Abstract: Although attention has been given to the intellectual functioning of children with attention-deficit/hyperactivity disorder (ADHD) relative to their non-ADHD peers, few studies have examined intellectual functioning in adults with ADHD. The purpose of the current investigation was to examine differences in intellectual ability between adults with and without ADHD via a meta-analytic review. Of the 33 studies meeting inclusion criteria, primary analyses focused on 18 studies representing 1,031 adults with ADHD and 928 non-ADHD, nonclinical comparison adults and containing Wechsler Adult Intelligence Scale (WAIS; D. Wechsler, 1955, 1981, 1994) Full Scale IQ scores or estimates. A significant effect was found such that adults with ADHD scored lower than non-ADHD adults on WAIS intelligence tests. However, this difference was small and not clinically meaningful. The presence of several moderators reflecting characteristics of the ADHD samples and study methodology suggested that only a subset of adults with ADHD (e.g., those with comorbid disorders) may experience lower general intellectual ability relative to non-ADHD comparison adults. Implications of the findings for clinical and research settings are presented as well as suggestions for improving methodology and reporting in future research.

Abstract: Evidence from longitudinal studies indicates that lower IQ score in childhood and early adolescence increases risk of schizophrenia and schizophrenia spectrum disorders (SSD). This study investigated the association between premorbid IQ and risk of SSD in a population-based cohort of 17-year-old conscripts. Fifty four thousand males assessed by the Israeli Draft Board during two consecutive years were followed by means of the Israeli National Psychiatric Hospitalization Case Registry for up to 11 years. Tests of verbal and non-verbal reasoning, mathematical knowledge and instructions comprehension and several psychosocial variables were recorded by the Draft Board. Risk for SSD increased with decreasing IQ score. Only poorer non-verbal reasoning conferred a significant increased risk for SSD after taking into account general intellectual ability. IQ was not associated with age of onset. These results confirm the importance of low intellectual functioning as a risk factor for SSD. This is unlikely to be due to prodrome.

Abstract: Background: There has been considerable effort expended on defining neurobehavioral characteristics of children with fetal alcohol spectrum disorders (FASD) Children with FASD display a range of cognitive deficits and behavioral problems In this article, we report on the neurobehavioral characteristics of children with FASD in selected communities in Italy It was expected that both inattentive and hyperactive/impulsive characteristics would discriminate children with FASD from controls and that the groups would also differ on intellectual functioning, language comprehension, and academic skills Methods: Eighty-two children, 22 diagnosed with FASD and 60 control children, participated in this study The children were administered tests of nonverbal reasoning, language comprehension, academic achievement, and behavior Results: On tests of nonverbal reasoning and language comprehension, the FASD group earned lower scores than did controls Moreover, on a test of academic achievement the FASD group scored lower When comparing these 2 groups on disruptive behavioral symptomatology, similar results were obtained, the FASD group showing greater attentional difficulties and hyperactivity/impulsivity behaviors and more overall behavioral problems Stepwise logistic regression analysis showed that a model containing inattention and error scores on the language comprehension task correctly classified 85% of the participants Compared with the control group, a significantly greater proportion of children with FASD met the Diagnostic and Statistical Manual of Mental Disorders—fourth edition (DSM-IV) criteria of ADD, inattentive type, as reported by teachers In contrast, hyperactive symptoms among children with FASD were comparable with the control group Teachers rated children with FASD as having more inattentive behaviors and as performing lower in academic skills than controls The association between reported hyperactivity symptoms and achievement scores was nonsignificant for both language and math scores, suggesting that it is not the hyperactivity causing problems, but the child's inattention Conclusions: This research indicates that a nonclinic-referred sample of Italian children with FASD display a profile of neurobehavioral functioning consistent with that reported by other researchers Furthermore, the neurobehavioral characteristic most identified with children diagnosed with FASD was inattention followed by hyperactivity

Abstract: Intelligence has long been seen as linked to the spoken and written word. Because most deaf people have poor spoken language skills and find reading a significant challenge, there is a history in both psychology and education of considering deaf individuals to be less intelligent or less cognitively flexible than hearing individuals. With progress in understanding natural signed languages and cognitive abilities of individuals who lack spoken language, this perspective has changed. We now recognise, for example, that deaf people have some advantages in visuospatial ability relative to hearing people, and there is a link between the use of natural signed languages and enhanced visuospatial abilities in several domains. Such findings contrast with results found in memory, where the modality of mental representation, experience, and organisation of knowledge lead to differences in performance between deaf and hearing individuals, usually in favour of the latter. Such findings demonstrate that hearing loss an...

Abstract: Background Craniosynostosis, the premature fusion of the skull bones, is a congenital deformity that has functional and morphologic implications. Cranial vault reconstructive surgery is required to improve skull shape and increase intracranial volume. Craniosynostosis disorders carry a risk of brain insult and associated neurologic and cognitive dysfunction. This study investigated the long-term effects of craniosynostosis on intelligence in children and adolescents with syndromic and nonsyndromic disorders who had undergone cranial expansion surgery during infancy. Methods Global intellectual evaluations were obtained on 31 children aged 7 to 16 years with mixed syndromic (n = 13) and nonsyndromic (n = 18) craniosynostoses. Results of intellectual assessment were compared with norm-referenced data. Age at surgery and gender comparisons were also made. Results Mean +/- SD general intelligence quotient of the total sample was within the average range (intelligence quotient, 95.6 +/- 21.2). Intellectual functioning was significantly lower in children with syndromic craniosynostosis (mean intelligence quotient, 83.1 +/- 21.9) than nonsyndromic craniosynostosis (mean intelligence quotient, 104.7 +/- 15.8). The majority of children with syndromic craniosynostosis (77 percent) were of normal intelligence. Children with nonsyndromic craniosynostosis did not display obvious evidence of intellectual dysfunction. There were no age or gender differences in intellectual outcomes in this sample. Conclusions Findings are contrary to the historical impression that has regarded syndromic craniosynostosis as synonymous with intellectual disability. Children with nonsyndromic craniosynostosis are of normal intelligence during their school-age years.

Abstract: The aim of this study was to provide a comprehensive profile of the sensory, motor, language, and intellectual functioning of a non-referred community sample of 49 preschool children with attention-deficit-hyperactivity disorder (ADHD; 39 males, 10 females; mean age 4y 7mo [SD 7mo]; range 3y 10mo-6y) and 48 typically developing children (38 males, 10 females; mean age 4y 8mo [SD 6mo]; range 3y 11mo-6y) matched by age, sex, and maternal education who underwent a broad battery of neurodevelopmental tests. The results showed that the scores of the ADHD group were significantly lower than the comparison group on all measures. In addition, 23 (47%) of the children with ADHD had clinically significant co-occurring deficits in two or more areas. Logistic regression indicated that the only significant predictors of group classification were scores of verbal intelligence and motor and sensory functioning, accounting for 44.1% of the variance. These findings suggest that preschool children with ADHD have multiple developmental deficits over and above the core symptoms of ADHD and emphasize the importance of evaluating the sensorimotor functioning of preschool children with ADHD symptoms.

Abstract: Psychophysiological science proposes close interactions between cognitive processes and autonomic responses, yet the consequences of autonomic failure on cognitive functioning have not been documented. This pilot study investigates, for the first time, the cognitive profile of 14 patients with Pure Autonomic Failure (PAF). Each patient was administered a comprehensive battery of neuropsychological tests and neuroimaging investigation. A number of patients (n = 6) presented with cognitive impairment. The two most frequent types of impairment were: deficits of speed and attention, and executive functioning. Impairments of free recall memory, intellectual functioning, nominal and calculation functions were also documented, albeit in a much lower frequency. These cognitive changes were not always associated with white matter abnormalities. We speculate that the cognitive impairments associated with PAF represent consequences of systemic hypotension with cerebral underperfusion. However, a failure in integrated bodily arousal responses during cognitive behaviours may also contribute to some of the observed deficits.

Abstract: Objectives. We assessed the extent to which borderline mental retardation and mental retardation at preschool ages are related to emotional and behavioral problems in young adulthood. We also explored early risk factors for having mental health problems as a young adult that might be related to preschool differences in cognitive ability.Methods. We used data from a cohort of births studied in the Johns Hopkins Collaborative Perinatal Study and followed up in the Pathways to Adulthood Study. Preschool cognitive functioning was assessed at 4 years of age. Individual characteristics, psychosocial factors, and mental problems were prospectively evaluated from birth through young adulthood.Results. Children with subaverage cognitive abilities were more likely to develop mental health problems than their counterparts with IQs above 80. Inadequate family interactions were shown to increase 2- to 4-fold the risk of emotional or behavioral problems among children with borderline mental retardation.Conclusions. Sub...

Abstract: Previous studies of neuropsychological performance in borderline personality disorder (BPD) have exhibited mixed results. The high rate of co-occurring major depressive disorder (MDD) in BPD makes it difficult to specify whether neuropsychological deficits in BPD predominantly reflect co-occurring MDD or unique aspects of their psychopathology. To address this issue, 22 participants with borderline personality disorder and concurrent major depressive disorder (BPD-MDD) and 33 participants with MDD and no concurrent personality disorder were compared on a neuropsychological battery that assessed seven domains of performance: general intellectual functioning, motor skill, psychomotor speed, attention, memory, working memory, and executive function. Neuropsychological performance did not differ between BPD-MDD and MDD. However, BPD-MDD participants reported higher levels of anger, anxiety, and of overall emotional distress compared to MDD. When levels of anxiety were controlled, BPD-MDD participants exhibited superior general intellectual performance, psychomotor speed, and attention. Deficits found in previous BPD samples may reflect their susceptibility to co-occurring MDD. The impact of anxiety on neuropsychological performance in BPD, though, indicates a need for future experimental studies of the effects of mood on cognitive function to determine whether mood dysregulation, rather than core depressive symptoms, underlie cognition impairments in BPD.

Abstract: These commentaries [1,2] as well as the Engberg & Morral [3] paper, raise important and thought-provoking questions concerning the role of adolescent substance use in academic outcomes. Godley [1] makes the point that, regardless of the nature of the relation between academic achievement and substance use, schools are an important potential intervention environment for adolescents who are at risk for substance use problems. Indeed, our own findings and those of Engberg & Morral [3] suggest that adolescent drug use is related to reductions in sustained engagement in academic pursuits, which implies that interventions outlined by Godley [1] could improve school engagement and attendance. Engberg & Morral’s data are particularly compelling, as they demonstrate that reducing substance use through a treatment program increases school attendance among heavy drug-using adolescents. Taken together, the results of both empirical studies suggest that decreasing drug use will produce improvements in academic outcomes. Results of both studies [3,4] underscore the importance of clarifying the mechanisms by which substance use influences academic outcomes. Research suggests at least two potential mechanisms. First, substance use itself may impair cognitive development which, in turn, reduces academic achievement and disrupts academic progression. Recent studies have shown that heavy adolescent substance use can lead to problems with working memory and attention due to changes in adolescent brain activity [5]. In turn, these memory and attention problems may lead to decreases in academic performance and engagement in school, and ultimately increase risk for school problems and dropout. However, these findings have been reported with heavy drinking and drug-using adolescents (similar to the clinical sample used by Engberg & Morral), and it is unclear whether such effects would emerge at lower levels of use. Moreover, the magnitude and permanence of these effects are unclear in terms of whether they extend to impair academic functioning. For example, studies [6,7] suggest that withdrawal is an important predictor of the neurocognitive deficits associated with adolescent drinking, but it is not clear whether prolonged periods of abstinence rectifies these deficits or whether they are permanent. Alternatively, it could be that drug and alcohol use during adolescence leads to association with antisocial peer groups, which in turn diminishes school engagement and increases other behavioral and social problems. Indeed, as Godley and the current studies support, substance use is related to many school-related outcomes that have a strong behavioral and social component. That is, outcomes such as school grades, attendance, school completion and dropout are influenced not only by intellectual functioning, but also by motivation, organizational skills and social/behavioral skills. In other words, the effects of substance use on academic outcomes may have motivational, social and behavioral components in addition to any effects on cognition and cognitive development. Thus, negative academic outcomes may be due to both the direct effect of substance use on cognitive skills as well as the constellation of motivational, social and behavioral risk factors associated with substance use in adolescence. Interestingly, the findings from the current studies suggest that the mechanism by which substance use influences academic performance may differ depending on the nature of the adolescent sample (clinical versus community) and the developmental outcome that is studied (high school attendance versus academic achievement and college completion). Specifically, the substance use of heavy drug-using adolescents may directly impair academic (cognitive) abilities which limits academic performance in adolescence. For most adolescents who use drugs at a lower level, however, adolescent drug use may serve as a maturational ‘snare’ that keeps some adolescents engaged in deviant peer groups as others move on to more normative groups, thus having a long-term direct effect on educational attainment. Other studies [8–10] have discussed similar processes, in which differential pathways to problematic outcomes are determined, in part, by the level of multiple risk behaviors. If we believe that multiple mechanisms are operating, then it follows that preventive interventions aimed at improving academic engagement should broaden their focus beyond drug use in adolescence. We echo Godley’s [1] suggestion that community and family risk factors should also be targets of intervention. Our findings showed that drug use in adolescence partially mediated the effect of adolescent externalizing behaviors on college completion; adolescent externalizing also had direct effects on both adolescent reading achievement and on degree completion [3]. This implies that a powerful target of intervention would be externalizing behaviors, especially for adolescents who have not yet developed heavy or problematic levels of alcohol and/or drug use.

Abstract: Purpose of reviewAlcohol is widely available and one of the most commonly used psychoactive substances. This review examined the recent literature for empirical research addressing the cause, prevalence and treatment of alcohol-related problems in adolescents and adults with intellectual disabilitie

Abstract: The relationship between poor health and cognitive impairment is not fully understood yet. People with Down syndrome are prone to a number of health problems, including congenital heart defect, visual impairment, hearing loss, autoimmune diseases, epilepsy, early-onset Alzheimer's disease and intellectual disability. Our aim was to assess the impact of impaired health on cognitive performance in people with Down syndrome. A series of people with Down syndrome (n=129) were studied for their intellectual disability, sensory impairments and health concerns. The medical and psychological records of all persons with Down syndrome in the Intellectual Disability Service Register of Kainuu from 1970 to 2004 were analysed. The detected health issues were related to the individuals' cognitive levels. Visual impairment, poor dental health and acute neurological disease were associated with the severity of intellectual disability and ageing.

Abstract: Purpose of reviewTo examine most recently published studies of schizophrenia spectrum disorders in people with intellectual disabilities.Recent findingsStudies that have been published in the review period have advanced understanding of the epidemiology, presentation, assessment, suspected neuropath

Abstract: Circadian arousal impacts both physiological and intellectual functioning in humans and has been shown to vary significantly over the lifespan. Normative data indicate that children (ages 7 to 12 years) tend to have morning peaks in arousal, but that adolescents shift to eveningness. This evening preference continues through young adulthood and then shifts back to morningness late in life. While circadian and arousal patterns for older children and adolescents have been well documented, their impact on very young children has not received the attention it merits. The present study assessed circadian patterns for children aged 2 to 6. The data suggest that 2- and 3-yearolds show extreme morning tendencies, with roughly 90% of all children scoring as morning types. Morningness tendencies remain strong, but are more moderate in 4- and 5-year-olds (with roughly 75% scoring as morning types). These findings hold important implications for curriculum development, times for standardized testing, and psychological assessments.

Abstract: Using data from a U.S. longitudinal investigation of psychological effects of occupational conditions (a project of the National Institute of Mental Health's unit on Socioenvironmental Studies), we examined the relationship between the complexity of household work and 2 psychological variables: intellectual flexibility and self-esteem. Longitudinal reciprocal effects analyses revealed that for men (n = 351) and women (n = 355), more complex household work was associated with increased intellectual flexibility. For women, complex household work was also associated with increased self-confidence and decreased self-deprecation. For men, complex household work was associated with decreased self-confidence. The results are discussed in terms of theories of the cognitive and neurological effects of environmental complexity and of theories of self-esteem. Key Words: family roles, housework/division of labor, personality, self-esteem. Over the past few decades, sociological and psychological investigations of men's and women's participation in household work have increased dramatically in number. Research has demonstrated that there are gender differences both in the amount and the type of household labor performed and a variety of theoretical approaches have been proposed to explain these differences (Baxter, 2000; Blair & Lichter, 1991; Greenstein, 1996; Lennon & Rosenfield, 1994). In this article, we take a different but related tack: We focus not on gender differences in the distribution of domestic labor but on the psychological effects of household work (see also Bird, 1999; Dempsey, 2001; Spitze & Loscocco, 2000). In particular, we examine effects of the complexity of household work on intellectual functioning and on two aspects of self-esteem (self-confidence and self-deprecation) in men and women. Environmental Complexity and Intellectual Functioning Environmental complexity, including household work complexity, may be considered the degree to which an environment's demands are intellectually challenging. According to Schooler ( 1990), "The more diverse the stimuli, the greater the number of decisions required, the greater the number of considerations to be taken into account in making these decisions, and the more ill defined and apparently contradictory the contingencies, the more complex the environment" (p. 348). Psychological and physiological research has demonstrated that complex environments improve both cognitive and brain functioning in animals. A number of aspects of brain functioning appear to be involved, including neurogenesis and changes in neuron morphology in many areas of the brain (Greenough, Cohen, & Juraska, 1999; Kempermann, Kuhn, & Gage, 1997; Mohammed et al., 2002; Schooler, 1990). In humans, environmental complexity has been repeatedly demonstrated to have beneficial effects on intellectual and cognitive abilities (Kramer, Bherer, Colcombe, Dong, & Greenough, 2004). A long-term study of the National Institute of Mental Health (NIMH) unit on Socioenvironmental Studies centers on the collection of data from a representative sample of American men in 1964, from a representative subsample of those men as well as their wives in 1974, and finally from the 1994/1995 sample, which includes those 1974 respondents available for interviews in 1994/1995. A central concern of this longitudinal project has been the effects of substantively complex paid work on intellectual functioning (Kohn & Schooler, 1983; Schooler, Mulatu, & Gates, 1999,2004). Substantively complex work is defined as the degree to which the performance of work requires thought and independent judgment (Kohn & Schooler, 1983, p. 245). As described in Kohn and Schooler (pp. 340 - 343), it is based on the complexity of people's work with data (ranging from comparing to synthesizing on a 7-point scale), with things (ranging from handling to setting up on an 8-point scale), and with people (ranging from serving to mentoring on a 9-point scale). …

Abstract: Background. Routine use of standardized outcome measures within adult mental health services is compulsory in many countries, but not common in clinical practice. As well as political and professional factors, one reason may be that there is little empirical evidence of benefit for patients. It is therefore important to identify predictors of response. Pre-morbid intellectual functioning has predicted response to other interventions. This paper tests the hypothesis that pre-morbid IQ impacts on the effectiveness of routine assessment and feedback of outcome measures. Method. The Feedback of Outcomes to Users and Staff (FOCUS) single-blind randomized controlled trial (RCT) investigated routine completion and feedback of outcome measures for 160 (101 intervention, 59 control) adult mental health service patients in Croydon, South London (International Standard RCT Number 16971059). Results. Patients in the top quarter (pre-morbid IQ>110) differentially improved in patient-rated unmet need (adjusted difference 3 . 4, 95 % CI 0 . 8t o 5 . 9, p=0 . 012) and in the top half (pre-morbid IQ>99) in quality of life (adjusted difference x0 . 6, 95% CI x1 . 1t ox0 . 1, p=0 . 02). The top quarter result remained when controlling for the influence of baseline (p=0 . 004) and baseline plus follow-up variables (p=0 . 047). Conclusions. Feedback of routine outcome measures may improve outcome for patients with higher pre-morbid IQ. There is a need to understand more how routine outcome information is used by staff and patients to inform care. If the goal of routine use of outcome measures is to benefit patients directly, then targeted policies are required.

Abstract: Summary The need for specialized treatment programmes to address the specific requirements of different populations has been well recognized. One important area of treatment development has been for offenders who are unsuitable for existing mainstream treatment programmes. This paper describes the process of adapting an existing sexual offender treatment programme for use with sexual offenders who have special needs in an Australian correctional setting. The population comprised individuals with a variety of special needs including borderline or mild intellectual functioning, severe literacy problems, significant communication difficulties, and other important deficits and special needs. It should be noted that some of these special needs individuals would not meet the diagnostic criteria for intellectual disability and this programme is aimed at the broader group inclusive of a number of special needs. Therapeutic adaptations have been guided by current research and practice, and specific examples are described and discussed. The authors believe that these adaptations may also have some utility for mainstream sexual offender treatment programmes. Research into the efficacy of these treatment adaptations with this population is currently underway.

Abstract: Background Compared with that in mental illness, cultural variation in popular conceptualisations of intellectual disability has been rarely addressed Methods A survey of the relevant literature was conducted Results and Conclusion Preliminous conclusions are that local conceptualisation does not lead to invariant social response, but that intellectual disability is generally distinguished from mental illness

Abstract: Background This study aims to evaluate differences in the clinical profiles and use of psychiatric services by people with schizophrenia with and without borderline intellectual functioning. Both groups in this study were receiving standard community psychiatric care. Methods A naturalistic sample of 372 people with schizophrenia completed the National Adult Reading Test. Data were collected prospectively over 18 months on psychiatric symptoms and service use. Three hundred and thirteen had normal intellectual functioning (mean age 43, range 20–76 years) and 59 had borderline or lower intellectual functioning (mean age 45, range 21–81 years). This was defined by a National Adult Reading Test error score of more than 40. Results People with borderline or lower intellectual functioning had a lower quality of life, more severe psychotic symptoms, reduced functioning and fewer antidepressant prescriptions. There were no significant differences in service use including hospital admission. Conclusions People with schizophrenia and borderline or lower intellectual functioning are a more disabled group within general adult psychiatric services who should be the focus of initiatives for improved service delivery.

Abstract: Purpose of reviewThe presence of problem behaviours often impede an individual's quality of life and ability to be fully included in the environments of his or her choice. Functional behavioural assessment has been gaining widespread use in all settings in which people with intellectual disabilities

Abstract: The aim of this study was to examine the experience of the first generation of sibling advocates in Hong Kong. A qualitative approach was adopted and six sibling advocates of people with intellectual disabilities from one non-government organization were interviewed. Data were analyzed using a constant comparative method and content analysis. Findings revealed that the six participants were reactive in the process of taking up the caregiver responsibility and they performed three functions: to advocate for more service provision, to improve service quality, and to facilitate communication between individual service units and family members of people with intellectual disabilities. All of the participants expressed that they needed support from service providers when they tried to function as the sibling advocates. Strategies to promote the involvement of siblings of people with intellectual disabilities as advocates are discussed and it is expected that more siblings of people with intellectual disabilities will be supported to have a higher level of involvement in advocacy.

Abstract: Communication difficulties are a common consequence of brain injury and neuropathological processes. Equally common is the inability to assess intellectual functioning in many communication-impaired populations because the aphasia and physical disability of such patients prevents measurable performance on traditionally administered tests of mental functioning. This study demonstrates that concept formation abilities can be assessed using event-related brain potentials. It also provides further evidence for the efficacy of this innovative assessment method in which standardized and validated psychometric tests are formatted for computer presentation and simultaneous recording of neural activity, which serves as the response measure in lieu of verbal/behavioral responses.

Abstract: This contribution discusses the aetiology of learning disability. Learning disability, termed ‘mental retardation’ in ICD-10, is defined as significantly below average general intellectual functioning (IQ