Non-pharmacological interventions for challenging behaviours of adults with intellectual disabilities: A meta-analysis.
E Bruinsma, B J van den Hoofdakker, A P Groenman and 4 others
PMID 32558050WHAT IT FOUND
Non-pharmacological interventions reduced challenging behaviours in adults with intellectual disabilities by a moderate amount, and these gains held up over follow-up periods of 3 to 18 months.
Key findings
01The overall treatment effect was moderate, with a Cohen's d of 0.573.
02Effects at follow-up (3-18 months) were not significantly different from post-intervention effects.
03Interventions combining mindfulness and behavioural techniques showed a significantly higher effect than other intervention types.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
High heterogeneity means the average effect size may not apply to every specific intervention or patient. Publication bias was identified, with missing studies likely reporting negative or null results. Twelve eligible studies were excluded due to missing data, increasing the risk of bias. The superiority of mindfulness-based interventions is based on studies from a single research group, lacking independent verification. The analysis could not determine if interventions using functional analysis were more effective due to ambiguous reporting in the included papers.
Declared interests
No conflicts of interest were declared. The study was funded by the Dutch Research Council.
The easy way to misread this
Do not assume mindfulness-based interventions are proven superior. This finding came from subgroup analysis of studies conducted by a single research group, and the authors explicitly state that head-to-head randomised trials from other groups are needed to confirm this.