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PubMed1986

Community professionals' compliance with consultants' recommendations for developmentally disabled children.

Much of the responsibility for managing children with developmental disabilities lies with professionals working in community services. In many instances advice and consultation for these frontline professionals is available from a regional consultation facility. The purpose of this study was to prospectively examine the relationship between community professional clients' perceptions of the quality of the consultations received and their subsequent compliance with the recommendations made to them for the management of children in their care. Two hundred and ninety-nine consultation recommendations were followed: 2 weeks after the advice had been provided, clients completed a general satisfaction questionnaire and a client perceptions questionnaire. Two months later, compliance with the recommendation was determined by a validated self-report questionnaire. Overall, compliance was good for 73% of the recommendations. Negative client perceptions regarding several aspects of the consultants' skills in conducting the consultation were strongly associated with subsequent noncompliance. The findings suggest that community professional compliance may be enhanced by attention to improving the process of consultation.

Child↗
PubMed1989

Sibling relationships involving developmentally disabled people.

Forty-six sisters of moderately to profoundly developmentally disabled individuals completed questionnaires measuring qualitative aspects of their sibling relationships. In comparison to relationships with their nondisabled siblings, these relationships were described as less competitive and less intimate as well as different in nurturance, admiration, and domination patterns. Relationship scores were predicted, either independently or interactively, by sibling dependency, sibship constellation variables, the ages of subjects and their siblings, and living arrangements. Implications of these results were discussed as they pertain to various conceptualizations of sibling relationships and to future research.

Adolescent↗
PubMed1988

Causes of death of patients in an institution for the developmentally disabled.

The causes of death of 53 severely to profoundly developmentally disabled patients who died in an intermediate care facility were reviewed. Respiratory disease, predominantly pneumonia and aspiration, accounted for 72% of deaths. Seven patients died of nonrespiratory causes, and in 8 patients, no cause of death could be determined, even after a complete autopsy or investigation. The median age at death was 20 years. The weights of these patients' organs at autopsy were lower than those for normal individuals of the same age. The lifespan of these severely impaired individuals continues to be significantly shortened, even with improved methods of care.

Adolescent↗
PubMed1988

Provision of health care for persons with developmental disabilities living in the community. The Morristown model.

Persons with developmental disabilities living in the community have a greater number and variety of health care needs than the average population of the same age and sex. The erroneous assumption that the generic health care system would be able to provide all necessary services to the large number of individuals recently transferred from state residential facilities to the community has proved to be an unexpected disappointment to human service policymakers. In an effort to remedy this situation, a program of health care services was established by the New Jersey Department of Human Services at a community teaching hospital to supplement the existing generic system of medical care. Within four years, the program had rapidly grown to provide care for 729 patients who had come to rely on the center for primary care, specialty medical and dental services, and medical case management. The demographic characteristics of this program are described as well as data on morbidity, service utilization, and special problems encountered when care was provided to this complex and medically underserved population.

Adolescent↗
PubMed1995

Crisis intervention for community-based individuals with developmental disabilities and behavioral and psychiatric disorders.

When individuals with a developmental disability experience a behavioral or psychiatric crisis, their community placement may be threatened. A model crisis intervention program for individuals with dual diagnoses was discussed and performance and outcomes of such a service for 267 children and adults reviewed. Analysis indicated that 69% of the individuals required only one crisis intervention. Of the 31% requiring two or more, nearly all were re-referred earlier than 2 years post initial crisis intervention. The central, gulf-bridging role of a crisis intervention service in a comprehensive, coordinated, community-based mental health system for dually diagnosed individuals was discussed.

Activities of Daily Living↗
PubMed1987

Barriers to the effectiveness of EPSDT for children with moderate and severe developmental disabilities.

Barriers were examined to the effectiveness of the EPSDT program for children with moderate and severe developmental disabilities. Responses from parents of 281 Michigan children and from the 45 directors of local EPSDT clinics were used to identify three sets of barriers. Strategies to overcome these obstacles are presented and implications for services are discussed.

Autistic Disorder↗
PubMed1985

Developmental disabilities. Recent trends in prevention and treatment.

The author outlines the recent advances in the field of developmental disabilities and discusses how these advances have expanded the role and scope of various professional groups. Genetic conditions and chromosomal aberrations, prenatal diagnosis, the infant at risk, and trends in assessing intelligence are detailed within the context of prevention. Treatment modalities are covered in detail.

Birth Weight↗
PubMed2000

Positive behavioral support of adults with developmental disabilities: assessment of long-term adjustment and habilitation following restrictive treatment histories.

The long-term maintenance of behavioral treatment effects is an important measure of clinical significance but is not reported with regularity in the published literature. The present report concerned therapeutic maintenance by evaluating five adults with developmental disabilities who had been exposed to multiple, restrictive procedures (food deprivation, mechanical restraint, electric shock) in a prior residential treatment facility and were transitioned to a new habilitation setting where these procedures were terminated in favor of alternative methods of behavior support. As revealed through a 24-month follow-up period, all of the participants were able to maintain clinically acceptable levels of challenging behaviors following the removal of the restrictive treatment procedures. Quality of life measures also revealed that the participants experienced greater independence, reduced supervision, and increased diversity in their living and work environments. These findings add to the limited studies on extended maintenance outcomes from behavioral intervention for serious clinical disorders in adults with developmental disabilities by demonstrating that positive adjustment can be sustained in the long-term without the continuation of restrictive treatment procedures.

Activities of Daily Living↗
PubMed2006

An evaluation of a stimulus preference assessment of auditory stimuli for adolescents with developmental disabilities.

Previous researchers have used stimulus preference assessment (SPA) methods to identify salient reinforcers for individuals with developmental disabilities including tangible, leisure, edible and olfactory stimuli. In the present study, SPA procedures were used to identify potential auditory reinforcers and determine the reinforcement value of preferred and non-preferred auditory stimuli. The results from this study suggest that the paired stimulus procedure utilized was effective in identifying preferred and non-preferred auditory stimuli, as the contingent application of the identified auditory stimuli produced higher rates of correct responding than did non-preferred auditory stimuli for all participants.

Acoustic Stimulation↗
PubMed1980

Dental diagnostic problems of potential genetic significance: the dental practitioner as geneticist in the developmental disabilities clinic.

A high incidence of aberrant dental formation can be anticipated in developmentally disabled children, particularly where the etiologic factors for developmental retardation are presumably of organic origin. The dentist, practicing in the developmental clinic, must frequently determine the developmental significance of such dental variation. In this capacity, his familiarity with the dental features of genetic disease can contribute significantly to more precise diagnosis.

Child↗
PubMed2000

Effects of deprivation on engagement in preferred activities by persons with developmental disabilities.

This study examined the effects of deprivation on engagement in activities for 3 adult men with developmental disabilities. First, an assessment was conducted to identify a high- and a low-preference activity for each participant. Second, the high-preference activity was made available following three amounts of deprivation of the activity (15 min, 2 hr, and 1 to 4 days); the low-preference activity was made available following the schedule of deprivation that produced the highest level of engagement by each participant in the high-preference activity. The results were that 1 to 4 days of deprivation produced the highest average amounts of engagement in the high-preference activity for each participant; this amount of deprivation did not produce high engagement in the low-preference activities. Third, the deprivation procedures and results were replicated when high-preference activities were presented by teachers during the participants' daily activities when their engagement had been quite low.

Adult↗
PubMed2002

Role of topiramate in adults with intractable epilepsy, mental retardation, and developmental disabilities.

The efficacy and safety of topiramate in patients with intractable mixed seizures, mental retardation (MR), and developmental disabilities (DD) were investigated. Twenty patients (eight females and 12 males) aged 21-57 years old with intractable epilepsy with mixed seizures, MR [profound (five), severe (three), moderate (two), mild (eight) and borderline (two)], and DD were treated with adjunctive topiramate 25 mg per day for 1 week followed by titration to clinical response (range 50-350 mg per day). Other antiepileptic drugs (AEDs) were decreased simultaneously. Topiramate therapy was discontinued in four patients for adverse events consisting of disorientation, unsteadiness, and pneumonia (one patient); anaphylactic shock from a tuna fish allergy (one); patient choice (one); and loss to follow-up (one). Seizures improved by gt-or-equal, slanted 50% in 11 of 16 patients (69%). Two patients (13%) were seizure free, including one patient who prior to topiramate therapy was seizure free but experiencing an intolerable adverse effect during therapy with another AED. Seizure duration and/or severity decreased in seven patients (44%). An increase in alertness was observed in 11 patients (59%). Topiramate was associated with improvement in seizure severity and alertness in this series and may be useful as adjunctive therapy in patients with mixed seizures, MR, and DD.

Adult↗
PubMed1997

Fathers and mothers of school-age children with developmental disabilities: parental stress, family functioning, and social support.

Thirty pairs of fathers and mothers who had school-age children with mental retardation and other disabilities were compared with each other and with 32 father and mother pairs of parents of children without disabilities. Responses to family scales indicated that fathers and mothers of children with developmental disabilities did not differ from each other nor from fathers and mothers of children without disabilities in parental stress, family social support, or family functioning. However, parents of children with disabilities experienced a disproportionately greater level of stress relating to their children than did those of children without disabilities. Fathers' and mothers' stress was associated with aspects of family functioning as perceived by themselves and their spouses.

Adaptation, Psychological↗
PubMed1982

A transdisciplinary mobile intervention program for rural areas (developmental disabilities, pediatrics, rural health).

A critical priority in allied health today is the efficient delivery of comprehensive services with the family and professionals as equal partners. In rural areas this is particularly important because of sparsely located populations and limited distribution of services. Few facilities in the rural community are able to deliver comprehensive services to a wide geographical area. Location of the services also presents additional burdens on the rural family with a developmentally disabled child. In this paper the stages of program development to meet a specific regional health need are described. The use and characteristics of a mobile program of early intervention serving developmentally disabled infants and preschoolers in rural areas of southwestern New York State are discussed. The practical application of this approach is considered.

Child↗
PubMed1995

Reinforcer assessment for children with developmental disabilities and visual impairments.

We assessed the applicability of two previously developed reinforcer assessment procedures to children with developmental disabilities and visual impairments. Greater differentiation between stimuli was observed with a choice procedure than with a preference procedure. Measurement of compliance and rate of responding in adaptive skill training confirmed that the choice procedure accurately identified reinforcing stimuli. The preference procedure produced false positive predictions of reinforcer efficacy.

Adolescent↗
PubMed1998

Diagnosis and treatment considerations with comorbid developmentally disabled populations.

Differential diagnosis in client populations presenting with complexities of developmental disabilities has become a time honored psychodiagnostic practice. Standard practice has been to ignore comorbidity in client groups where mental disorders and retardation coexist. In persons with mental retardation, differential diagnosis prioritizes the many presenting symptoms, identifying a single causation. Attention deficit hyperactivity disorders, mood disorders, pervasive developmental disorders, stereotypic movement disorders, and mental disorders due to a general medical condition often coexist with mental retardation. As mentally retarded populations move from institutional to community residency, comorbidity appears more prevalent, often becoming a client management issue. Dual diagnosis is important in considering treatment plans, obtaining access and funding for services. interdisciplinary communication, and generating epidemiological data.

Adolescent↗
PubMed2004

Music therapy assessment for children with developmental disabilities: a survey study.

The purpose of this study was to survey music therapists working with children with developmental disabilities to examine and describe the following: (a) the major skill areas and subcategories most frequently assessed, (b) how these areas are assessed, (c) the common features of their current assessment tools, (d) the positive and/or negative aspects of their current assessment tools, and (e) the 3 most important features desired in a standardized music therapy assessment for use in their clinical practice. Of the 207 respondents who expressed interest in completing a music therapy assessment survey in a pilot study, 108 surveys were returned for a 52% return rate; 95 (46%) were used as data for this study. The respondents most frequently assessed the following major skill areas: Motor (95%), Communication (83%), Social (79%), Cognitive (64%), and Music (35%). Of the 34 (36%) respondents who enclosed an actual assessment form with their survey, 100% require data collection through behavior observation. Respondents most frequently noted the following positive aspects of their forms: Thorough (34%), Individualized (26%), and Easy to Use (26%), and the following negative aspects of their forms: Subjective (28%), Limiting (26%), and Time Consuming (22%). The 3 most commonly desired features of a standardized assessment were the following: Easy to Use (23%), Comprehensive (19%), and Adaptable (13%).

Child↗