Response to article: Behavioral management in children with intellectual disabilities in a resource-poor setting in Barwani, India

Sir,

We read with great interest the article by Lakhan on “Behavioural management in children with intellectual disabilities in a resource-poor setting in Barwani, India.”[1] The author has indeed done a commendable job by providing research evidence on the effectiveness of behavioral interventions and rehabilitation efforts for patients with intellectual disability and behavioral problems in a community setting in India. It will serve as a useful reference for practitioners as well as service planners and policymakers.

The utility of this research will be further enhanced if following additional information can be provided:

• The division of the patients into the community-based rehabilitation, and clinic intervention groups have not been pursued or interpreted in the results, since the tables in the article present pooled data. This data, divided according to the two-intervention groups with a clear mention of the pre-intervention and post-intervention scores in each would help the readers understand the comparison between the effectiveness of the interventions done in the two settings.

• The baseline (pre-intervention) scores of the participants, according to the parameters under study with regard to the first-research question would help the readers understand better how the participants scores on the behavioral assessment scales for Indian children-mental retardation scale varied with respect to the parameters of the sociodemographic profile. This would help the readers get some insight about the extent of behavioral problems in patients with intellectual disability, and how parameters such as age, sex, population type (tribal/nontribal) etc., affect them

• We would also like the author to provide information if the clinic intervention group patients were on medication for any psychiatric co-morbidities that they were found to be suffering from.

• “Physical restraint” has been listed as one of the behavioral interventions carried out in these patients. We request the author to elaborate the methods/practices employed as physical restraint as well as circumstances under which it was employed, as there is a scope for undesirable activities along this line of intervention being inadvertently promoted based on this otherwise valuable research evidence.

Once again, we congratulate the author on his effort.