QualitativeDevelopmental medicine and child neurology2022

Reported clinical incidents of children with intellectual disability: A qualitative analysis.

Natalie Ong, Laurel Mimmo, Diana Barnett and 3 others

PMID 35578400

WHAT IT FOUND

Parents identified care issues in 13.63% of incident reports for children with intellectual disability, compared to 4.79% for those without.

This was the only category with a significant difference. Staff did not consistently document contributing factors, limiting understanding of why incidents occurred.

Key findings

01Care issues identified by parents were reported significantly more often in children with intellectual disability (13.63%) than in those without (4.79%), while other incident categories showed no significant differences between groups.

02The contributing factors section of incident reports was incomplete in over half of cases for both groups (52.27% for children with intellectual disability and 62.87% for those without), hindering the ability to understand context.

03Multiple clinical incidents occurred in a single report more frequently for children with intellectual disability (31.81%) than for those without (22.7%), often described as co-occurring failures.

STILL TO COME

How it was doneWhat they found

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What it does not show

The study relied on incident reports, which are known to under-represent the true number of safety events. The sample of analysed reports was relatively small (44 and 164), limiting the power to detect differences in other categories. The free-text fields were often incomplete or lacked detail on contributing factors, preventing a full understanding of the causes. The analysis could not determine if the intellectual disability diagnosis itself influenced the type of incident, only that the reported themes were similar across groups. The study did not capture parent-reported issues regarding staff attitudes or communication, which are prominent in other literature.

Declared interests

The authors declared no competing interests. The study was approved by the organization's human research ethics committee.

The easy way to misread this

Do not interpret the lack of significant differences in most incident categories as evidence that children with intellectual disability are equally safe. The authors note that incident reporting is often incomplete and that the contributing factors were poorly documented, meaning the true nature and frequency of safety issues may be underestimated.

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The study

Participants
44 incident reports for children with intellectual disability and 164 for children without
Certainty of evidence
Very low

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    Natalie Ong, Laurel Mimmo, Diana Barnett, et al. Reported clinical incidents of children with intellectual disability: A qualitative analysis. Developmental medicine and child neurology. 2022.

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