Developmental disabilities and mental health


Professor Stewart Einfeld

20 June 2011

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Voice-over: Welcome to this National Health and Medical Research Council podcast.

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Introduction: Hello I’m Carolyn Norrie of the NHMRC. I’m here today speaking with Professor Stewart Einfeld an NHMRC Program Grant recipient and distinguished researcher at the University of Sydney. Hello Professor Einfeld.

Prof. Einfeld: Good morning.

Interviewer: I understand that your area of interest is developmental disabilities and mental health. Can you tell me a little bit more about what developmental disabilities are?

Prof. Einfeld: Ah, well developmental disabilities by that term we mean impairments in function that occur during the childhood period, often genetic disorders affecting childrens’ development that are apparent from early on in development but also including the effects of later damage to the developing brain. So we include in the term developmental disability, intellectual disabilities, autism, and sometimes even more broadly the term is widened to include children with sensory and motor deficits.

Interviewer: What are the causes of these disabilities?

Prof. Einfeld: Well we usually divide them into antenatal causes, perinatal and postnatal. The antenatal causes are principally the genetic ones...the most common one would be Down’s Syndrome chromosomal abnormality and then there are other genetic conditions such as Fragile X Syndrome or Williams Syndrome and many others. There are actually hundreds of genetic causes many of them rare but collectively they are not rare…. collectively about two and a half percent of children are affected by developmental disabilities. Then there are problems that occur in the perinatal period such as asphyxia where children suffer brain impairments sometimes resulting in cerebral palsy and then there are post natal causes such as head injuries, meningitis and so on. Basically anything which significantly damages the developing brain can be a cause of developmental disability. Also an important antenatal one, which is not necessarily genetic, is Foetal Alcohol Syndrome caused by alcohol intake by the mother during pregnancy.

Interviewer: And how did these disorders affect the mental health of these young people?

Prof. Einfeld: Well good mental health requires to be supported by a healthy brain and if one has significant impairments to brain function then that very frequently manifests in significant behavioural and emotional disturbances that are sometimes severe enough to constitute mental disorders.

Interviewer: And how do those problems manifest themselves with the family and the community?

Prof. Einfeld: Well it means that parents of course have not only concerns and tasks related to helping the child to acquire developmental skills say from infancy you know, walking and toilet training and language acquisition because the child’s acquisition of these skills is slower than the’s not only that but they’re also having to cope with significant levels of behavioural and emotional disturbances of various kinds. There might be increased rates of tantrums or various kinds of disruptive behaviours, aggressive behaviours, sometimes aggressive behaviours directed towards the self such as various kinds of self injury behaviours and high levels of emotional disturbances such as predispositions to anxiety and distress. So these not only manifest – not only issues for the family- but in the child’s environment, in particular the school, and coping with the high levels of emotional and behavioural disturbances is a major challenge for the education system and later on this is what compromises the adaptation in terms of vocational adaptation and independent living.

Interviewer: And the research you’re doing entitled Mental Health of Young People with Developmental Disabilities …where do you see that research taking you?

Prof. Einfeld: Well what we are planning to do is to utilise a parent training method that has been widely applied for families with children with normal development and to use a special version of that designed for families of children with developmental disabilities and see if through this parent training process we’re able to reduce the public health burden of mental health problems in young people with developmental disabilities.

Interviewer: What’s innovative about your research?

Prof. Einfeld: Well one of the innovations is that for the first time here we’re going to design the interventions with not only the parts of the program which are in common across various causes but also with specialised interventions tailored for particular causes, so that what we’ll be providing for families of children with Down’s Syndrome will be somewhat different from those for children with Fragile X Syndrome for example. That hasn’t been done before.

Interviewer: Thank you Professor Stewart Einfeld. I appreciate you speaking to us today.

Prof Einfeld: It’s a pleasure.

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