A Call for Inclusion: Children With Intellectual Disabilities in Trauma Treatment Research.

Area of Science:

• Psychiatry
• Developmental Psychology
• Clinical Psychology

Background:

• Children with intellectual disabilities (ID) face significant disparities in mental health care.
• These children experience higher rates of trauma, including physical, emotional, and sexual abuse.
• Exclusion from medical research may exacerbate healthcare inequities for individuals with ID.

Purpose of the Study:

• To determine the extent to which children with intellectual disabilities (ID) are excluded from trauma treatment research.
• To assess the representativeness of current posttraumatic stress disorder (PTSD) treatment research for children with ID.

Main Methods:

• Reanalysis and coding of 62 randomized controlled trials (RCTs) from the International Society for Traumatic Stress Studies (ISTSS) clinical care guidelines meta-analysis.
• Articles were double-coded to identify exclusion criteria related to ID or co-occurring developmental disabilities.
• Surveys were sent to study authors to assess the likelihood of ID eligibility.

Main Results:

• Over 61% of reviewed studies reported exclusion criteria that could exclude children with ID, using terms like 'cognitive impairment' or 'autism spectrum disorder'.
• Exclusion criteria were often poorly defined and operationalized.
• Few studies reported the number of children excluded due to an ID diagnosis.

Conclusions:

• The evidence base for current child PTSD treatment guidelines is not representative of children with ID.
• Improved documentation and reporting of inclusion/exclusion criteria are necessary.
• Inclusion of children with ID in future PTSD treatment trials is crucial for equitable research representation.