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PubMed1993

Efficacy of psychotropic drugs for reducing self-injurious behavior in the developmental disabilities.

Self-injurious behavior (SIB) is a serious and moderately prevalent problem behavior among developmentally disabled persons, and it frequently leads to treatment with psychotropic medication. The empirical literature relating to the efficacy of pharmacological intervention is comprehensively reviewed. The rationales for using some "newer" agents, such as serotonin reuptake blockers, opiate blockers, and beta-adrenergic blockers are described. In general there are insufficient data to draw conclusions about specific agents. Evidence for a possible role in managing SIB is strongest for thioridazine, lithium carbonate, and the opiate antagonists. However, further research is needed to define the specific indications, if any, for each of these. Impediments to past research are discussed, possible refinements are offered for future research, and recommendations for treatment are offered.

Adrenergic beta-Antagonists↗

PubMed1990

Transition of persons with developmental disability from extended sheltered employment to competitive employment.

The proposition was tested that persons with developmental disabilities randomly assigned to a supported work program would obtain more employment in the competitive labor market than would a randomly assigned group of control subjects receiving conventional workshop services. A measure of association (chi-square) conducted between the two groups and three categories of work showed that the experimental group obtained significantly more employment.

Adolescent↗

PubMed1994

Oral feeding treatment of children with chronic food refusal and multiple developmental disabilities.

This research concerned the treatment of chronic food refusal in 2 children with multiple developmental disabilities. Therapeutic intervention consisted of a multicomponent treatment package that included the (a) elimination of feeding "demands" that provoked child agitation, (b) incorporation of sensory stimulation as contingent reinforcement, and (c) gradual introduction of the requirements for oral consumption. Each child received treatment during individualized training sessions and, subsequently, under naturalistic mealtime conditions. Consistent oral consumption was achieved rapidly by both children. Results were maintained at follow-up assessments ranging from 4 to 12 months.

Association Learning↗

PubMed1997

Survival and developmental disability in infants with birth weights of 501 to 800 grams, born between 1979 and 1994.

OBJECTIVE: Because the survival rate has increased for extremely low birth weight neonates, many have raised the concern that the rate of developmental disability among survivors will also increase. To address this concern, we analyzed changes over time in survival and major neurosensory impairment in a sample of extremely low birth weight infants born between July 1, 1979, and June 30, 1994. METHODS: The study sample included 513 infants with birth weights of 501 to 800 g who were cared for in either of the two neonatal intensive care units that serve a 17-county region in northwest North Carolina and who were born to mothers residing in that region. At 1 year of age (corrected for gestation), survivors were examined by a pediatrician and were tested using the Bayley Scales of Infant Development. Major neurosensory impairment was defined as cerebral palsy, a Bayley Mental Developmental Index <68, or blindness. A total of 209/216 (97%) of survivors were examined at 1 year of age. Epoch of birth was defined as follows: epoch 1, July 1, 1979 to June 30, 1984; epoch 2, July 1, 1984 to June 30, 1989; and epoch 3, July 1, 1989 to June 30, 1994. RESULTS: Survival rates for epochs 1, 2, and 3 were, respectively, 24/120 (20%), 63/175 (36%), and 129/218 (59%). In contrast, the proportions with a major neurosensory impairment did not increase over time; rates for successive epochs were 6/24 (25%), 17/61 (28%), and 26/124 (21%). Rates of cerebral palsy were 3/24 (13%), 12/61 (20%), and 9/124 (7%); rates of delayed mental development were 4/24 (17%), 12/61 (20%), and 17/124 (14%); and rates of blindness were 2/24 (8%), 0/62, and 5/124 (4%), respectively. CONCLUSIONS: This analysis suggests that the increasing survival of extremely low birth weight neonates since the late 1970s has not resulted in an increased rate of major developmental problems identifiable at 1 year of age.

Blindness↗

PubMedDate not supplied

The Family Stress and Coping Interview for families of individuals with developmental disabilities: a lifespan perspective on family adjustment.

BACKGROUND: The present study investigated the psychometric properties of the Family Stress and Coping Interview (FSCI), a questionnaire designed to quantitatively and qualitatively examine the experiences of parents of children with developmental disabilities (DDs). METHODS: The participants consisted of 106 primary caregivers of 106 individuals with DDs from centres in Eastern, Central and North-western Ontario, Canada. The participants completed a demographic questionnaire, the FSCI, and the Vineland Adaptive Behaviour Scales. RESULTS: The results of this study indicate that the FSCI has adequate reliability (i.e. internal consistency and long-term stability) and validity (i.e. independent item ratings and discriminant validity). CONCLUSIONS: The results of this study support the use of the FSCI as a measure of family stress in research and practice.

Adaptation, Psychological↗

PubMedDate not supplied

Contribution of sickle cell disease to the occurrence of developmental disabilities: a population-based study.

PURPOSE: Population-based surveillance of children aged 3-10 years from metropolitan Atlanta was used to determine if stroke-related neurological damage in children with sickle cell disease (SCD) is associated with developmental disabilities (DD). METHODS: School and medical records were reviewed annually to identify eligible children. Observed-to-expected ratios, P values, and population attributable fractions were calculated. RESULTS: Children with SCD had increased risk for DD (O/E = 3.2, P < 0.0001), particularly mental retardation (O/E = 2.7, P = 0.0005) and cerebral palsy (O/E = 10.8, P < 0.0001). This risk was confined to DD associated with stroke (O/E = 130, P < 0.0001; for DD without stroke: O/E = 1.3, P = 0.23). CONCLUSIONS: Children with SCD have increased risk for DD associated with stroke; thus, aggressive interventions are needed to prevent stroke in these children.

Anemia, Sickle Cell↗

PubMed2002

Community-acquired methicillin-resistant Staphylococcus aureus in institutionalized adults with developmental disabilities.

Methicillin-resistant Staphylococcus aureus (MRSA) has recently been reported to emerge in the community setting. We describe the investigation and control of a community-acquired outbreak of MRSA skin infections in a closed community of institutionalized adults with developmental disabilities. In a 9-month period in 1997, 20 (71%) of 28 residents had 73 infectious episodes. Of the cultures, 60% and 32% obtained from residents and personnel, respectively, grew S. aureus; 96% and 27% were MRSA. All isolates were genetically related by pulsed-field gel electrophoresis and belonged to a phage type not previously described in the region. No known risk factors for MRSA acquisition were found. However, 58 antibiotic courses had been administered to 16 residents during the preceding 9 months. Infection control measures, antibiotic restriction, and appropriate therapy resulted in successful termination of this outbreak. Selective antibiotic pressure may result in the emergence, persistence, and dissemination of MRSA strains, causing prolonged disease.

Adolescent↗

PubMed1993

What we do not know about families with children who have developmental disabilities: Questionnaire on Resources and Stress as a case study.

A selective review of studies using the Questionnaire on Resources and Stress (QRS) was presented in order to highlight current problems and future directions for research about families who are rearing children with developmental disabilities. Three primary difficulties--definitional problems, multiple measures of the same construct that do not converge, and failure to replicate--were high-lighted, and recommendations for approaches to solving them were provided. These approaches include the separation of demands, stresses, and strains, perhaps by a variation of the multitrait-multimethod technique, and more extensive norming and programmatic replication.

Adaptation, Psychological↗

PubMed2003

Goodness-of-fit ethic for informed consent to research involving adults with mental retardation and developmental disabilities.

This article reviews current theory and research on informed consent policies for adults with mental retardation within a relational ethics framework that re-conceptualizes consent vulnerability in terms of the goodness-of-fit between participant decisional capacities and the specific consent context. Conceptualizing informed consent competence as a product of the relationship between person and consent context shifts assessment of decisional capacity away from an exclusive focus on a research participant's cognitive deficiencies to (a) an examination of those aspects of the consent setting that are creating or exacerbating consent vulnerability and (b) consideration of how the setting can be modified to produce a consent process that best reflects and protects the hopes, values, concerns, and welfare of adults with developmental disabilities.

Adult↗

PubMed2006

Discrimination of temporal synchrony in intermodal events by children with autism and children with developmental disabilities without autism.

BACKGROUND: This project examined the intermodal perception of temporal synchrony in 16 young children (ages 4 to 6 years) with autism compared to a group of children without impairments matched on adaptive age, and a group of children with other developmental disabilities matched on chronological and adaptive age. METHOD: A preferential looking paradigm was used, where participants viewed non-linguistic, simple linguistic or complex linguistic events on two screens displaying identical video tracks, but one offset from the other by 3 seconds, and with the single audio track matched to only one of the displays. RESULTS: As predicted, both comparison groups demonstrated significant non-random preferential looking to violations of temporal synchrony with linguistic and non-linguistic stimuli. However, the group with autism showed an impaired, chance level of responding, except when presented with non-linguistic stimuli. CONCLUSIONS: Several explanations are offered for this apparently autism-specific, language-specific pattern of responding to temporal synchrony, and potential developmental sequelae are discussed.

Adaptation, Psychological↗

PubMed1977

The Minnesota Child Development Inventory ad an aid in the assessment of developmental disability.

Parents' reports on their children's functioning were obtained from the Minnesota Child Development Inventory (MCDI) during a review of 132 cases. These data were found to be highly correlated (r = .92) with mental ages obtained during formal psychometric evaluation. The data support the use of the MCDI as an additional tool in the assessment of clinical population of children suspected of having developmental disabilities.

Child↗

PubMedDate not supplied

Relapse prevention for individuals with developmental disabilities, borderline intellectual functioning, or illiteracy.

The use of relapse-prevention-specific interventions in clinical addictions treatment programs is widely supported. While there is considerable information and research available regarding relapse prevention, there is little if any available regarding such interventions for individuals with developmental disabilities, borderline intellectual functioning, or illiteracy. A group design is proposed for this population that can be easily utilized by programs struggling with a lack of resources for the target population. This group model can be applied to individuals who are dually diagnosed because it is versatile and nonthreatening.

Adult↗

PubMed2005

Newborn screening for developmental disabilities: reframing presumptive benefit.

A fundamental tenet of newborn screening is that screening should lead to a proven benefit for the infant. The standard is usually construed as medical benefit that significantly improves a child's health. Screening for many conditions that cause developmental disabilities does not currently meet this standard. We argue for expanding concepts of presumptive benefit. Newborn screening provides access to early intervention programs that are shown to positively influence child development and support families. Consumers want information about their children's health and their own reproductive risk, and they have a broader view than policymakers of what constitutes a treatable disorder. Newborn screening provides other societal benefits that, in the absence of data showing harm and with appropriate attention to ethical and legal issues, warrant consideration of an expansion of targets for newborn screening.

Child↗

PubMed2001

Finding a Voice: Poetry and People With Developmental Disabilities.

Poetry may be used as a vehicle for self-expression with individuals who have developmental disabilities, even with those who may be only minimally verbal. Poetry by well-known poets may be used to illustrate concepts and to enhance the creative experience. Then, through strategic questioning, participants' ideas are recorded in poetic form. The results may be therapeutic in many ways as well as powerful expressions of human experience.

Journal Article↗

PubMed1994

Hypothesis-based interventions for tantrum behaviors of persons with developmental disabilities in school settings.

We conducted a functional assessment of problem behaviors of 2 students with developmental disabilities in their classroom environments. Results of the assessments showed that although there were more tantrums in demand than in no-demand conditions, the function of the behavior was to gain attention (positive reinforcement) rather than to avoid or escape demands (negative reinforcement); demand conditions apparently served a discriminative function for the availability of attention. Therefore, intervention was based on the positive reinforcement hypothesis, resulting in a substantial reduction of tantrums for both subjects.

Attention↗

PubMed2003

Self-harm among adolescents with developmental disabilities. What are they trying to tell us?

Self-harm behavior exhibited by adolescents with developmental disabilities can be the most challenging behavior for caregivers and health care professionals to address. Past interventions have taken a behavioral approach and focused on functional analysis to guide assessment and treatment. However, self-harm behavior is becoming more recognized as a means of communication. Therefore, it is important for health care professionals and caregivers to listen to adolescents' attempts to communicate and try to understand the meaning of the behavior. Early assessment is crucial to understanding the meaning of the behavior, and early intervention is necessary to prevent escalation or chronicity. Thorough assessment guides interventions and must be implemented in the context of clients' families and social world, and the broader community. Establishment of trusting relationships among adolescents, their families, and health care professionals is imperative. This article discusses self-harm behavior from a psychosocial perspective related to prevalence, onset, purpose, maintenance, and escalation. It also introduces a comprehensive framework to guide assessment and intervention.

Adolescent↗

PubMed1975

Nutrition and drug therapy for persons with developmental disabilities.

Literature relevant to drugs reported as affecting or not affecting nutrient metabolism and diet for developmentally disabled persons was summarized. Many investigators have found side effects of anticonvulsant drugs on vitamin D, calcium, folid acid, and vitamin B12 metabolism. Growth-retarding effects of certain central nervous system stimulants have also been reported. It has beed found that tranquilizers and antidepressant therapy show no effects on nutrient metabolism. Vitamins used in pharmacologic doses are considered as drugs; their therapeutic use was briefly reviewed here. The need for more research on biochemical interaction of drugs and nutrients was recommended.

Anticonvulsants↗

PubMed1992

Self-injurious behavior in the developmentally disabled: assessment techniques.

Self-injurious behavior (SIB) is a major cause of difficulty for the developmentally disabled person. Causes are varied, but medical, neurological, and psychiatric disorders should be considered before nonspecific approaches to treatment are chosen. A careful assessment should include a thorough medical and psychiatric evaluation as well as laboratory and diagnostic studies. Various assessment instruments are available to aid in the evaluation process and, to some extent, in the evaluation of the effectiveness of treatment for SIB.

Humans↗