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PubMed2005

Delta and spindle components in the integrated EEG during nocturnal sleep for infants with developmental disabilities.

The delta and spindle components in the integrated EEG for 121 infants with developmental disabilities (from 4 mo. to 6 yr. of age: M=1.79, SD=0.14; 57 girls and 64 boys) were studied throughout nocturnal sleep. In 80 (66.1%, Group A) of 121 subjects, periodic changes of delta and spindle rhythm powers were noted in measurements of EEG made during sleep. In 28 (23.1%, Group B), delta but not spindle rhythm powers were found, and in the remaining 13 subjects (10.7%, Group C) neither delta nor spindle rhythm powers were found throughout measurements of EEG made during sleep. The Tsumori-Inage Questionnaire for Infants was administered to the parents to estimate subjects' behavioral developmental level as Developmental Quotients. Significantly lower mean Developmental Quotients were found for Groups B and C than Group A. These findings suggested that the presence or absence of delta and spindle rhythm powers in EEG measurements made during nocturnal sleep could be taken as an index of the severity of developmental disorders in infants with developmental disabilities.

Child↗

PubMedDate not supplied

Maternal responses to the life and death of a child with a developmental disability: a story of hope.

Losing a child is probably the most devastating event that a mother can experience. When a child with a developmental disability dies, this painful loss may follow months or years of exhausting parenting. How do mothers of children with developmental disabilities respond to this dual loss (the loss of their ideal child and then the loss of their actual child)? This project used a semistructured interview and the Grief Experience Inventory to explore the bereavement experience of eight mothers who have lost such children. It explored variables that are associated with optimal or complicated bereavement. It was found that most of the mothers were very successful in using cognitive coping strategies to find meaning and benefit in the life and death of their children and were able to continue seeing the world as benevolent and purposeful. Exceptional cases are discussed, and implications for helping professionals are offered. The findings of this study fill a significant gap in the theory of parental coping and bereavement.

Adaptation, Psychological↗

PubMed1987

Prevention of developmental disabilities: a model for organizing clinical activities.

Prevention of developmental disabilities receives widespread support, however, a comprehensive approach involving federal and local governments, major professional groups, and the general public has yet to be defined and implemented. Three major issues appear to impede a coordinated approach: (a) prevention's image problem; (b) the complexity surrounding prevention efforts; and (c) the absence of consistent evaluation methods. The University of California, Irvine-University Affiliated Program has developed a model for prevention activities in response to these issues. This model is interdisciplinary, promotes reasoned cooperative efforts, and provides a basis for evaluation and research. This paradigm can be helpful to policy makers in prioritizing prevention activities. The model is composed of five major and functional approaches to prevention with a central core devoted to ethical considerations. The model emphasizes the variety, scope and interdisciplinary nature of prevention/intervention activities, as well as the necessity for a longitudinal approach.

Attitude↗

PubMed2002

Efficacy of levetiracetam in developmentally disabled patients: a review of the literature and six case reports.

Objective. Seizures in developmentally disabled are often refractory to treatment. This study aimed to expand the clinical experience with levetiracetam as an antiepileptic drug (AED) for this population.Methods. Four males and two females (aged 25-51) with mental retardation requiring institutionalization and uncontrolled seizures (1.7-12.2/month) received levetiracetam (0.5-2.5g/day) in addition to their standard AEDs. Clinical response was closely followed for 4-10 months (mean, 6 months) with respect to seizure control and adverse effects.Results. Two of the patients became seizure-free, while the other four had seizure reductions ranging from 71 to 92%. None of the patients experienced adverse effects, and three had improvements in behavior.Conclusions. Levetiracetam may be extremely effective in patients with developmental disability. Behavioral abnormalities improved in 50% of the patients.

Journal Article↗

PubMed1989

Comprehensive employment preparation for adolescents with developmental disabilities: an empirical paradigm.

This paper presents a comprehensive employment preparation intervention for adolescents with developmental disabilities. Vocational preparation is viewed in terms of the development of job and related psychosocial skills. The Comprehensive Employment Preparation program is designed to help youth and young adults with developmental disabilities acquire the skills necessary to prepare them for effective functioning as self-sustaining, working members of society. Substantial research indicates that social, problem-solving and employment-seeking skills are significant factors in attaining and maintaining employment. At this time, relevant literature clearly reveals that progress is being made in assessing individual deficiencies and programs for development of improved social competency. Future policy and research issues are reviewed.

Adolescent↗

PubMed2001

Caring dynamics as perceived by staff supporting daily occupations for developmentally disabled adults.

This study addresses caring staff experiences of hindrances and help in the support of daily occupations among people with developmental disabilities. Data were collected by means of a questionnaire consisting of open-ended questions about the staff perceptions of their work experiences. The respondents (n = 81), corresponding to 94.1% of all care staff employed in a geographically defined care area in southern Sweden, worked in various day activity units supporting the daily occupations of their clients. A constant comparative method of data analysis was used. Staff expressions were classified in two main categories of caring dynamics: an operational level and a managerial level. Four areas were identified at the operational level: encountering realities of practice, attitudes to the clients and work demand, using the potential of knowledge and strategies and applying helping actions to the client. The managerial level included two areas, generalized work strategy and individualized work strategy. It is suggested that to develop the quality of interventions for supporting daily activities among persons with developmental disabilities, efforts should be made to identify caring dynamics as experienced by the caring staff.

Adult↗

PubMed1992

Academic and environmental effects of small group arrangements in classrooms for students with autism and other developmental disabilities.

The use of small group instructional formats with children who have autism and developmental disabilities has received mixed results in the research literature (Reid & Favell, 1984). The purpose of the two studies reported herein was to address this controversy by comparing the performance of students in one-to-one instruction to those transitioned to small groups for a variety of teachers, students, settings, and under different training circumstances. In the first study, 41 students, ranging in age from 5 to 21 years old, from six classrooms, participated; and 25 students from six classrooms participated in the second study. Measures of environmental effects included academic gains via pre- and posttests, on-task and self-stimulatory behavior levels, correct responding, and frequencies of teacher behaviors during both one-to-one and small group formats. Results of both experiments indicated that students were able to successfully transition to small group formats across several curriculum areas including language, math, readiness, and shopping. Further, experienced teachers and administrators were able to train a second group of staff to use the small group procedures effectively. The successful application for this number of students and teachers within natural learning environments is unprecedented and provides important documentation for both the utility and practicality of small group instruction with students who have developmental disabilities.

Achievement↗

PubMed2006

PECS and VOCAs to enable students with developmental disabilities to make requests: an overview of the literature.

This paper provides an overview of the literature dealing with the use of the Picture Exchange Communication System (PECS) and voice output communication aids (VOCAs) for promoting the performance of requests by students with developmental disabilities. Computerized and manual searches were carried out to identify the studies published during the last 15 years (i.e., the period between 1992 and 2006 during which PECS and VOCA approaches became popular). Thirty-seven studies were identified and then divided into three groups concerning the use of the PECS or equivalents, the use of VOCAs or equivalents, and the comparison of both these approaches, respectively. Of the 173 students involved in studies using the PECS or equivalents only three could be considered failures, while a fourth one did not progress in the program due to illness. Similarly, of the 39 students who used VOCAs or equivalents only three could be considered failures, while one was partly successful. Finally, of the 11 students involved in the comparisons between PECS and VOCAs none could be classified as a failure. The results are very encouraging but methodological concerns and the relatively limited use of the systems in terms of request items and request opportunities suggest caution. Caution may also be needed in interpreting the reported similarities between the two systems in usability and effectiveness.

Adolescent↗

PubMed1997

Food safety training needs exist for staff and consumers in a variety of community-based homes for people with developmental disabilities.

OBJECTIVE: To determine staff and consumer-focused food safety training needs in community-based homes for people with developmental disabilities as well as dietitians' perceptions of food-handling practices in these homes. DESIGN: Direct-care staff and dietitians were surveyed according to a modified Dillman method using a mailed, self-administered questionnaire. Main outcome measures included food-handling knowledge, attitudes, and practices of staff and consumers as reported by staff and dietitians; critical control points in safe food preparation in the homes based on the Hazard Analysis and Critical Control Point system; and learning preferences of staff and consumers. SUBJECTS: A 10% probability sample of direct-care staff in homes for people with developmental disabilities in western Massachusetts and a nonprobability sample of dietitians who work with this population were surveyed. Results are reported from 132 and 18 respondents, respectively. STATISTICAL ANALYSES PERFORMED: Descriptive statistics, chi 2 statistic, and the Fisher's exact test. RESULTS: Staff knowledge of safe food preparation is lacking in several areas, including storage and handling procedures. Although staff and consumers do not always follow safe food-handling practices, the staff reported that they follow recommended food-handling practices more often than the dietitians reported they do. Most staff and dietitians reported that staff and consumers had never attended a food safety training program, but that all of the critical control points surveyed would be somewhat helpful if they were included in a food safety workshop. APPLICATIONS: A food safety training program would be beneficial for staff and consumers. Programs should be geared to staff and include ideas and materials for consumers. Consumer modules could then be adapted to individual learning levels by direct-care staff in the homes. The Safe Food at Home workshop was developed on the basis of the results of this study and incorporates the approaches described in this article.

Adult↗

PubMed1998

Exercise and sports in children and adolescents with developmental disabilities. Positive physical and psychosocial effects.

This article reviews findings to date on the effects of exercise and sports in children and adolescents with developmental disabilities. Although much work remains, exercise and sports are associated with reduced maladaptive behavior in children with disabilities, as well as with improved physical fitness, self-esteem, and social competence. Improved physical and psychosocial functioning are found in studies of both children and adults with mental retardation, as well as in research on athletes enrolled in Special Olympics International, the largest recreational sport program in the world for persons with developmental disabilities. The review ends with recommendations for promoting recreation and sports in children and adolescents with disabilities.

Adolescent↗

PubMedDate not supplied

Family adjustment to childhood developmental disability: a measure of parent appraisal of family impacts.

OBJECTIVE: To develop the Family Impact of Childhood Disability Scale (FICD) to assess subjective interpretation or "primary appraisal" of parents regarding the impact of a child with developmental disabilities on the family. METHOD: A random sample of 87 families was assessed while children with developmental disabilities were in the preschool years. After 7 years had elapsed, 64 of these families were interviewed again when the children were in the preteen years. A set of standardized self-report measures provided mother and father views of child, parent, and family functioning. RESULTS: The FICD demonstrated adequate internal consistency, with some evidence of discriminant and predictive validity. The FICD total score, based on the discrepancy between positive and negative subscale scores, was found to be a significant predictor of future parenting stress of mothers and of fathers, even when controlling for other important explanatory variables such as marital adjustment and level of disability in a child. CONCLUSIONS: The 15-item FICD offers a brief assessment of both positive and negative parent appraisals, with a total discrepancy score that predicts long-term parenting stress.

Adaptation, Psychological↗

PubMed1998

General anesthesia for the provision of dental treatment to adults with developmental disability.

The management of the behavior of mentally challenged adults when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Our institution has a designated program to provide required dental care to this group of patients. Because of the high incidence of poor cooperation, which may include aggressive antagonistic behavior, many of these patients are scheduled for dental care under general anesthesia with an incomplete preoperative medical assessment. The purpose of this study was to determine the impact and limitations that an incomplete medical assessment may present in the delivery of dental care under general anesthesia to these adults with developmental disability. After approval from the institutional review board, the medical records of 139 patients treated in this program between 1992 and 1994 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental and radiographic examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. There were 149 procedures performed on these patients, some more than once. The mean age was 29.5 yr. Males predominated females by a ratio of 2:1. All had multiple diagnoses, medical problems, and medications. Twenty-three patients had Down's Syndrome, four had schizophrenia disorders, 42 had seizure disorders, 11 had hypothyroidism, seven had heart disease, and 14 had central nervous system and neuromuscular disorders. The remainder had a variety of diagnoses, including rare syndromes. One hundred had intravenous (i.v.), 25 had mask inhalation, and 24 had intramuscular ketamine (Ketalar) induction. Nasotracheal intubation was uneventful in 139 patients, five had difficult visualization of the larynx and intubation. Ten patients experienced intraoperative complications, including nonfatal ventricular arrhythmia, slight fall in blood pressure and hypertension (greater than 20% of preoperative value), and four individuals developed laryngospasm. In the Post Anesthetic Care Unit, five patients experienced minor airway problems resulting in a desaturation of oxygen to a level below 85%. Adults with developmental disabilities can be safely managed under general anesthesia for dental treatment in a hospital setting with minimal morbidity and without extensive preoperative investigations.

Adolescent↗

PubMed1985

Nutrient intake of institutionalized developmentally disabled individuals: impact of the nutrition knowledge of paraprofessionals.

The role of the caretaker in enhancing nutrient intake of developmentally disabled individuals living in an institutional setting was examined. Eighty developmentally disabled residents living at the Western Carolina Center, Morganton, NC, were assessed for anthropometric measurements and for dietary intake, with a 3-day plate waste study. Seventy paraprofessionals/feeders working at the same center were assessed for knowledge of nutrition and food practices and participated in a series of inservice programs on nutrition. Pretest and post-test scores for knowledge of nutrition and food practices were determined. For the paraprofessionals/feeders, inservice programs on nutrition resulted in increased knowledge of nutrition but did not increase the nutritional quality of their own diets. However, statistically significant differences were noted in residents' diets for calories (p less than .05), iron (p less than .05), and niacin (p less than .05) attributable to the inservice programs on nutrition.

Adolescent↗

PubMed1991

Sexual counseling with a developmentally disabled couple: a case study.

This article describes the process of sexual counseling with a developmentally disabled couple, illustrating principles and techniques that were unique to this couple's concern. The author asserts that this aspect of a marital relationship should not be denied a couple simply because they are handicapped. Her intent is to help nurses understand some of the issues involved in sexual counseling with developmentally disabled persons, and to motivate nurses to help those who may express concerns.

Female↗

PubMed1986

Parental attitudes toward the developmentally disabled among Arab communities in Israel: a cross-cultural study.

The present study investigated the attitudes of 184 Arab families toward their developmentally disabled children, using a questionnaire on Attitudes Towards Disabled Persons, (Yuker, Block and Campbel, 1960). The major findings were that generally attitudes were positive, with the Druze showing the most positive ones, while the Muslims and Christians expressed less positive attitudes. A major factor that was found to correlate with less positive attitudes was education. In our sample the more educated (many Christians) showed less favorable attitudes. The main conclusion of this study was that since Arab society in Israel is dynamic, and old traditions are forespoken for new ones, it is important to preserve positive attitudes--which have their roots in past traditions--towards developmentally disabled by enhancing modern concepts relating to their education and rehabilitation.

Attitude↗

PubMed1994

The developmentally disabled, psychiatrically impaired client. Proper treatment of dual diagnosis.

1. As many as 30% to 35% of all developmentally disabled persons have a psychiatric impairment. Nurses must be aware that in a developmentally disabled client, psychiatric impairments are frequently exhibited as negative behaviors. 2. Nursing interventions are the same as those used in general mental health settings, but are adapted to the client's needs. If needed, nurses should encourage the full range of psychiatric medications. 3. Care of these patients requires undertaking much investigative work and review of old files, interviewing persons who know the client well, and doing some guess work.

Activities of Daily Living↗

PubMed2000

Disclosure of developmental disability: a study of parent satisfaction and the determinants of satisfaction.

OBJECTIVE: To investigate the level of parent satisfaction with the first communication of a diagnosis of developmental disability in their child ('disclosure') and the determinants of this satisfaction. METHODOLOGY: Interviews with parents of children with developmental disabilities regarding their experiences at the time of disclosure and their level of satisfaction with the process were carried out. RESULTS: Parent satisfaction with disclosure overall was found to be high (82.6%). Parents were more likely to be satisfied if they received a large amount of information. Parent satisfaction was found to be higher when the disclosing professional communicates well with the parents, has an understanding of parental concerns, and is direct in manner. Having both parents, the child or support people present were not found to have any significant relationship to parent satisfaction. CONCLUSIONS: The high level of satisfaction with disclosure in this study supports the claim made by earlier researchers that parental dissatisfaction with the disclosure process is not inevitable. The major determinants of parental satisfaction with disclosure are directness, understanding of parental concerns and good communication on the part of the disclosing professional, and receiving a large amount of information.

Adult↗

PubMed1995

Unprovoked seizures and developmental disabilities: clinical characteristics of children referred to a child development center.

Few data are available on the risk of seizures in young children with developmental problems. A retrospective evaluation of 1,946 children 0-5 years of age referred to the Tel Aviv Child Development Center (CDC) between 1981 and 1990 was performed. The study was undertaken to determine the cumulative risk of unprovoked seizures in children referred to a CDC and to assess the risk factors associated with seizures in these children. The center serves the Tel Aviv area for a variety of developmental disabilities. Cumulative risk of seizures and risk factors were assessed using Kaplan-Meier methodology. Unprovoked seizures occurred in 58 patients (3%), including 10 with a single seizure and 48 with two or more seizures. Risk factors for seizures included cerebral palsy (CP) (relative risk [RR] = 28.7), neonatal seizures (RR = 15.2), mental retardation (MR) (RR = 7.8), febrile seizures (RR = 7.7), autism (RR = 3.2), and prematurity (RR = 2.7). The cumulative risk of seizures by age 5 years in children with MR, CP, and MR plus CP was 8%, 47%, and 68%, respectively, compared with 1% in those without MR or CP. On multivariate analysis, CP, MR, prior febrile seizures, and prematurity were associated with an increased risk of seizures. The risk of experiencing unprovoked seizures by age 5 in children with developmental disabilities is 3%, which is fourfold greater than that of the general population. Much of this increased risk is limited to selected subgroups with major disabilities. However, if neither MR nor CP is present, the 1% risk of developing unprovoked seizures by age 5 in children with other developmental problems is not substantially different from that expected in the general population.

Cerebral Palsy↗