Legislative changes in line with changing societal perspectives have resulted in increased service pressure on primary health practitioners to take further responsibility for the assessment and treatment of co-morbid psychiatric disorders in individuals with intellectual disability (ID) and for secondary and tertiary level services to reduce waitlists. The unique attributes of the ID population and a core lack of training for health professionals in the ID field has resulted in a large number of practitioners feeling under-trained and under-resourced to carry out this role effectively, to the potential detriment of the ID population. The challenges health practitioners experience when diagnosing co-morbid mental health disorders in individuals with ID and how they overcome these challenges was explored in this study. Participants were health practitioners of varying professions, including Psychiatrists, Clinical Psychologists and General Practitioners. Health practitioners completed an online survey and/or partook in a focus group or individual interview. The method used in this research was thematic analysis. The study found that health practitioners use holistic and contextual approaches to carry out assessments of individuals with ID, utilise ID specific tools, and liaise with experienced, specialised health practitioners as ways of dealing with the complexity of diagnosing co-morbid mental health difficulties in individuals with ID. In addition, it is recommended that more training in the ID area is provided for health practitioners, particularly for GPs in light of recent policy changes with emphasis of assessment and treatment occurring at the primary health level and for best practice guidelines to be developed. A further research project is suggested, exploring specific challenges facing GPs in this area of practice.

This essay consists of a review of 34 scientific articles. The aim is to describe and compile current research about students with intellectual disability (ID) and neurodevelopmental disorder (NDD). The research questions focus on what challenges for learning and teaching the diagnoses imply, if there are any differences between girls and boys, and how the learning environment may be adapted for these students. The theoretical framework in this study consists of gender theory and social constructions. The results show that many students with ID also have diagnoses within NDD and that it affects the students’ executive, adaptive and social abilities. Girls show other symptoms than boys, but there tends to be fewer differences when the students have a severe ID. Girls are often quieter than boys and seem to have better social skills, while boys more frequently have challenging behaviour. The differences contribute to boys receiving more support in school and that they are referred to neuropsychiatric assessment at an earlier age. Girls however are more difficult to discover, which causes that girls often receive a diagnosis later than boys. Considerably more boys than girls get a diagnosis within NDD; research has for many years focused on boys’ symptoms, which has affected the formation of the diagnostic tools. The result shows that there is a huge need of adapting the education to each student’s ability and level of knowledge with help from a clear structure in a calm setting with few disturbances. The students need support in developing their executive, adaptive and social skills. Early interventions have shown to be of great importance. Regardless of cognitive level, pedagogues need to have high expectations on the students, encourage them and give them the support they need. The students may for example need longer time, rehearsal or that the exercises are divided into smaller parts. The result indicates that students with disabilities have the best opportunity for development when they are together with students in general education. / Den här forskningsöversikten består av en granskning av 34 vetenskapliga artiklar. Syftet är att beskriva och sammanställa aktuell forskning om elever som har IF och NPF. Frågeställningarna fokuserar på vilka utmaningar för lärande och undervisning diagnoserna innebär, om det förekommer några skillnader mellan flickor och pojkar samt hur lärmiljön kan anpassas för dessa elever. Det teoretiska ramverket i studien utgörs av genusteori och sociala konstruktioner. Resultatet visar att många elever med IF har diagnoser inom NPF och att det påverkar elevernas exekutiva, adaptiva och sociala förmågor. Flickor uppvisar ofta andra symtom än pojkar, men skillnaderna tenderar att vara mindre vid svår eller grav IF. Flickor är i regel tystare än pojkar och verkar ofta ha en högre social kompetens, medan pojkar i högre utsträckning är utåtagerande. Skillnaderna bidrar till att pojkar ofta får mer stöd i skolan och att de utreds i ett tidigare skede. Flickor är däremot svårare att upptäcka, vilket bidrar till att flickor ofta får diagnos senare än pojkar. Betydligt fler pojkar än flickor får diagnos inom NPF; forskning har i många år utgått från pojkars symtom, vilket har påverkat utformandet av utredningsverktygen. Resultatet visar att det finns ett stort behov av att individanpassa undervisningen utifrån elevernas förmågor och kunskapsnivå med hjälp av tydlig struktur i en lugn miljö med få störande moment. Eleverna behöver stöd för att utveckla sina exekutiva, adaptiva och sociala förmågor. Tidiga insatser har visat sig vara av stor betydelse. Oavsett kognitiv nivå krävs att pedagoger möter eleverna med höga förväntningar och uppmuntran samt ger dem det stöd de behöver. Exempelvis kan det handla om att få längre tid på sig, repetition eller att uppgifterna delas upp i mindre delar. Resultatet indikerar att elever med funktionsnedsättningar har störst möjlighet att utvecklas tillsammans med elever inom reguljär skola.

<p>  </p> <p><em>Syngap1+/-</em> is a mouse mode for intellectual disability and autism spectrum disorder where haploinsufficiency of the <em>Syngap1</em> gene and therefore downregulation of SynGAP1 leads to early maturation of synapses within the brain within post-natal days fourteen and sixteen instead of at the normal developmental schedule of post-natal day thirty. This early-shifted timeline falls directly before the visual critical where binocular matching between inputs from the two eyes occurs, and during a period where neurons become selective to specific orientations. High-level visual and cognitive issues observed in autism spectrum disorder patients might follow from deficits in basic sensory processing development, but it is not yet understand how <em>Syngap1</em> haploinsufficiency affects visual development and visual processing. Therefore, to characterize visual processing within the <em>Syngap1+/-</em> mouse model of autism spectrum disorder, acute electrophysiological recordings were performed within the monocular and binocular regions of the mouse visual cortex (V1). Responses to a series of visual stimuli were analyzed to measure and compare receptive field size, orientation selectivity, and binocularity between <em>Syngap1+/-</em> mice and littermate controls. In order to understand how potential deficits in physiology could translate into visual perception, a behavioral training protocol was implemented which isolated visual acuity in mice. In accordance with known developmental timelines in the visual cortex, it was found that the receptive field sizes of V1 neurons in <em>Syngap1+/-</em> mice were unchanged from wild type controls. However, these same neurons had wider tuning curves and lower firing rates than neurons in littermate controls. Ocular dominance was unaltered between <em>Syngap1+/-</em> and wild type mice, but this was possibly due to low sample sizes of neurons from the binocular regions of V1. At the behavioral level, lower visual acuities were discovered in <em>Syngap1+/-</em> mice with a size degree difference compared to littermate controls – a minor but significant difference. These results indicate a reduction in SynGAP1 expression has a perceivable effect on V1 development and function at both physiological and behavioral levels.</p>

Studiens syfte var att beskriva hur Alternativ och Kompletterande Kommunikation (AKK) används av lärare i den anpassade skolan för att främja elevers arbete med ämnesinnehåll, språkutveckling och kognition. Studien utgick från det sociokulturella perspektivet. En kvalitativ intervjustudie genomfördes och data analyserades i en tematisk analys. Urvalet bestod av åtta lärare i den anpassade skolan. Resultatet visade att lärare använder AKK i stor utsträckning för att möjliggöra arbete med ämnesinnehåll. Användandet av AKK gynnade elevernas språkutveckling och kognition, då lärarna möjliggjorde arbete i den proximala utvecklingszonen. Både empirisk och teoretisk generalisering låg till grund för arbetet med ämnesinnehåll, och vi fann exempel på lärare som arbetade liknade en learning activity. Lärarna önskade utveckla arbetet med att tolka elevernas deltagande i ämnesarbetet, samt att få mer stöd i form av färdigutvecklade lektionsstrukturer. Eleverna utmanades att fördjupa sitt kunnande vilket också kan gynna dem i ett samhällsperspektiv på lång sikt. Resultatet av studien kan användas av lärare i det didaktiska planeringsarbetet. / The aim of the study was to describe how Alternative and Augmentative Communication (AAC) is used by teachers in special schools to promote students' work with subject content, language development and cognition. The study was based on the sociocultural perspective. A qualitative interview study was conducted and the data was analyzed in a thematic analysis. The sample consisted of eight teachers in special schools. The results showed that teachers use AAC to a large extent to enable work with subject content. The use of AAC benefited the students' language development and cognition, as the teachers enabled work in the zone of proximal development. Both empirical and theoretical generalization was the basis for the work with subject content, and we found examples of teachers whose work was similar to a learning activity. The teachers also wanted to develop the interpretation of the students' participation in the subject work, as well as to receive more support in the form of fully developed lesson structures. The students were challenged to deepen their knowledge, which can also have long term societal benefits for students. The results of the study can be used by teachers in didactic planning work.