BACKGROUND:
A
risk informed, early intervention strategy for self-injurious, aggressive and
destructive behaviours in children with severe intellectual disability is
gaining support. The aims of this study were to establish the cumulative
incidence and persistence of self-injury, aggression and destruction and the
relationship between these behaviours and two potentially predictive
behavioural risk markers (repetitive behaviour, and impulsivity and
overactivity) in children at high risk.
METHODS:
In a
longitudinal design self-injury, aggression and destruction were assessed by
teachers of 417 children with severe intellectual disability on two occasions
separated by 15-18 months.
RESULTS:
Aggression,
destruction and self-injury were persistent (69%, 57% and 58% respectively).
Repetitive and restricted behaviours and interests (RRBI) and
overactivity/impulsivity (O/I) were significantly associated with aggression
(O/I OR=1.291, p<.001), destruction (RRBI OR 1.201, p=.013; O/I OR 1.278,
p<.001) and/or self-injury (RRBI, OR 1.25, p=.004; O/I OR=1.117, p<.001).
The relative risk of the cumulative incidence of self-injury, aggression and
destruction was significantly increased by repetitive and restricted behaviours
and interests (self-injury 2.66, destruction 2.16) and/or overactivity/impulsivity
(aggression 2.42, destruction 2.07).
CONCLUSIONS:
The
results provide evidence that repetitive and restricted behaviours and
interests, and overactivity/impulsivity, are risk markers for the onset of
self-injury, aggression and destruction within the already high risk group of
children with severe intellectual disability.
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