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PubMed2000

Federal old-age, survivors and disability insurance and Supplemental Security Income for the Aged, Blind, and Disabled; medical and other evidence of your impairment(s) and definition of medical consultant. Social Security Administration. Final rules.

We are revising the Social Security and Supplemental Security Income (SSI) disability regulations regarding sources of evidence for establishing the existence of a medically determinable impairment under title II and title XVI of the Social Security Act (the Act). We are doing this to clarify and expand the list of acceptable medical sources and to revise the definition of the term "medical consultant" to include additional acceptable medical sources.

Disability Evaluation↗
PubMed2001

Federal old-age, survivors and disability insurance; determining disability and blindness; revision to medical-vocational guidelines. Final rules.

We are clarifying section 201.00(h) of the medical-vocational guidelines in appendix 2 of sub part P of regulations part 404. This section provides guidance for evaluating disability in individuals under age 50 who have a severe impairment(s) that does not meet or equal in severity the criteria of any listed impairment in appendix 1 of sub part P, but who have a residual functional capacity for no more than the full range of sedentary work and cannot do any past relevant work. The revisions only clarify the current rules.

Disability Evaluation↗
PubMed1989

Disabled clients, constituencies, and counsel: representing persons with developmental disabilities.

Legal representation of people with developmental disabilities entails singular challenges. Within the past two decades, nevertheless, lawyers, clients, and constituency or self-advocacy organizations have worked to establish particular educational, residential, and activity services as legal rights. When violations of these rights occur, litigants may initiate either individual or multiparty actions capable of placing institutions or service delivery systems under mindful judicial scrutiny. Remaining barriers to instituting and sustaining effective attorney/client relationships need to be overcome, lest enforcement of constitutional and statutory rights be inhibited.

Adult↗
PubMed1983

Frequency judgment accuracy as a function of age and school achievement (learning disabled versus non-learning-disabled) patterns.

The accuracy of children's judgments of relative situational frequency was examined in two experiments. In Experiment 1 children with normal achievement in Grades 2 and 3 were compared with such children in Grades K and 5, as well as with three groups of low-achieving children in Grades 2 and 3. These latter groups consisted of children low in reading achievement, those low in math achievement, and those identified as learning disabled. Frequency judgment accuracy increased from kindergarten to Grades 2 and 3. No other comparisons yielded significant differences. Experiment 2 confirmed both the above age difference and the absence of any frequency judgment deficiency on the part of the low-achieving groups.

Achievement↗
PubMed2005

Frailty, hospitalization, and progression of disability in a cohort of disabled older women.

PURPOSE: To determine the association between a previously validated frailty phenotype and the development of new-onset dependence in activities of daily living, independent of hospitalizations and other established predictors of disability. SUBJECTS: Seven hundred and forty-nine women enrolled in the Women's Health and Aging Study-I who were independent in all activities in daily living when enrolled in the cohort. METHODS: Assessments and interviews were conducted through home visits at 6-month intervals for 3 years. Frailty was classified using a validated phenotype (> or =3 of the following: weight loss, exhaustion, slow walking, sedentariness, and weak grip), and hospitalizations were identified by self-report. Grouped-time proportional hazard models assessed associations among frailty, hospitalization, and the development of dependence in activities in daily living, adjusting for other factors. RESULTS: Twenty-five percent of the cohort (186/749) were frail at baseline; 56% (104/186) of frail versus 20% (23/117) of nonfrail women developed dependence in activities in daily living (P <.001). In multivariate analysis, frailty was independently associated with the development of dependence in activities in daily living (hazard ratio [HR] = 2.2; 95% confidence interval [CI]: 1.4 to 3.6), adjusting for hospitalization status, age, race, education, baseline functional status, cognition, depressive symptoms, number of chronic diseases, and self-reported health status. Additionally, a dose-response relationship existed between the number of frailty criteria that a woman had and the hazard of subsequent dependence in activities in daily living. CONCLUSION: Frailty, conceptualized as an underlying vulnerability, and hospitalization, which marks an acute deterioration in health, were strongly and independently associated with new-onset dependence in activities in daily living. Additional research is needed to determine if dependence can be minimized by targeting resources and programs to frail older persons.

Activities of Daily Living↗
PubMed2006

High outpatient visits among people with intellectual disabilities caring in a disability institution in Taipei: a 4-year survey.

Few studies reported in the literature have addressed the long-term trend of the use of medical care for people with intellectual disabilities (ID) in institutions. The subject cohort in this study was made of 168 individuals with ID in a public residential facility from 1999 to 2002 in Taipei, Taiwan. The average age of participants was 19.3 years, and their average stay in an institution was 6.6 years. The average annual outpatient visit of the study participants was 18.2 in the previous 4 years. It was found that they had more medical visits than the general population. Nearly 20.8-34.5% (average 29.0%) of the participants utilized more than 25 visits annually which was defined as high outpatient visit users. This group of high outpatient users consumed more than half of the total annual outpatient care visits in the past 4 years. In the full model of Generalized Estimating Equations to compare the high and non-high outpatient users, the factor of individuals with ID dwelling in the institution were more likely to be high outpatient care users than individuals who were only accepting institutional day care services (OR=6.29, 95% CI=1.35-29.30). The present study provides general information of high outpatient utilization and its determinants of people with ID and provides evidence for medical care decision makers dealing with policy development for people with ID care in institutions.

Adolescent↗
PubMed1999

'A woman's heaven is at her husband's feet'? The dilemmas for a community learning disability team posed by the arranged marriage of a Bangladeshi client with intellectual disability.

The present case report describes the arranged marriage of a Bangladeshi woman with moderate intellectual disability. It explores some of the social and cultural factors influencing the decision to arrange her marriage, and the dilemmas this presents in terms of bridging cultural differences between professional and lay concerns.

Adult↗
PubMed2000

Test battery for the diagnosis of dementia in individuals with intellectual disability. Working Group for the Establishment of Criteria for the Diagnosis of Dementia in Individuals with Intellectual Disability.

A working battery of tests for the diagnosis of dementia, which is applicable to most adults with intellectual disability, is proposed by an international Working Group. The battery, reflecting contemporary research and practice findings, includes scales for informant report of functioning and tests for direct assessment. The Working Group recommends the international use of the battery both as part of ongoing and new longitudinal research, and in clinical practice. The widespread use of a common battery will enhance communication and collaborative opportunities among researchers and clinicians at various sites, and will help to standardize diagnostic protocols and research findings. The collaborative evaluation of such a battery will address one of the greatest challenges in the field, that of differentiating change associated with ageing from that associated with dementia.

Adult↗
PubMed2002

Dual diagnosis in offenders with intellectual disability: setting research priorities: a review of research findings concerning psychiatric disorder (excluding personality disorder) among offenders with intellectual disability.

Studies of so-called 'dual diagnosis', i.e. intellectual disability (ID) with an additional psychiatric disorder, are reviewed with particular reference to offending behaviour. Because of the paucity of studies of psychopathology in offenders with ID, the present paper opens with studies of broader issues of psychopathology among people with ID, notably those with depression, schizophrenia, mild depressive disorder, other major psychotic disorders, anxiety/neurotic disorder, autistic spectrum disorders and attention deficit hyperactivity disorder. There follows a review of the most established and commonly used measurement scales for dual diagnosis in ID. The review then focuses directly on those studies which have looked at the issues of dual diagnosis among offenders with ID. In keeping with other reviews in this series, the latter studies are classified according to the same criteria. Based on this review, it is apparent that there are high-priority research questions which concern the extent and nature of psychopathology among offenders with ID, most notably those with autistic spectrum disorders.

Comorbidity↗
PubMed2003

Workplace accommodations for people with disabilities: National Health Interview Survey Disability Supplement, 1994-1995.

As American workers age, workers with impairments and functional limitations make up a larger percentage of our workforce. This investigation presents data from the National Health Interview Survey Disability Supplement 1994-1995 (NHIS-D) describing the nature of workplace accommodations in the American workforce and factors associated with the provision of such accommodations. Of a nationally representative sample of workers aged 18 to 69 years with a wide range of impairments, 12% reported receiving workplace accommodations. Males (odds ratio (OR) 0.64: 95% confidence interval (CI) 0.53-0.78) and Southerners (OR 0.57; 95% CI = 0.47-0.70) were less likely than others to receive workplace accommodations. Those with mental health conditions were less likely than others to receive accommodations (OR 0.56; 95% CI = 0.44-0.70). College graduates (OR 1.53; 95% CI = 1.22-1.91), older workers, full time workers (OR 3.99; 95% CI = 2.63-3.87), and the self-employed (OR 1.76; 95% CI = 1.28-2.41) were more likely than others to receive accommodations.

Activities of Daily Living↗
PubMed2005

A population-based study of the recurrence of developmental disabilities--Metropolitan Atlanta Developmental Disabilities Surveillance Program, 1991-94.

Serious developmental disabilities (DD) are quite common and affect approximately 2% of all school-aged children. The impact of DDs with respect to the need for special education services, medical care and the demand on family members can be enormous. While this impact can be magnified for families with more than one child with a DD, little is known regarding the epidemiology of recurrence of DDs. When the cause of a DD is unknown, genetic counsellors rely on recurrence risk estimates which for DDs are over 10 years old. The objectives of our study were to: (1) assess the contribution of recurrent cases to the prevalence of DDs; (2) provide current, population-based recurrence risk estimates; and (3) examine characteristics of the first affected child as predictors of recurrence. Two population-based data sources were used to identify all children born to the same mother during the period 1981-91 in the five-county metropolitan Atlanta area with at least one of four DDs: mental retardation (MR), cerebral palsy, hearing loss, or vision impairment. Recurrence risk estimates for these DDs ranged from 3% to 7% and were many times higher than the background prevalences. The risk of recurrence of DDs was greatest for MR - approximately eight times greater than the baseline MR prevalence. Isolated mild MR (IQ 50-70) was highly concordant between siblings with MR. Sex, race, and birthweight of the index child, maternal education, and maternal age were not significantly associated with recurrence risk. Further research is needed to investigate the roles of genetic and environmental factors on the recurrence of DDs, particularly isolated mild MR.

Child↗
PubMedDate not supplied

Studying disability and disability studies: shifting paradigms of LDA synthesis of responses to Reid and Valle.

In this article, I discuss the 11 diverse responses to Reid and Valle's work on the discursive practice of learning disabilities (LD), implications for instruction, and parent-school relations. I highlight key ideas from each article and then focus on three common areas of interest shared by most respondents: the unacceptable status quo of schooling practices; desired changes in schooling practices; and knowledge production in the field of special education and its relation to schooling practices. In light of the many issues raised, I urge the need for a reflective turn in the field of LD and for openness toward diversification of thought.

Child↗
PubMed2000

Provision of educationally-related services for children and adolescents with chronic diseases and disabling conditions. American Academy of Pediatrics. Committee on Children with Disabilities.

Children and adolescents with chronic diseases and disabling conditions often need related services. As medical home professionals, pediatricians can assist children, adolescents, and their families with the complex federal, state, and local laws, regulations, and systems associated with these services. Expanded roles for pediatricians in Individual Family Service Plan, Individualized Education Plan, and 504 Plan development and implementation are recommended. The complex range of federal, state, and local laws, regulations, and systems for special education and related services for children and adolescents in public schools is beyond the scope of this statement. Readers are referred to the policy statement "The Pediatrician's Role in Development and Implementation of an Individual Education Plan (IEP) and/or an Individual Family Services Plan"(1) by the American Academy of Pediatrics for additional background materials.

Adolescent↗
PubMed1992

Mortality, disability, and falls in older persons: the role of underlying disease and disability.

BACKGROUND: Falls are prevalent in older persons and can have serious consequences. METHODS: Data from the Longitudinal Study on Aging were analyzed to study the relationship between falls and both mortality and functional status in 4270 respondents age 70 and over. The effects of demographic traits, chronic conditions, and disability present at baseline were controlled for by means of multivariable analyses. RESULTS: Risk of death within 2 years was greater for both single fallers (crude odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1-2.0) and multiple fallers (crude OR, 2.2; 95% CI, 1.7-2.8). This excess risk was dissipated when selected covariates were added to the model. No crude or adjusted association was evident between single falls and functional impairment; however, multiple falls were an independent risk factor (adjusted OR, 1.6; 95% CI, 1.2-2.0). CONCLUSIONS: Multiple falls in older persons increase risk of functional impairment and may indicate underlying conditions that increase risk of death.

Accidental Falls↗
PubMed2000

Federal old-age, survivors, and disability insurance and supplemental security income for the aged, blind, and disabled; evaluating opinion evidence. Social Security Administration. Final rules.

We are revising the Social Security and Supplemental Security Income (SSI) regulations concerning the evaluation of medical opinions to clarify how administrative law judges and the Appeals Council are to consider opinion evidence from State agency medical and psychological consultants, other program physicians and psychologists, and medical experts we consult in claims for disability benefits under titles II and XVI of the Social Security Act (the Act). We are also defining and clarifying several terms used in our regulations and deleting other terms.

Expert Testimony↗
PubMed2001

American Academy of Pediatrics: Committee on Child Abuse and Neglect and Committee on Children With Disabilities. Assessment of maltreatment of children with disabilities.

Widespread efforts are continuously being made to increase awareness and provide education to pediatricians regarding risk factors of child abuse and neglect. The purpose of this statement is to ensure that children with disabilities are recognized as a population that is also at risk for maltreatment. The need for early recognition and intervention of child abuse and neglect in this population, as well as the ways that a medical home can facilitate the prevention and early detection of child maltreatment, should be acknowledged.

Child↗