A Population-Based Study on Comorbidity in Children with Severe Motor and Intellectual Disabilities: Focus on Feasibility and Prevalence

Comorbidity is common in children with severe motor and intellectual disabilities (SMID). We performed a population-based study in 196 children with SMID, focusing on respiratory infections, respiratory function, constipation, dysphagia, gastro-oesophageal reflux and nutritional state. Although respiratory problems are common, no pulmonary function method was available. We showed that the interrupter technique (respiratory resistance) is feasible in a majority of the children with SMID, with a moderate but acceptable reproducibility. Furthermore, we propose rejection criteria to evaluate measurements with the interrupter technique that are not population specific. Next, a pilot study in 36 children with SMID has demonstrated that Bioelectric Impedance Analysis (BIA) is a feasible nutritional assessment method. Since it was well tolerated by most children, its value for use in this specific population deserves further research. Another studied comorbidity is constipation. Regular pediatric definitions are not applicable in children with SMID; therefore we propose a new definition. We showed that 54% of the children used laxatives. Even still, 22% was constipated. No correlations with intake or disability severity were found. Dairies on dietary intake showed! that most children do no meet the criteria for water and fiber intake. In the general discussion of the thesis we focus not only on the feasibility of the used diagnostic methods, but use our experience in research practice in children with SMID to formulate recommendations for future research practice.

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