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Results for “Developmental Disabilities”

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PubMed1982

Integration of the plantar grasp reflex as an indicator of ambulation potential in developmentally disabled infants.

The integration or lack of integration of the plantar grasp reflex, as tested in supported standing, was investigated in 26 developmentally disabled infants and was related to the attainment of independent ambulation without assistive devices. All infants who displayed integration of the plantar grasp reflex later developed independent ambulation. Thirteen infants did not display integration of the reflex during three to five years of follow-up. Of those 13 infants, only 1 achieved independent ambulation. This preliminary clinical investigation provides evidence of the prognostic value of the presence or absence of the plantar grasp reflex as an indicator of ambulation potential in developmentally disabled infants.

Developmental Disabilities↗

PubMed1994

Toward a functional analysis of drug treatment for behavior problems of people with developmental disabilities.

A brief review of the use of psychotropic medications for people with developmental disabilities was presented. Although in some cases therapeutic effects were obtained, in many cases no positive effects, or negative ones, were observed. We suggest that prescribing drugs based on topographical features of the problem behavior (e.g., self-hitting), without considering the function the behavior serves for an individual, contributes to the variability in clinical response. Functional analyses of behavior disorders, with appropriate consideration of the neurochemical and developmental variables involved, may provide the basis for a more rational approach to pharmacotherapy for people with developmental disabilities.

Adult↗

PubMedDate not supplied

Surveillance of developmental disabilities with an emphasis on special studies.

The developing central nervous system seems to be particularly vulnerable to chemical insults. A model for developmental disabilities surveillance is presented that provides a reasonable framework for monitoring the prevalence of various developmental abnormalities in human populations. Effective monitoring will not only increase the likelihood of detecting the adverse effects of new physical or chemical agents in the environment but will provide a readily available case series for specially directed case-control studies. A specific example is provided of a large case-control study of cerebral palsy and intrapartum magnesium exposure among very low birth weight children, which is being conducted within the framework of a developmental disabilities surveillance program.

Adult↗

PubMedDate not supplied

Residual developmental disabilities in children with transient hypertonicity in infancy.

Developmental disabilities occurred in children who manifested transient neurologic abnormalities in early infancy. In an attempt to identify associated problems at an earlier age, the neuromotor and developmental progress of 33 children who had transient hypertonicity during early infancy was analyzed. At 2-3 years of age, various developmental abnormalities were identified in more than two-thirds of these children. Delays in speech and language development and also in fine motor/adaptive and behavioral difficulties were most frequently present. Over time, these problems persisted and other disorders also became apparent. At 5 years of age or older, learning disabilities were frequent and associated with language and perceptual problems. None of the patients had epilepsy; mental retardation was present in only 2 children. Our study demonstrates that children with transient hypertonicity in early infancy are at risk for various developmental problems which can be identified as early as 2 years of age. It also indicates that although their severity lessens over time, these developmental abnormalities tend to persist.

Adolescent↗

PubMed1980

Objectively defined linguistic parameters in children with autism and other developmental disabilities.

The language of children with autism and other developmental disabilities was examined systematically according to a set of objectively defined linguistic parameters. These criteria were drawn from clinical observations reported in the literature and from developmental norms of language acquisition. Data analysis identified sets of parameters that were correlated with psychiatrists' clinical diagnoses but failed to isolate individual parameters (such as echolalia or noncommunicativeness) that have been suggested to be pathonomic.

Autistic Disorder↗

PubMed2003

[Children and adolescents with developmental disabilities in the pediatrics ambulatory service].

OBJECTIVE: To review the literature on outpatient care of children and adolescents with developmental disabilities, focusing on prevention, early diagnosis, treatment, outcomes and rehabilitation. SOURCES: Search of Medline and Lilacs databases; publications of scientific committees of institutions for children with special needs; and outpatient care reports of reference centers for the treatment of children and adolescents with mental and developmental disabilities. SUMMARY OF THE FINDINGS: This population presents health problems associated with the basic pathology and its consequences in addition to the usual problems of the specific age group. The etiology of developmental disorders and the main characteristics of each type of disability are discussed. Special attention is given to outpatient pediatric care. CONCLUSIONS: The most recent study of the Brazilian population, performed in 2000, showed that 14.5% of this population presented some type of developmental deficiency. Therefore, developmental problems are one of the most prevalent health problems among children and adolescents. Consequently, pediatricians need to be prepared to evaluate and identify factors that may influence normal children development. Pediatricians are responsible for prevention, early diagnosis and coordination of the multidisciplinary treatment of these patients in addition to basic medical assistance, which is essential to guarantee the patients' good quality of life.

Adolescent↗

PubMed1986

Occupational therapy treatment goals for adults with developmental disabilities.

This study examined whether occupational therapists were using treatment time to prepare adults with developmental disabilities for independent living opportunities. Eighty-eight occupational therapy evaluations for 54 adults with developmental disabilities in 18 different community agencies in the Boston area were reviewed to ascertain the focus of treatment goals that reflect treatment approaches. Results indicate that remedial goals significantly outnumbered adaptive ones. Within the adaptive goals, self-care and community living skills were equally represented, but some important community skill areas like advocacy, money management, personal care attendant management, sexuality, and transportation received little or no attention. Implications of these findings for therapists, clients, and third-party payers are discussed.

Activities of Daily Living↗

PubMed2002

Brain development and the ontogeny of developmental disabilities.

Brain development is an active process that continues throughout life. During the past few decades, increased knowledge of this process has led to an improved understanding of the causes of its disruption. Complex genetic and molecular processes have been identified as components of the sequence of events leading to mature brain formation. However, the limitations in our knowledge about brain development are still significant. For example, 10% to 20% of persons with severe mental retardation of unknown origin appear entirely normal by standard neuropathologic studies. In this chapter, we review normal brain development and discuss how alterations during this process can lead to developmental disabilities. An overview of the most important steps in brain development, the basic mechanisms involved, and possible etiologies for the clinical manifestations of developmental disabilities is provided. General concepts about brain development, timing, and environmental influences are also considered. As we learn more about the genetic mechanism and molecular processes underlying brain development, we will better understand the ontogeny of various developmental disabilities and hopefully improve approaches to prevention and treatment.

Brain Chemistry↗

PubMed2003

Nurse's role in promoting health transitions for adolescents and young adults with developmental disabilities.

This article examines the impact of cultural factors influencing the youth's transition process and includes recommendations for addressing these needs within the context of nursing practice. Youth-centered transition planning begins with a comprehensive, culturally competent assessment of adolescent and family needs in order to foster youth autonomy and family support during this important stage of development. Nurses who work with youth with developmental disabilities are faced with many questions from youth and families regarding the how, what, when, and where of transition planning, such as "Where do I find an adult health care provider who has the clinical expertise and sensitivity to my disability concerns?" and "Where can I get health insurance coverage when I "age out" of the health insurance program I am currently enrolled in?" The questions youth and families have not only reflect their needs for services and supports, but also represent the cultural context of their experiences. Who is this youth who is fast growing up, soon to become an adult? What has been this young person's experiences as a boy or a girl, a person with a developmental disability, a member of his or her family, and a member of the community? Each youth's experiences have an enormous impact shaping his or her progression through adolescence, and the impact continues with adult development. Nurses can serve as pivotal members of the team assisting these youths with developmental disabilities and their families in confronting the challenges and excitement of successfully transitioning to adulthood.

Adolescent↗

PubMed2001

A biogenic amine-synapse mechanism for mental retardation and developmental disabilities.

Recent studies have demonstrated that biogenic amines have a function of facilitating formation and maintenance of synapses in diverse regions of the central nervous system in developing and adult animals. The normal number of synapses maintained by biogenic amines are crucial to acquire learning and memory. The level of biogenic amines was reported to decrease in the brain by several neurodevelopmental disorders associated with mental retardation and developmental disabilities such as Rett syndrome, autism and Down syndrome. Taken into consideration this fact together with the function of biogenic amines for synapses, the density of synapses appears to decrease considerably in the brains of patients suffered from the neurodevelopmental disorders. The synaptic overproduction during the critical period of development especially 1 year after birth has been considered as a background mechanism to provide plasticity for the developing brain. Synaptic overproduction does not appear to occur in the brains of patients suffered from the neurodevelopmental disorders, which they are observed mental retardation occurring in the first 1 year after birth. Along with the neurodevelopmental disorders, environmental factors (stress, drugs and nutrition) during pre- and post-natal critical developmental periods are known to change levels of biogenic amines in the brain. In fact, maternal stress has been shown to decrease the levels of serotonin and the density of synapses in the hippocampus of the offspring, and they showed developmental disabilities in the spatial learning and memory. A cascade appears to exist from either the child neurological disorders or the environmental factors to mental retardation and developmental disabilities by decreases in the levels of biogenic amines and synaptic density.

Animals↗

PubMed2001

Melatonin for treatment of sleep disorders in children with developmental disabilities.

This study explored the safety and efficacy of synthetic melatonin in the treatment of sleep problems in 20 children with developmental disabilities, in a randomized, double-blind, placebo-controlled 6-week trial of melatonin versus placebo. All but 2 children fell asleep more quickly when receiving melatonin than placebo. Overall, the greater the sleep latency (time to fall asleep) was at baseline or when receiving placebo, the more pronounced was the decrease in sleep latency with melatonin. The effect of melatonin on sleep latency was significant (P < .05). The duration of sleep while receiving melatonin was significantly greater than baseline (P < .007) but was not significantly different from placebo, and no difference in the number of awakenings was noted. No side effects were reported. Eleven of 18 parents (61%) correctly identified the weeks their child received melatonin. This study suggests that synthetic melatonin reduces sleep latency in children with developmental disabilities.

Antioxidants↗

PubMed1995

Adaptive behavior of young urban children with developmental disabilities.

Adaptive behavior was investigated for 497 urban preschool children with developmental disabilities (autism, pervasive developmental disorder, language impairment, mental retardation, attention-deficit hyperactivity disorder, cognitive deficit), ranging in age from 15 to 71 months, 38% of whom were in foster care. Disabilities were identified through comprehensive multidisciplinary evaluation. Adaptive behavior was assessed with the Vineland Adaptive Behavior Scales. Results indicate a strong positive relation between adaptive behavior and intelligence if measured globally. When Vineland domains were assessed separately, this relation varied across domains and disability groups. With intelligence controlled, adaptive behavior patterns differed for disability groups in communication and socialization.

Activities of Daily Living↗

PubMed2002

Antiepileptic drug treatment in the developmentally disabled: treatment considerations with the newer antiepileptic drugs.

Epilepsy is a common comorbidity among developmentally disabled (DD) patients, and special considerations apply to its treatment. In particular, clinicians should try to avoid antiepileptic drugs (AEDs) with sedating properties or adverse cognitive effects that might further diminish quality of life for DD patients. Behavioral changes due to medication and significant pharmacokinetic interactions with other medications are also concerns. The newer AEDs, approved in the 1990s, offer new options for the treatment of individuals with developmental disability and epilepsy. Gabapentin does not interact with the hepatic metabolism of other AEDs or psychotropic agents, results in a statistically significant reduction in seizure frequency in mentally retarded children, and is generally well tolerated. Felbamate is an effective broad-spectrum AED, but has serious toxicity issues limiting its use. Lamotrigine has been extensively studied in the DD population, achieving seizure reduction rates of up to 50% in some trials. Although it is usually well tolerated in this population, its pharmacokinetic profile is influenced by concomitant medications. Levetiracetam has been found to be effective against kindled seizures and has been approved as adjunctive therapy for partial epilepsies. It does not cause any pharmacokinetic interactions, but may have behavioral side effects. Oxcarbazepine is a homologue of carbamazepine that has fewer drug interactions. It is approved for mono- or adjunctive therapy in patients with partial seizures, and its use in DD individuals appears to be worthwhile. Tiagabine is extensively bound to plasma proteins and is therefore subject to protein-binding displacement interactions by other highly protein-bound drugs, such as sodium valproate. While there are trial data showing its efficacy as adjunctive therapy in partial epilepsy in adults and children, there is a paucity of data specific to the DD population. Common side effects include sedation. Topiramate is a broad-spectrum AED approved as adjunctive therapy for partial and primary generalized tonic-clonic seizures. It appears to be particularly effective in patients with Lennox-Gastaut syndrome and those with cognitive disabilities. It appears to be better tolerated in the DD population than in the general population. Zonisamide has been effective in the DD population, yielding a seizure reduction of 50% in 41% of children in 1 trial. It has been associated with renal stone formation, sedation, and cognitive effects, however. The new AEDs have a role in treating seizures in the DD. Side effects that limit their use include anorexia, behavioral changes, and sedation. Seizure exacerbation can occur with the new AEDs and success is defined empirically and by improvements in quality of life.

Journal Article↗

PubMed1998

External causes of death among persons with developmental disability: the effect of residential placement.

The authors analyzed death rates from external causes (accidents, injuries, homicides, etc.) for persons with developmental disability in California. There were 520 such deaths during the 1981-1995 study period, based on 733,705 person-years of exposure; this represents all persons who received any services from the state. Compared with the general California population, persons with developmental disability were at lower risk of homicide, suicide, and poisonings (standardized mortality ratios, 0.31-0.68), but higher risk of pedestrian accidents, falls, fires, and, especially, drowning (standardized mortality ratio=6.22). A major focus of the study was comparisons between different residential settings. Persons in semi-independent living had significantly higher risk than did those in their family home or group homes, with homicides rates being three times higher and pedestrian accidents rates being doubled, while persons in institutions had much lower risks with respect to most causes. Of the 28 deaths due to drug and medication overdoses, 79 percent occurred in supported living or small-group homes. Avoidable deaths could be reduced by making direct care staff more aware of the risks and better trained in acute care, along with improved monitoring of special incidents.

Accidents↗

PubMed2005

Introduction: novel therapies in developmental disabilities--hope, reason, and evidence.

Complementary and alternative medicine (CAM) is used both alongside (complementary) and as a substitute for (alternative) conventional therapies. Although CAM use is reported to be high among children with typical development, reported rates for CAM use to address symptoms of children with developmental disabilities may be higher. Increased use in this population may relate to hope for amelioration of symptoms, concerns regarding side effects of conventional treatments, and a need on the part of families to participate in decision making regarding their child's care. Primary health care providers may find that the child's needs are best served when they maintain a dialogue with families to evaluate the evidence supporting novel therapies. Interventions need to be assessed in an evidence based fashion whether or not they are initially preceived as CAM. This issue of Mental Retardation and Developmental Disabilities Research Reviews contains reviews of CAM used to treat several developmental disabilities as well as some broader discussions related to the determinants of CAM use, current efforts to evaluate novel therapies, and how to consider the possibility of placebo effects.

Attention Deficit Disorder with Hyperactivity↗

PubMed2006

A multi-dimensional approach to the transition of children with developmental disabilities into young adulthood: the acquisition of adult social roles.

PURPOSE: To test the hypothesis that the difficulties young adults with developmental disabilities have in obtaining adult social roles are not inevitable consequences of their childhood impairment. We used the conceptual framework of the International Classification of Functioning, Disability, and Health to test this hypothesis. METHOD: We used a structured questionnaire to obtain information on the consequences of childhood impairment in young adulthood and to examine the relationship between impairment and acquisition of adult social roles. The sample (n = 635) came from the Metropolitan Atlanta Developmental Disabilities Follow-up Study of Young Adults, a population-based cohort of young adults aged 21 - 25 years identified at age 10 with childhood impairment. RESULTS: The results suggest that: (i) attaining adult social roles varies by impairment type and severity, (ii) experiencing activity limitations partially mediate the relationship between impairment and adult social roles, and (iii) attending postsecondary education increases the likelihood of attaining markers of adulthood. CONCLUSIONS: Intervention to reduce activity limitations and to develop strategies to increase attendance in postsecondary education may increase the likelihood for the acquisition of adult social roles among young adults with childhood impairment.

Adolescent↗

PubMedDate not supplied

Oral self-injurious behavior in the developmentally disabled: review and a case.

Self-injurious behavior occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavioral and biochemical aspects of self-injurious behavior are poorly understood and several etiologies have been suggested. Treatments for self-injurious behavior in developmentally disabled individuals fall into three main categories: pharmacological, behavior modification and physical restraints. The dental management of self-injurious behavior is often difficult. Numerous appliances of various design have been reported in the literature. Osteotomies or extraction of the offending teeth may have to be considered if less invasive methods are unsuccessful. A case is reported where a child engaged in tonic lip biting secondary to a neurological and seizure disorder is treated using a removable lip-protruding device. No impression or lab construction is required. The appliance presents minimal interference with oral hygiene procedures and it can be removed and reinserted as needed. We conclude that a removable lip-bumper may be a viable option in treating transient and acute episodes of self-injurious behavior involving the lower lip and buccal mucosa.

Adolescent↗

PubMed2006

Medicaid managed care model of primary care and health care management for individuals with developmental disabilities.

Lack of sufficient accessible community-based health care services for individuals with developmental disabilities has led to disparities in health outcomes and an overreliance on expensive models of care delivered in hospitals and other safety net or state-subsidized providers. A functioning community-based primary health care model, with an integrated care management component, functioning in the general health care practice marketplace, is described and shown to address recent Surgeon General recommendations as well as evaluative criteria for availability, affordability, acceptability, and appropriateness of care. The model functions in both fee-for-service and managed care environments, including Medicaid managed care for individuals with developmental disabilities. Experience shows this model to be both scalable and replicable, resulting in positive health outcomes and increased patient satisfaction.

Health Services Accessibility↗