Humor is Crucial for Social and Emotional Well-being in People With Intellectual Disabilities, Review Shows

Humor is essential for the social, developmental and emotional well-being of people affected by different types of intellectual disabilities, including Angelman syndrome, and their caregivers, according to a recent literature review.

The review, “Investigating humor in social interaction in people with intellectual disabilities: A systematic review of the literature,” published in Frontiers in Psychology.

Creating and appreciating humor are two types of positive social interactions that facilitate communication between people. Although previous studies have reported a strong link between humor and an individual’s well-being, this form of social behavior is rarely studied, especially in people with intellectual disabilities.

In this review, authors focused on gathering and summarizing findings from other studies regarding the impact of humor in social interactions of people with intellectual disabilities and their caregivers, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

The review included data from four databases ranging from 1954 to 2017 and a 32 published research articles.

Most studies focused on assessing the influence of humor on children and adolescents with different types of neurological diseases associated with intellectual disabilities, including autism, Down syndrome, Williams syndrome, Angelman syndrome and Rett syndrome.

Angelman syndrome patients often smile and laugh. Although not always the case, these facial and vocal expressions may occur when no stimulus is present, or be disassociated from the context, making interactions more difficult to establish and maintain.

Studies have incorporated humor-related behaviors (laughing/smiling) in patients with Angelman syndrome and explored the role of social and environmental influences on these behaviors.

One study found that smiling and laughing were greatest when enthusiastic interaction was taking place, moderate in instructional interactions and when there were others present but no interaction, and lowest when individuals were alone.

Another study revealed that smiling and laughing decreased with age during full interactions in this patient population, as they transitioned from childhood toward puberty/adolescence. More laughing and smiling have also been observed with familiar contacts when eye contact was maintained.

“Findings suggest that young people with intellectual disabilities show appreciation of humor. However, humor comprehension was poorer in people with DS [Down syndrome] and WS [Williams syndrome] compared with age matched to typically developing controls,” the authors wrote.

“For people with complex support needs and more severe cognitive impairments (e.g., those with Angelman syndrome), humor was also found to be a response to familiar interactional stimuli,” they added.

The authors noted that gestures may potentially be a useful support for humor comprehension in young people with intellectual disabilities.

Various types of humor, including physical, visual and verbal, were found to be appreciated by children with intellectual disabilities. However, some studies indicate that children and adolescents with Williams syndrome and Prader-Willi syndrome have difficulty understanding non-literal humor, such as irony and sarcasm, which could have a negative impact on the social relationships they form with their peers.

On the other hand, very few studies evaluated the impact of humor appreciation and comprehension among adults with intellectual impairments, confirming that this field of research warrants further investigation.

Likewise, the role of humor in the development of social relationships, communication, creativity and stigma all lacked attention and should be considered in future studies, the authors noted.

The team also highlighted the importance of humor as a coping mechanism for caregivers.

“One of the ways in which humor and shared humor operated as important aspects of the social worlds of people with intellectual disabilities was as a coping strategy carers used to manage and bring enjoyment and value to the caring responsibilities and societal stigma which accompanied their role,” they wrote.

Humor seems to be relevant for social interactions among people with intellectual disabilities and their carers. However, literature is still limited and further investigations are necessary.

“Such work will enable the ways in which humor serves both positive and negative functions in people’s lives to be better understood, fostered and combated,” researchers concluded.