1. Poverty, Adversity and the Wellbeing of people with Developmental Disabilites Eric Emerson

2. Four Questions ›What is poverty? ›How should we measure it? ›Is it important for people with intellectual or developmental disabilities? ›What should we be doing about it?

3. What Is Poverty? ›‘The inability, due to lack of [economic] resources, to participate in society and to enjoy a standard of living consistent with human dignity and social decency’ Fabian Commission on Life Chances and Child Poverty (2006)

4. How Should We Measure Poverty? ›Traditionally -Current household income (adjusted for household composition) ›More recently -Material & social hardship due to lack of resources ( http://www.poverty.ac.uk/) http://www.poverty.ac.uk/ -Neighbourhood deprivation (but …..) ›Under consideration -measures of ‘multidimensional’ poverty (DfE/DWP) Emerson, E., Graham, H., & Hatton, C. (2006). The measurement of poverty and socio- economic position in research involving people with intellectual disabilities. In L.M. Glidden (Ed.) International Review of Research in Mental Retardation, New York: Academic Press.

5. Is Poverty Important? ›Centuries of research -Living in poverty (especially in childhood) is associated with -constrained life opportunities -Increased risk of a range of adversities -poorer cognitive, emotional, social and behavioural development -poorer health -premature mortality

6. Environmental Adversity & Well-Being ›Villermé (1826) -Annual mortality rates (per 1,000) related to Arrondisement wealth in Paris (1817-21) 6

7. Is Poverty Important? ›Centuries of research -Living in poverty (especially in childhood) is associated with constrained life opportunities, increased risk of a range of adversities, poorer cognitive, emotional, social and behavioural development, poorer health, premature mortality -Many children in the UK are growing up in poverty (3.6 million; 27% ….. and growing) -Children with severe intellectual disability or autism are at least as likely as other children to grow up in poverty -Children with less severe intellectual disability are much more likely than other children to grow up in poverty -Unless they are immune to the effects of poverty …….

8. Child Poverty and SEN Emerson, E. (2012). Deprivation, ethnicity and the prevalence of intellectual and developmental disabilities. Journal of Epidemiology & Community Health 66, 218-224.

9. Immunity? ›Is there an association between poverty and wellbeing among children with intellectual disabilities? Emerson, E., & Hatton, C. (2007). The mental health of children and adolescents with intellectual disabilities in Britain. British Journal of Psychiatry 191, 493-499.

10. What Should We Be Doing? 1.Reduce exposure -‘Upstream’ interventions (poverty reduction) o regulation of labour markets (e.g., minimum wage, salary/bonus caps, flexible employment) o redistributive tax policies -‘Downstream’ interventions that aim to disrupt the pathways that mediate the link between poverty and child wellbeing o biological pathways -‘allostatic load’ resulting from dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis -inflammation responses

11. Social/Environmental Pathways Poverty Parental Wellbeing Parenting Child Wellbeing Partner Conflict Conger, R. D., & Donnellan, M. B. (2007). An interactionist perspective on the socioeconomic context of human development. Annual Review of Psychology, 58, 175-199. Lack of investment in developmental activities

12. ‘Downstream’ Risks Associated with Poverty ›2,236 families in SW England supporting a child under 5 with developmental delay

13. Parenting Interventions ›Extensive evidence of long-term efficacy among ‘at risk’ children in general ›Growing evidence in intellectual and developmental disabilities (e.g., SSTP) -Tailoring interventions to -Social context of parenting a child with intellectual or developmental disabilities -Syndrome-specific issues Tellegen, C. L., & Sanders, M. R. (2013). Stepping Stones Triple P-Positive Parenting Program for children with disability: a systematic review and meta-analysis. Research in Developmental Disabilities, 34, 1556-1571.

14. What Should We Be Doing? 1.Reduce exposure 2.Build resilience ›Supporting -Children -Families -Communities ›Building and sustaining -Behavioural health -Problem solving -Self-esteem -Achievement and purpose -Relationships -Belonging

15. Many Unanswered Questions ›Strength of association (OR) between environmental risk at age 9 months and 3 years and the persistence of conduct difficulties from age 3 to ages 5 and 7 in UK children with/without intellectual and developmental disabilities

16. Four Questions ›What is poverty? ›How should we measure it? ›Is poverty important for people with intellectual or developmental disabilities? ›What should we be doing? Emerson, E. (online early). Commentary: Childhood exposure to environmental adversity and the well-being of people with intellectual disabilities. Journal of Intellectual Disability Research doi: 10.1111/j.1365-2788.2012.01577.x eric.emerson@lancaster.ac.uk