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Biomedical subjects

R L Sprague

Publications and source records attributed to R L Sprague.

At least 19 recordsLinked to original sources
PubMed1992

Postural stability, tardive dyskinesia and developmental disability.

The postural stability of four adult populations was examined through force platform methods. The four groups were classified as: (1) developmentally disabled (severely and profoundly mentally retarded) with tardive dyskinesia; (2) developmentally disabled but with no history of neuroleptic medication; (3) tardive dyskinetic but of normal intelligence; and (4) a normal and healthy control group. Postural conditions included standing still with arms at side, standing still with one arm or both arms parallel to the ground, and standing still while swinging both arms in the sagittal plane. The findings showed that both tardive dyskinetic and/or developmentally disabled groups exhibited greater sway and variability in centre of pressure motion in contrast to the control group. The developmentally disabled with tardive dyskinesia group also exhibited a strong tendency to produce a different form to the postural sway strategy in that they produced rhythmical centre of pressure motions during stance that were, to some degree, task dependent. The findings show that the combined effects of developmental disability and tardive dyskinesia produce qualitatively and quantitatively different features in postural stability patterns. The data suggest that postural stability measures may be a useful index to assess tardive dyskinesia.

Antipsychotic Agents↗
PubMed1991

Reliability, validity, and a total score cutoff for the dyskinesia identification system: condensed user scale (DISCUS) with mentally ill and mentally retarded populations.

The reliability and validity of the Dyskinesia Identification System: Condensed User Scale (DISCUS) are presented for mentally ill (n = 2,822) and mentally retarded (n = 4,649) populations, as are DISCUS item means and standard deviations. A total score cutoff was developed and tested against physician diagnosis and the Research Diagnoses for Tardive Dyskinesia (RD-TD) intensity criterion. DISCUS total score significantly increased as age increased and was significantly greater for 108 TD cases compared to 108 matched no-TD cases. The DISCUS total score of 5 or above was significantly associated with physician TD diagnosis, the RD-TD intensity criterion, and an increasing number of individuals meeting the cutoff score as age increased. Based upon the data, the DISCUS is a reliable and valid TD assessment instrument. It is concluded that the DISCUS cutoff score is as valid a measure of TD as the current operationally defined RD-TD intensity criterion.

Adult↗
PubMed1989

Maladaptive behaviors associated with neuroleptic drug maintenance.

In this study we examined whether the decision to maintain mentally retarded persons on neuroleptic drugs was associated with specific maladaptive behaviors. A drug-withdrawal group, a drug-reinstatement group, and a drug-control group were used. A two-way repeated measures multivariate analysis of variance design indicated that mentally retarded persons were more likely to be maintained on drugs because of events that were perceived as significant and recorded by institutional staff in clinical notes than because of the reasons for which the drugs were prescribed initially. In particular, staff members' perceptions of disturbing behavior, self-stimulation, and physical aggression were likely to influence their decision to maintain mentally retarded persons on neuroleptics.

Adult↗
PubMed1989

Psychotropic medication of mentally retarded residents in community long-term care facilities.

Medicaid billing information was used to examine the administration of psychotropic medication to residents of community long-term care facilities providing mental retardation services. In 1984, 5,766 individuals receiving Medicaid in Illinois resided continuously in these facilities for the entire year. Of these, 1,667 (28.9%) received at least one psychotropic medication during the year, with thioridazine, haloperidol, and chlorpromazine being prescribed most frequently. Data for frequency, dose, and length of administration of individual psychotropic medications were reported for the total group and by level of mental retardation. Separate analyses indicated little or no influence of demographic and facility variables on either the probability of drug administration or amount administered.

Adolescent↗
PubMed1989

Psychometric properties of the Dyskinesia Identification System: Condensed User Scale (DISCUS)

Individuals with developmental disability (N = 400) were assessed with the Dyskinesia Identification System: Condensed User Scale (DISCUS), a 15-item tardive dyskinesia rating scale shortened from the 34-item Dyskinesia Identification System-Coldwater (DIS-Co). Interrater reliability assessments were made for 148 individuals, and 2-week stability (test-retest) assessments were made for 128 individuals. Mean DISCUS total score was 4.1 (SD = 3.5); reliability was .92, p less than .001, and stability was .40, p less than .001. Based upon this study and a larger study of 4,649 individuals with developmental disability, we recommend that clinicians carefully evaluate for tardive dyskinesia any individuals with developmental disability who have been prescribed antipsychotics for greater than 3 months and who score 6 or above on the DISCUS.

Adolescent↗
PubMed1988

Training clinical personnel to assess for tardive dyskinesia.

1. Two hundred and sixty-three people were trained to assess for tardive dyskinesia using the Dyskinesia Identification System: Condensed User Scale. 2. A videotape pretest was given before training, a videotape posttest was given after training, and in vivo (actual patient) ratings were required. The data was analyzed for overall training effects as well as by four professional groups: registered nurses, licensed practical nurses, physicians/pharmacists, and others such as psychologists/educators. 3. No group displayed accurate abnormal involuntary movement assessment ability before training, and a highly significant improvement occurred as a result of training. The four professional groups did not differ on assessment ability before or after training, and all professions showed significant improvement. 4. The data suggests that formal training must occur to teach accurate and reliable tardive dyskinesia assessment ability. A wide variety of professions can be trained, thus making large scale monitoring systems for applied clinical settings possible.

Dyskinesia, Drug-Induced↗
PubMed1985

A change of mind: the Conners abbreviated rating scales reconsidered.

A cutoff score of 15 on the Conners 10-item Abbreviated Teacher Rating Scale (ATRS), based on a study from this laboratory, has been widely used by investigators for diagnosis of the syndrome known now as Attention Deficit Disorder with or without Hyperactivity. A replication of the original research employing a larger norm sample indicates that the suggested score of 15 is too low. Comparing the norm sample with hyperactive subjects selected by cutoff of 15 on the ATRS showed that the groups differed greatly on hyperactivity but not on inattention. The abbreviated form of the Conners scale does not effectively select children with attention deficits. Numerous problems with both the 39-item teacher scale and the abbreviated form suggest strongly that they be abandoned as research tools.

Attention↗
PubMed1977

Methylphenidate in hyperkinetic children: differences in dose effects on learning and social behavior.

Methylphenidate (Ritalin) is widely prescribed for hyperkinetic children. This study showed a peak enchancement of learning in children after being given a dose of 0.3 milligram per kilogram of body weight, and a decrement in learning in those given larger doses; social behavior showed the most improvement in children given 1.0 milligram per kilogram. These results had been hypothesized from theoretical dose-response curves which indicate different target behaviors would improve at different doses.

Child↗
PubMed1976

Cardiovascular responses of hyperactive children to methylphenidate.

Heart rate, blood pressure, and oxygen consumption were measured in 27 hyperactive children during rest, exercise, and recovery, once taking placebo and again taking methylphenidate hydrochloride. Half were measured first taking the drug and half first taking the placebo. Twenty-three matched controls were also measured twice to test for reproducibility of results. Drug and placebo ECGs were recorded on 12 of the subjects. Oxygen consumption did not change (P = .40), but heart rate (P = .001) and blood pressure (P = .003) increased significantly with methylphenidate therapy. There was a significant correlation between size of dose in milligrams per kilogram and increase in heart rate (.38, P less than .05) and blood pressure (.50, P less than .05 systolic) (.46, P less than .05 diastolic). No evidence of the development of tolerance to these drug effects was found in children who had been taking methylphenidate from two months to more than a year. No ECG changes other than tachycardia were seen.

Age Factors↗