad media 33 (rango de edad de 20 a 53 años). Distribuidos en seis Centros donde trabajan personas con Discapacidad Intelectual, ubicados en las siguientes localidades de Extremadura: Don Benito, Cáceres, Badajoz, Jerez de los Caballeros, Azuaga y Villafranca de los Barros. Conclusiones: El sexo no es una variable importante en el grado de autonomía de las personas con DI; en cuanto a la edad, las personas menores de 45 años son ligeramente más autónomas que los mayores a esta edad; con referencia al centro de trabajo, en los Centros Ocupacionales (CO) se encuentra la mayoría de la muestra y no es significativa la diferencia en su grado de autonomía, mientras que en los Centros Especiales de Empleo (CEE), hay casi el doble de trabajadores con alta autonomía que con baja autonomía. Por último, y en cuanto al grado de inteligencia, a mayor severidad en la discapacidad, menor es el nivel de autonomía de la persona.