The Use of Psychotropic Medication in Iranian Children with Developmental Disabilities

The use of psychotropic medication in children is increasing worldwide. Children with developmental disabilities seem to be prescribed these medications at a higher rate compared to their non-disabled peers. Little is known about prescribing in non-Western, middle-income studies. In Iran, the file records of 1133 children, aged 2 to 17 years, assessed as having autism spectrum disorder (ASD) or an intellectual disability (ID) in Tehran City and Province from 2005 to 2019 were collated, and information from parental reports of medications was extracted. Upwards of 80% of children with ASD and 56% of those with ID were prescribed a psychotropic medication with around one quarter in each group taking two or more medications. The rates were higher among male children showing difficult-to-manage behaviors such as hyperactivity, but less so for children of fathers with higher levels of education. The lack of alternative management strategies may be a significant driver for the use of psychotropic medications in Iran and other Low and Middle Income countries, despite their known side effects, and their failure to address the developmental needs of the children. Rather, multi-disciplinary, behavioral, therapeutic, and educational interventions are required, but these are not available widely in Iran, although a start has been made

An exploration of lifestyle/obesity programmes for adults with intellectual disabilities through a realist lens: Impact of a ‘context, mechanism and outcome’ evaluation

Background Obesity is higher in people with intellectual disabilities. Aims There are two aims of this explorative paper. Firstly, using a realist lens, to go beyond ‘what works’ and examine the ‘context, mechanisms and outcomes’ (CMO) of lifestyle/obesity programmes for this population. Second, using a logic model framework to inform how these programmes could be implemented within practice. Method We explored six‐review papers and the individual lifestyle/obesity programmes that these papers reviewed using the CMO framework. Results There were few theoretically underpinned, multi‐component programmes that were effective in the short to long‐term and many failed to explore the ‘context and mechanisms’. We developed a logic model and engaged in two co‐production workshops to refine this model. Discussion Using a realist approach, programmes need to be underpinned by both individual and systems change theories, be multi‐component, have a closer understanding of the interplay of the ‘context and mechanisms’, and co‐designed using a logic model framework

Barriers and facilitators of physical activity in adolescents with intellectual disabilities: An analysis informed by the COM-B model

BACKGROUND: Adolescents with intellectual disabilities are insufficiently physically active. Where interventions have been developed and delivered, these have had limited effectiveness, and often lack a theoretical underpinning. AIM: Through application of the COM‐B model, our aim is to explore the factors influencing adolescent physical activity within schools. METHODS: A qualitative methodology, using focus groups with students who have mild/moderate intellectual disabilities, their parents'/carers' and teachers'. The COM‐B model provided the lens through which the data were collected and analysed. RESULTS: We identified of a range of individual, interpersonal, and environmental factors influencing physical activity, across all six COM‐B constructs, within the context of the ‘school‐system’. CONCLUSION: This is the first study to use the COM‐B model to explore school‐based physical activity behaviour, for adolescents with intellectual disabilities. Identification of such physical activity behavioural determinants can support the development of effective and sustainable interventions