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Biomedical subjects

S R Schroeder

Publications and source records attributed to S R Schroeder.

At least 19 recordsLinked to original sources

Predictors of urgency of out-of-home placement needs.

A random sample of 137 families from an out-of-home placement waiting list were surveyed through structured face-to-face interviews with the primary caregivers. Our purposes were to identify predictors of urgency of a family's placement need and obtain information about needed support services, which might help to maintain the person at home. A hierarchical regression analysis was calculated with caregiver stressors and behavior problems as independent variables and the urgency of out-of-home placement need as the dependent variable. Only caregiver stress variables emerged as a significant predictor.

Adolescent

The future of children is now.

A community resource network, Annie Sullivan Enterprises, Inc., is described as a system for community integration of children and youth who have developmental disabilities and mental health problems. A brokerage model is espoused for accessing and delivering services. The model is based on Hobb's (1975) view that organization of human services must be based primarily on the client's needs rather than on the needs of the service agency. Lessons and recommendations based upon 7 years of successful operation are described.

Autistic Disorder

Pharmacotherapy for self-injurious behavior: preliminary tests of the D1 hypothesis.

1. The D1 dopamine hypersensitivity model of self-injurious behavior leads to a testable clinical hypothesis: that the mixed D1/D2 dopamine antagonist fluphenazine may improve the symptoms of self-injurious patients. 2. The hypothesis was tested in an open pilot trial in six patients and a partially controlled trial in nine patients. 3. Some degree of clinical improvement was observed in eleven of the fifteen. 4. The trials represent a partial affirmation of the D1 hypothesis. However, it is also clear that conventional methodology for psychopharmacologic research is inappropriate for the proper clinical evaluation of self-injurious patients. The proper method should include the following elements: i) An epidemiologically representative sample ii) A naturalistic study environment iii) A longitudinal design with long-term follow-up iv) Concurrent behavioral ratings using direct observations and a reliable, treatment-sensitive rating scale. 5. Before subjects enter a clinical trial of an experimental medication, a neuropsychiatric differential diagnosis should be applied to limit the diversity of the sample.

Adolescent

Effects of serum zinc supplementation on pica behavior of persons with mental retardation.

Although pica is one of the most frequently observed eating dysfunctions among people with mental retardation, it is significantly underreported in the literature. Of 806 institutionalized adults with mental retardation in the present study, 15.5% exhibited pica. Prevalence estimates from previous studies have ranged from 25.8% to 3%. Fifty-four percent of the pica group had serum zinc levels below normal range, whereas 7% of the control group had serum zinc levels below the normal range. After supplementation with chelated zinc, residents had significant reductions in pica. Data indicated zinc as a possible adjunct to other treatment approaches.

Adult

Pharmacotherapy for self-injurious behavior: preliminary tests of the D1 hypothesis.

The D1 dopamine hypersensitivity model of self-injurious behavior leads to a testable clinical hypothesis: the mixed D1/D2 dopamine antagonist fluphenazine may improve the symptoms of self-injurious patients. The hypothesis was tested in an open pilot trial in six patients and a partially controlled trial in nine patients. Some degree of clinical improvement was observed in 11 of the 15 patients. The trials represent a partial affirmation of the D1 hypothesis. However, it is also clear that conventional methodology for psychopharmacologic research is inappropriate for the proper clinical evaluation of self-injurious patients. The proper method should include the following elements: 1. An epidemiologically representative sample. 2. A naturalistic study environment. 3. A longitudinal design with long-term follow up. 4. Concurrent behavioral ratings using direct observations and a reliable, treatment-sensitive rating scale. Before subjects enter a clinical trial of an experimental medication, a neuropsychiatric differential diagnosis should be applied to limit the diversity of the sample.

Adult

Comment on Starin and Fuqua's (1987) review of research on rumination and vomiting.

Starin and Fuqua seriously misread a critical study cited in their recent review in failing to characterize it as an experimental analysis of four treatment procedures, and therefore inappropriately criticized it for several shortcomings. This misreading and a tendency to equate vomiting with and without rumination compromise their conclusions regarding treatment choice. At the present time, the data base favors selection of several aversive procedures and the nonaversive satiation procedure over others, but the number of studies on nonaversive operant treatment procedures remains remarkably limited.

Behavior Therapy

Methylphenidate affects strategic choice behavior in normal adult humans.

The time course of serum concentration and performance on a concurrent probability matching task were evaluated in normal adults receiving 0.15 or 0.3 mg/kg of methylphenidate. The behavioral task, an arcade-like problem-solving game, revealed that drug-treated subjects improved their performance upon repeated testings during pharmacokinetic evaluation at a lower rate than did non-treated controls over the same time span. However, drug-treated subjects failed to adopt the adaptive problem-solving strategies selected by controls.

Adolescent

Tardive dyskinesia in young mentally retarded individuals.

The results of a systematic neuroleptic withdrawal study in 38 mentally retarded children, adolescents, and young adults are described. The focus of the study was the occurrence of side effects of chronic neuroleptic treatment: tardive dyskinesia, transient withdrawal dyskinesia, nondyskinetic withdrawal symptoms, and a possible behavioral analogue of withdrawal dyskinesia. Transient side effects were noted in 34% of the subjects, and tardive dyskinesia in an equal proportion. The data suggest that cumulative neuroleptic dose may play a role as a risk factor in the development of severe tardive dyskinesia.

Adolescent

Methylphenidate and exercise: additive effects on motor performance, variable effects on the neuroendocrine response.

It has been suggested that the effects of intensive environmental stressors and of psychostimulant drugs may be interchangeable. A specific test of this hypothesis was undertaken in a double-blind, placebo controlled, cross-over study of the stimulant drug, methylphenidate (MPH), and of intense exercise, alone and in combination. On measures of motor performance the effects of MPH and of exercise were additive while on measures of neuroendocrine response the individual and interactive effects were variable. The effects of MPH and of intense exercise are probably mediated by mechanisms that overlap to a degree but are by no means identical.

Adolescent

Relation of lead and social factors to IQ of low-SES children: a partial replication.

An independent replication of a previous study (Schroeder et al., 1985) of the effects of interactive social environmental factors on the relationship of lead and Stanford-Binet IQ was performed on 75 of 80 low-SES black children screened by county health departments in North Carolina. Children's mean blood lead (PbB) level was 20.8 micrograms/dl (range, 6.3 to 47.4). Multivariate regression analyses showed no significant interactions between PbB and age, sex, maternal IQ, Caldwell home environment score, or SES (Hollingshead Two-Factor Index). There was a highly significant negative relationship between both mean and maximum PbB levels with IQ, p less than .002; that is, IQ decreased linearly as PbB increased. The most accurate and precise regression model included lead, maternal IQ, home environment, and gender.

Child

Separating the effects of lead and social factors on IQ.

Initial evaluations of 104 low-socioeconomic status black children screened by the local community health departments in North Carolina showed significant effects of lead in the range 6-59 micrograms/dl on IQ after controlling for concomitant social factors, such as socioeconomic status, home environment, and maternal IQ. The main concomitant variable was socioeconomic status, which was multicolinear with other social factors. Five years later, when all blood lead levels were 30 micrograms/dl or less, lead effects on IQ were no longer significant. The correlation between maternal and child IQ, which had been suppressed initially in children with higher lead levels, returned to expected levels when decreases in blood lead level occurred, while concomitant variables remained stable over the 5-year period.

Child

Comparison of DRO and DRI on rate of suppression of self-injurious behavior.

Two procedures were used to compare the effects of differential reinforcement of other behavior (DRO) and differential reinforcement of incompatible behavior (DRI) on self-injurious behavior (SIB) of three profoundly retarded head-bangers in a multiple-schedule within-subjects design. We found that rewarding a response specifically incompatible with SIB suppressed it more rapidly than applying DRO without specifying an alternative response. The relationship of collateral behaviors to SIB were dependent upon the repertoires of the individual clients.

Adult