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Eur Child Adolesc Psychiatry. 2019 Jan;28(1):31-42. doi: 10.1007/s00787-018-1184-2. Epub 2018 Jun 22.

Education and employment trajectories from childhood to adulthood in individuals with 22q11.2 deletion syndrome.

Author information

1
The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5262000, Tel Hashomer, Israel. marymoshev@gmail.com.
2
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. marymoshev@gmail.com.
3
Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland.
4
The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5262000, Tel Hashomer, Israel.
5
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
6
Geha Mental Health Center and Felsenstein Medical Research Center, Petah Tikva, Israel.
7
Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Geneva, Switzerland.
8
Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.

Abstract

22q11.2 deletion syndrome (22q11.2DS) is the most common known microdeletion in humans occurring in 1 out of 2000-4000 live births, with increasing numbers of individuals with the microdeletion living into adulthood. The aim of the study was to explore the education and employment trajectories of individuals with 22q11.2DS from childhood to adulthood in a large cohort composed of two significant samples. 260 individuals with 22q11.2DS, 134 male and 126 female, aged 5-59 years (mean age 21.3 ± 10.8 years) were evaluated at two sites, Geneva (GVA) and Tel Aviv (TA). Psychiatric comorbidities, IQ score, and adaptive functioning were assessed using gold-standard diagnostic tools. Demographic factors, such as data about education, employment, marital status, and living status, were collected. Children entering elementary school (5-12 years) were significantly more likely to attend a mainstream school, while adolescents were significantly more likely to attend special education schools (p < 0.005). Cognitive abilities, and not adaptive functioning, predicted school placement. Among adults with 22q11.2DS (n = 138), 57 (41.3%) were unemployed, 46 (33.3%) were employed in open market employment, and 35 (25.4%) worked in assisted employment. In adulthood, adaptive functioning more than cognitive abilities predicted employment. Surprisingly, psychotic spectrum disorders were not found to be associated with employment. Individuals with 22q11.2DS are characterized by heterogeneity in educational and employment profiles. We found that cognitive abilities and adaptive functioning, and not the presence of psychiatric disorders, are key factors in school placement and employment. These factors should, therefore, be taken into account when planning optimal development of individuals with 22q11.2DS.

KEYWORDS:

Adaptive functioning; Education; Employment; Psychosis; Schizophrenia; VABS; Velocardiofacial syndrome

PMID:
29934817
DOI:
10.1007/s00787-018-1184-2
[Indexed for MEDLINE]

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