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PubMed1997

How mental health and developmental disabilities staff prioritize training and development needs.

This paper contrasts a staff training needs assessment distributed to three groups: staff serving persons with mental health needs in the community, staff serving persons with mental health needs in state hospitals, and staff serving persons with developmental disabilities in the community. Analyses revealed that all three groups rated team-related training as the area in greatest need of development. Further analyses suggested that community staff serving persons with developmental disabilities reported significantly less need for training on direct client care compared to community and inpatient staff who serve persons with mental health needs. The community staff serving persons with mental health needs did not differ significantly from the inpatient staff on any of the surveyed training areas. Results suggest that future development efforts should begin with team building skills.

Adult↗
PubMed2004

Re-injecting spontaneity and balance in family life: parents' perspectives on recreation in families that include children with developmental disability.

METHODS: Grounded in the naturalistic paradigm, a mixed-method research design (survey questionnaire, n = 65; and interview, n = 16) was used to explore the nature and benefits of, and constraints to, family recreation in families that included children with developmental disability. Statistical analyses were conducted on the quantitative data, while key theme and constant comparative methods were used to analyse the qualitative data. RESULTS: These analyses revealed that family recreation most often involved small combinations of family members - usually mothers and their children - in physical recreation activities (e.g. swimming, walking, bike riding). Parents viewed these interactions as beneficial for enhancing family relationships and providing children, particularly those with a disability, opportunities for skill and self development within an accepting and supportive environment. Difficulties in coordinating family members schedules, finding activities to accommodate wide age and skill ranges, planning demands, and limitations in marketing and promotional materials were among the constraints most commonly identified in relation to the family as a whole and the children with developmental disability. Links to existing family and leisure research, family systems theory, and considerations for future research also are discussed.

Adaptation, Psychological↗
PubMed1995

Correlations between clinical and neuropathological diagnosis of cortical anomalies in developmentally disabled children.

The capabilities and limitations of clinical diagnoses, particularly brain imaging of cortical anomalies, in developmentally disabled children are reviewed. Some aspects of diagnostic problems in generalized cortical dysgeneses, like lissencephaly type I and II, subcortical heterotopias, generalized polymicrogyria, or focal cortical anomalies and primary micrencephalies, are discussed.

Brain Diseases↗
PubMedDate not supplied

Providing dental care to patients with developmental disabilities. An introduction for the private practitioner.

During the past 20 to 25 years, in New York State, most individuals with developmental disabilities who had previously been housed in large institutions have been mainstreamed into community-based residences. This shift has created a need for dental services in the community. The article presented here provides information and tips to assist the general practitioner with integrating these patients into a private practice setting.

Child↗
PubMedDate not supplied

Diagnostic-based pharmacological treatment of behavior disorders in persons with developmental disabilities: a review and a decision-making typology.

This article reviews the diagnostic rationale for treatment of behavior disorders with psychotropic medication. After reviewing the concerns over the use of psychotropic medication and the use of diagnostic criteria with persons with developmental disabilities in the past, the variety of potential diagnoses that may underlie a behavior disorder are reviewed. A model to guide clinical decision making is then developed on the basis of this review, and areas for future research are suggested. The key questions are identified as making reliable differential diagnoses of behavior disorders and demonstrating that these differential diagnoses successfully identify more effective psychotropic medications for the treatment of behavior disorders in persons with developmental disabilities.

Diagnosis, Differential↗
PubMed1990

Munchausen syndrome by proxy presenting as a developmental disability.

Munchausen syndrome by proxy (MSBP) is a form of child abuse in which a parent falsifies illness in a child by fabricating or producing symptoms and presenting the child for medical care while disclaiming knowledge as to the cause of the problem. This report presents the case history of a child diagnosed with MSBP who was portrayed as having multiple developmental disabilities by her mother. Three elements of the case are noteworthy. The emphasis by the mother on multiple developmental disabilities has not been reported. The complexity of this case is unusual and may reflect the complexity of the mother's psychopathology. The interdisciplinary team evaluation was instrumental in making the diagnosis.

Cerebral Palsy↗
PubMed2002

Assessing secondary conditions among adults with developmental disabilities: a preliminary study.

Pope (1992) asserted that there was a significant need to examine secondary conditions among individuals with development disabilities. In the present study we focused on that need. The development of a secondary conditions surveillance instrument is described, as are the results of a pilot survey conducted with adults receiving state developmental disabilities program supports and with their direct-care service providers. Results of a pilot survey are presented to illustrate how survey data might be used to improve systems of services and supports to enhance the health and participation of adults with developmental disabilities in community life.

Adult↗
PubMed1986

From Roosevelt to Reagan: federal spending for mental retardation and developmental disabilities.

Results of an analysis of 50 years of federal government spending for mental retardation and developmental disabilities were summarized. Spending for services and income maintenance grew rapidly from the early 1950s through fiscal year (FY) 1981. Since FY 1981, total federal spending for mental retardation has plateaued. Federal support for research and training has declined steadily since the early 1970s. The lack of support for research and training imperils the achievement of national objectives in prevention of retardation and integration of retarded individuals into community settings.

Child↗
PubMed2004

Access to health care for individuals with developmental disabilities from minority backgrounds.

In this project we examined access to health care by individuals with developmental disabilities in Kansas from low-income populations and from minority backgrounds. Four criteria for determining access were employed: availability, accessibility, affordability, and appropriateness of care. Factors that pose barriers and that facilitate access are described and recommendations are set out, with particular reference to the 2002 Report of the Surgeon General of the United States, related to health status of people with mental retardation.

Child↗
PubMedDate not supplied

Persistence of early emerging aberrant behavior in children with developmental disabilities.

This study examined the persistence of early emerging aberrant behavior in 13 preschool children with developmental disabilities. The severity of aberrant behavior was assessed every 6 months over a 3-year period. Teachers completed the assessments using the Aberrant Behavior Checklist [Aman, M. G., & Singh, N. N. (1986). Aberrant Behavior Checklist: Manual. East Aurora, NY: Slosson Educational Publications; (1994). Aberrant Behavior Checklist--Community. East Aurora, NY: Slosson Educational Publications]. Problem behaviors were present in all children at the beginning of the study. Nine of the 13 children entered the study with relatively high levels of aberrant behaviors that showed little change over the 3 years. These data suggest that aberrant behaviors often emerge early and can be highly persistent during the preschool years. Prevention would, therefore, seem to require home-based interventions that begin before 4 years of age.

Child↗
PubMed2006

Assessment of deviant arousal in adult male sex offenders with developmental disabilities.

Ten individuals, residing in a treatment facility specializing in the rehabilitation of sex offenders with developmental disabilities, participated in an arousal assessment involving the use of the penile plethysmograph. The arousal assessments involved measuring change in penile circumference to various categories of stimuli both appropriate (adult men and women) and inappropriate (e.g., 8- to 9-year-old boys and girls). This approach extends the existing assessment literature by the use of repeated measurement and single-subject experimental design. Data from these assessments were analyzed to determine if clear and informative outcomes were obtained. Overall, three general patterns of results emerged. Some participants showed differentiated deviant arousal or higher levels of arousal to specific inappropriate stimuli (deviant is a term used in the existing sex-offender literature to describe this type of arousal). Other participants showed undifferentiated deviant arousal, in which case they showed nonspecific arousal to inappropriate stimuli. The remaining participants showed no arousal to inappropriate stimuli but did show arousal to appropriate stimuli. Implications for assessment, treatment, and future directions are discussed.

Adult↗
PubMedDate not supplied

Psychosocial theories of depression for individuals with intellectual and developmental disabilities: a historicist perspective.

The mental health care system has historically marginalized individuals with intellectual and developmental disabilities (I/DD). Until the mid-1980s, many clinicians doubted that individuals with I/DD were capable of depression (Sovner & Pary, 1993). Although it is now generally accepted that individuals with I/DD do have depression, they may not be treated or may be inappropriately treated (Matson et al., 2000). A historicist perspective takes into account the effect of marginalization on science and practice. Depression has both biological and psychosocial aspects. Key groups of theories regarding the psychosocial aspects of depression include psychodynamic/psychoanalytic, behavioral, cognitive, and ecological/interpersonal theories (Clark, Beck, & Alford, 1999; Joiner, Coyne, & Blalock, 1999). The application of psychosocial theories of depression to individuals with I/DD continues to reflect their marginalization and oppression. Behavioral theories of depression are limited in their conceptions for research, identification, and treatment of depression but continue to be used widely with individuals with I/DD. Cognitive theories of depression are widely used in research and treatment of depression in the general population, but have limited usage among individuals with I/DD. Interpersonal theories of depression are used in the general population and have many benefits, but are only now being investigated for use with individuals with I/DD. In this article, theories of depression as applied to individuals with I/DD are discussed from a historicist perspective.

Child↗
PubMed2004

Multispecialty telephone and e-mail consultation for patients with developmental disabilities in rural California.

The University of California (UC), Davis Health System, and California Department of Developmental Services (CDDS) developed the Physician Assistance, Consultation and Training Network (PACT Net) to assist primary-care providers (PCPs) care for patients with developmental disabilities in rural California. This manuscript describes PACT Net, a warm line using phone and e-mail, and its multispecialty panel. A pilot study evaluated whether or not PCPs needed such a consultation service, whether or not it assisted them in providing care, and their overall satisfaction with the service. PCPs were informed on how to request a consultation. Data were collected from patients (demographics), PCPs (satisfaction with preexisting consultation availability and quality, PACT Net consultation reason, preferred mode of contact, duration, and, satisfaction), and specialists (ease, quality of request, and satisfaction). Satisfaction was measured prospectively using a 7-point Likert scale. Data were collected on 30 consultations, 28 by telephone and 2 by e-mail; other data were by combined methods. The average duration of consultation was 47 minutes, and 24 responses occurred within one business day. The top three services requested for consultation were psychiatry (e.g., management of behavioral disturbance), medical genetics (diagnosis), and gastroenterology (miscellaneous). PCPs rated baseline satisfaction with: (1) pre-existing local services at 3.37, (2) timeliness of the PACT Net consultation at 5.45, (3) quality of the communication at 6.3, and (4) overall quality and utility of the consultation at 6.2. Specialists rated the quality of the communication at 6.45, and the ease of the service at 6.46. Phone and e-mail consultation appears satisfactory to PCPs and specialty providers as a way to enhance specialty input to rural patients.

Adolescent↗
PubMed2002

Dental care for individuals with developmental disabilities is expensive, but needed.

More than $35 billion in additional lifetime costs will be expended for all children in the United States born with mental retardation in 1998 alone. The figure is $4.7 billion for California children. These numbers include neither the costs for individuals with other developmental disabilities, nor the costs for dental services. Despite the findings that individuals with mental retardation have more untreated dental needs than individuals in the general population, most dental students and many practitioners have limited experience in providing care for patients with special needs. The significant additional general costs for the care of people with mental retardation and other developmental disabilities are a reality, but the dental profession must not lose sight of the need for its members to provide services for these individuals.

California↗
PubMed2003

The American Academy of Developmental Medicine and Dentistry: eliminating health disparities for individuals with mental retardation and other developmental disabilities.

Recent reports by Special Olympics International and the U.S. Surgeon General have revealed significant disparities and unmet health needs encountered by persons with mental retardation and other developmental disabilities (MR/DD). Factors contributing to these disparities include deinstitutionalization, increased survival of individuals with MR/DD, lack of appropriately trained providers, and inadequate financing of dental services. To address these problems, a group of academically oriented dentists and physicians formed the American Academy of Developmental Medicine and Dentistry (AADMD). The mission of the AADMD is to improve the quality of health services provided to persons with MR/DD by improving dental and medical school-based training of dentists and enhancing clinically relevant research. A central theme of the AADMD is full collaboration between physicians and dentists in meeting its goals. The National Action Strategy developed by the AADMD focuses on creating a series of university-based Developmental Medicine and Dentistry Programs (UDMDPs) in medical and dental schools, which collaborate in service, teaching, and research with community-based primary care clinics, community hospitals, intermediate care facilities, and other private service delivery systems such as the Special Olympics Healthy Athletes Program that serve these patients. Oral-systemic interactions will receive special emphasis by the training and research programs.

Adolescent↗
PubMed1985

Cognitive subtypes in developmentally disabled children: a pilot study.

Differential diagnoses within the pervasive developmental disorders have insufficient reliability, validity, and descriptive homogeneity within groups to be used as distinct categories for research purposes. This study reports the results of cognitive subtyping of 54 developmentally disabled children. Fifty-one were successfully categorized in a small number of groups, characterized by different strengths and weaknesses on verbal, performance, memory, and quantitative tests. About half of the children had the relatively good visuospatial performance expected on the basis of previous literature on autistic children; these children were not behaviorally more autistic than the others. Measures of internal validity are reported, as well as validation by cognitive and behavioral variables. These results tentatively suggest that such psychiatric manifestations as autistic aloofness and maintenance of sameness may be relatively independent of cognitive skill patterns.

Adolescent↗
PubMed1988

A comparison of laboratory and clinical methods for diagnosing pertussis in an outbreak in a facility for the developmentally disabled.

During a pertussis outbreak in a facility for the developmentally disabled, culture- or direct fluorescent-antibody-confirmed cases were identified in 24 residents and 17 staff members; 38 (93%) were culture positive for Bordetella pertussis. An enzyme-linked immunosorbent assay (ELISA) was used to detect serum IgG and IgA to the filamentous hemagglutinin and lymphocytosis-promoting factor of B. pertussis. Using criteria from ELISA values, we identified an additional 83 residents and 28 staff members as seropositive. Among seropositive persons, antibody levels were elevated by the time of onset of respiratory symptoms and, in three of the four assays, remained elevated for 14 mo. In 44 seropositive persons tested within two weeks of onset of symptoms, 80% were culture positive, compared with 33% of 15 tested two to four weeks after onset (P = .003) and none of 15 tested more than four weeks after onset. The most specific (94%) clinical case definition identified only 41% of seropositive persons. Thus, ELISAs are important tools for individual diagnosis and epidemiological studies of pertussis.

Antibodies, Bacterial↗