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Results for “Developmental Disabilities”

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PubMed1986

Gastroesophageal reflux and Barrett's esophagus in developmentally disabled patients.

Twenty-seven patients from an institution for the developmentally disabled underwent endoscopy for evaluation of vomiting, regurgitation, rumination, or upper gastrointestinal bleeding. The presence of gastroesophageal reflux and Barrett's esophagus was determined retrospectively. Twenty-three patients had an IQ less than 20, 19 were nonambulatory, and 14 were taking at least one neuroleptic drug daily. Seven patients (26%) had histologically documented Barrett's esophagus of the specialized-columnar type. Two patients with Barrett's esophagus had benign esophageal strictures, but no cases of adenocarcinoma were found. There were no significant differences (p greater than 0.05) between patients with or without Barrett's esophagus in regard to symptoms, age, sex, IQ, medications, or ambulatory status. The present data suggest that Barrett's esophagus may frequently occur in developmentally disabled patients with symptoms and signs of gastroesophageal reflux.

Adult↗

PubMed1988

Is the early and periodic screening, diagnosis, and treatment program effective with developmentally disabled children?

The effectiveness of the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) in identifying health and developmental problems and facilitating diagnosis, treatment, and follow-up for a sample of Michigan children with moderate and severe developmental disabilities was studied. Three data sets, derived from parent reports and Medicaid records concerning 281 Medicaid-eligible, young developmentally disabled children from nine representative counties in the state were studied. Approximately 56% of these children had used EPSDT, and 44% had not. Findings from the first data base, a parent questionnaire, indicated no differences between the two groups in terms of age at diagnosis, access to routine or specialized health care, or reasons for inability to obtain needed care. The second database, the screening summaries from the EPSDT sites, contained reports on 108 children. Many of the required procedures were not performed on these children. The final data set, the Medicaid claims records, was used to assess whether appropriate medical follow-up occurred in response to the screening encounter. Only 62% of the screenings with a referral had a Medicaid visit within 1 year of screening and only half of the referrals that resulted in a follow-up visit had a diagnosis that confirmed the reason for referral. Recommendations for improving the health and developmental screening of disabled children are presented and the policy implications of these findings are discussed.

Child↗

PubMedDate not supplied

Teaching students with developmental disabilities to locate their AAC device.

Students with autism and related developmental disabilities who do not speak are often taught to use some type of augmentative and alternative communication (AAC) system, such as a voice output communication aid (VOCA). One problem with such devices is that the person may be unable to communicate when the device is not readily accessible. We first taught three nonverbal students with autism to use a VOCA to request access to preferred items. Following this initial acquisition phase, however, none of the students would locate their VOCA when it was not within reach. A least-to-most prompting procedure was implemented to teach the students to locate their AAC device. The effectiveness of this procedure for teaching VOCA location skills was evaluated in a delayed multiple-baseline across subjects design. The results showed that the intervention was effective in teaching the students to locate their AAC device when they needed it to request access to preferred objects. Teaching VOCA location skills may be a useful and necessary component in AAC interventions for some people with developmental disabilities.

Adolescent↗

PubMed1989

Self-monitoring and self-managed reinforcement procedures for improving work productivity of developmentally disabled workers. A review.

This article reviews research that examined self-monitoring and/or self-managed reinforcement procedures for improving and maintaining work productivity of developmentally disabled workers. Seventeen articles were encountered that examined self-monitoring and/or self-administration of reinforcers for productivity. In total, 107 developmentally disabled persons experienced self-management procedures, with diagnoses varying from profoundly to mildly retarded. In most of the studies, work productivity improved during intervention conditions. However, in almost all cases, procedural limitations prevent us from confidently attributing improvements in productivity to the self-management components of the interventions. Moreover, because of practical limitations, we cannot yet offer self-management procedures as a viable strategy to maintain work rates of developmentally disabled workers at acceptable levels throughout typical working days. Additional research is needed that goes beyond the procedural and practical limitations of previous studies.

Adult↗

PubMedDate not supplied

Involvement in Special Olympics and its relations to self-concept and actual competency in participants with developmental disabilities.

The current study examined the relations among components of a physical activity program, Special Olympics (SO), and the self-concepts (i.e., perceived physical competence, social acceptance, and general self-worth) and adaptive behaviors of individuals with developmental disabilities. This research can assist in the development of theoretical models of how physical activity programs can be implemented to effect psychological change. Participants consisted of a randomly selected group of 97 individuals with developmental disabilities, between 9 and 43 years of age, and their parents. Participants' self-concepts and adaptive behaviors were measured both by direct interview and parental report. Examined program components consisted of the length of time affiliated to the organization, number of competitions attended, of hours spent in training, of sports, and of medals obtained. Multiple regression analyses suggest relations between specific components of SO and participants' self-concepts and adaptive behaviors. These relations highlight the importance of competition and sport for individuals with developmental disabilities.

Adaptation, Psychological↗

PubMed2000

Mental retardation and developmental disabilities influenced by environmental neurotoxic insults.

This paper sets a framework for the discussion of neurotoxicity as a potentially major contributor to the etiology of many types of mental retardation and developmental disabilities. In the past the literatures on developmental neurotoxicology and on mental retardation have evolved independently, yet we know that the developing brain is a target for neurotoxicity in the developing central nervous system through many stages of pregnancy as well as during infancy and early childhood. Our definitions and theories of mental retardation and developmental disabilities affect the models of neurotoxicity we espouse. For instance, models of developmental risk in neurotoxicology have guided environmental regulation to reduce the likelihood of neurotoxic effects. On the other hand, models of developmental risk for mental retardation aim not only at primary prevention,but also at secondary and tertiary prevention through early intervention. In the future, dynamic models of neuroplasticity based on the study of gene-brain-behavior relationships are likely to guide our views of developmental neurotoxicology and prevention of mental retardation and other disabilities.

Developmental Disabilities↗

PubMedDate not supplied

Developmental disabilities: genetic implications.

Knowledge and new techniques in genetics can aid in a better understanding of developmental disabilities. Through new treatments and better assessment skills, individuals with disorders such as phenylketonuria (PKU), Down syndrome, and fragile X syndrome are having diagnoses sooner and are living into adulthood. With the passage of public law 99.457, early intervention services are mandated for those who are 3 years old or younger and are developmentally delayed or at risk for delay. Organizations for paraprofessionals and professionals in the arena of developmental disabilities and genetics exist to create a forum for future action, awareness, and direction.

Child↗

PubMed1994

Seroprevalence of hepatitis A antibodies among residents of a centre for people with developmental disabilities.

BACKGROUND: In February 1993, 11 cases of hepatitis A virus (HAV) were identified in permanent residents of a centre for young people with developmental disabilities. AIMS: To define the extent of the outbreak in the centre, to determine the seroprevalence of hepatitis A antibodies (anti-HAV) in permanent residents, and to ascertain risk factors for serological evidence of HAV infection. METHODS: A cross-sectional serological survey of 270 permanent residents, aged eight to 40 years, in a centre for people with developmental disabilities, was conducted in western Sydney. Using a radioimmunoassay technique, sera were tested for anti-HAV (IgM and total antibody). We used logistic regression to determine risk factors for presence of anti-HAV. RESULTS: Blood samples were collected from 259 permanent residents (96%). Serological testing revealed anti-HAV in 128 residents tested (49%). Presence of anti-HAV was associated with living in specific residential units, and with residents' age and length of stay at the centre, but was not associated with reported behavioural factors. CONCLUSIONS: More than half of the residents of the centre were susceptible to HAV infection. Behavioural characteristics of the residents and their close contact with each other make HAV transmission difficult to control. HAV vaccine should be promoted in communities at risk, such as those with developmental disabilities.

Adolescent↗

PubMed2000

Rapid cycling bipolar disorder in individuals with developmental disabilities.

The assessment and treatment of the rapid-cycling variant of bipolar disorder in individuals with developmental disabilities is challenging. Outcomes are optimized by a long-term commitment to the establishment of objective monitoring systems by interdisciplinary teams. In this retrospective case series, we contrast the phenomenology, clinical outcomes, treatment responses, and clinical characteristics of 26 individuals with bipolar disorder and developmental disabilities, 12 with nonrapid cycling courses and 14 with rapid cycling courses. Similarities and differences are highlighted both within these two groups and in reference to published findings for individuals without disabilities.

Adolescent↗

PubMedDate not supplied

A family systems look at the developmentally disabled.

In summary, families of the developmentally disabled need to be looked at in terms of their system wholeness. Interacting elements of the subsystems have unique concerns and coping styles. Psychiatric nurses are in a key position in the mental health scene to assess these coping styles and to offer compassion, understanding, knowledge, and needed resources to assist these overburdened families to move in the direction of openness, growth, and health.

Adaptation, Psychological↗

PubMed1991

Friendship among adults who have developmental disabilities.

The difference between people with developmental disabilities who did and did not have peer-group friends was investigated by interviewing 36 adults attending day centers. Those with a friend were significantly more likely to describe themselves positively on all dimensions. Results showed that people without a peer-group friend were similar to lonely people without disabilities on two of the three factors explored. Qualitative analysis of subjects' descriptions of their friends suggested that most of the people interviewed had relatively shallow relationships.

Adult↗

PubMed1995

An evaluation of care coordination in controlling inpatient hospital utilization of people with developmental disabilities.

All admissions of people with developmental disabilities to a community hospital over 3 years were examined to evaluate the impact of a coordinated care model on length of stay and hospital charges. Admissions were divided into two groups, those receiving either coordinated care (program group) or routine care by community physicians (usual care group). The program group had shorter average lengths of stay and lower hospital charges than did the usual care group, especially when charges were adjusted for case mix. Similarity of severity across the groups was measured by number of discharge diagnoses and Medicaid case weights. Over the 3 years, for the 115 admissions in the program group, these differences amounted to more than $200,000 in potentially unnecessary hospital charges. Implications of care coordination services for community-based health care planning were presented.

Adolescent↗

PubMed1979

The effect of developmental disabilities on mental health.

Behavioral abnormalities in the developmentally disabled child are usually ascribed to parental mismanagement of a child perceived as abnormal. (Review of the available data points to the existence of primary behavioral abnormalities due directly to the cerebral dysfunction.) This has important implications for parental counseling and management.

Autistic Disorder↗

PubMed1997

A nutritional rehabilitation program for persons with severe physical and developmental disabilities.

Our purpose was to design and implement a nutritional rehabilitation program for persons with severe developmental disabilities who resided in a long-term-care facility or a group home. We used weight for height (WH) to classify residents of both facilities into three groups: group 1 (n=32), WH less than 5th percentile (Z scores < or = -1.650), goal=gain weight; group 2 (n=21), WH between the 5th and 85th percentile (Z scores ranging from -1.645 to +1.030), goal=maintain present rate of weight gain; and group 3 (n=8), WH greater than 85th percentile (Z scores > or = +1.036), goal=slow down rate of weight gain. The challenge in all groups was to bring about these changes without increasing the quantity of food (as assessed by 3-day food records) fed to the residents and to increase their fluid intake. For each subject, the project dietitian developed individualized menus that specified quantities and consistencies of food. Foodservice delivery was changed to a centralized system in the long-term-care facility to allow for closer control of the subjects' intake. A dietitian monitored the program with biweekly visits to the wards and frequent consultation with staff. Only a limited increase in fluid intake was noted; however, after 6 months of the program, the other goals were met. Our results suggest that nutritional rehabilitation of residents with developmental disabilities is enhanced by the involvement of a dietitian.

Adolescent↗

PubMed1985

Nutrition intervention in developmental disabilities: an interdisciplinary approach.

The nutritional status of developmentally disabled persons is influenced by variables infrequently encountered in normal nutrition. The multitude of factors requires an approach to care that must incorporate information and assistance from a variety of disciplines. A model for viewing the network of variables is proposed as a tool for identifying voids in nutrition care and for developing appropriate plans that include interdisciplinary interactions for those persons with special needs.

Adolescent↗

PubMed1999

Gynecological health care for adolescents with developmental disabilities.

The gynecological health care of adolescents with developmental disabilities presents a unique challenge to care providers. Adolescence is a time of turmoil for many girls and for adolescents with special needs it may seem overwhelming. Patients, their parents and their caregivers need special attention during these changes in their lives. This chapter focuses on how to perform a reproductive health evaluation focusing on the history and physical exam, especially the pelvic exam. Menstrual hygiene and menstrual abnormalities are discussed in detail. Other topics include abuse and abuse prevention, contraception, and cyclical behavior changes. Patience, persistence, and adaptation of the usual examination techniques can lead to a thorough and balanced assessment of the patient and help her, her parents, and her caregivers with the challenges of adolescence.

Adolescent↗

PubMed2002

Predicting the relative efficacy of three presentation methods for assessing preferences of persons with developmental disabilities.

Choices were presented to 9 individuals with developmental disabilities using a two-choice format. Each pair of items, selected based on prior preference assessment, was presented to each participant in three conditions (actual items, pictures of the items, and spoken-name presentation) using a reversal design. The evaluation was conducted using food items, and was then repeated using nonfood items. The participants were also given a test to measure their skills on discrimination tasks ranging in difficulty from simple to conditional discriminations. The participants' abilities to make consistent choices with food and nonfood items were predicted, with 94% accuracy, by their discrimination skills. The findings suggest that presentation methods can affect the accuracy of a choice assessment, and that the systematic assessment of basic discrimination skills can be used to predict the effectiveness of different presentation methods in this population.

Adolescent↗

PubMed2001

Oral health status of adults from a California regional center for developmental disabilities.

The oral health status and treatment needs of developmentally disabled adults (18 years and older) from a Los Angeles Regional Center who live in a variety of settings were measured as part of a comprehensive study to determine their overall health status. A dental assessment was performed on a sample of 325 persons which was similar in demographic composition to the entire population at the center. Approximately 80% of clients reported a personal dentist of record, and 73% brushed their own teeth. Edentulism was 9%. The mean number of retained teeth per person was 22. Subjectively, 15.7% of the sample was rated as having "good" overall dental health, 77.7% "fair," and 6.6% "poor." The major reasons rendering fair or poor assessments were oral hygiene, clinical periodontal disease, and dental caries. More females than males were assessed as having "good" overall dental health. The overall appearance of the teeth for a majority of the sample (76.5%) was rated as "same as most." Persons who brushed their own teeth had fewer missing teeth than those who did not. Persons with a dentist of record had fewer decayed and more filled teeth. Persons living at home with family or friends had a significantly lower DMFT index than those living independently or in facilities. In general, these findings are encouraging; however, caution must be exercised, since efforts to improve the oral health status of this population require continued attention.

Adult↗