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One agency describes a systematic approach to recruitment of prospective adoptive families for children with developmental disabilities. The recruitment methodology, preliminary conclusions, and implications for future recruitment of families are presented.
Critical circumstances that predict parents' requests for residential placements for developmentally disabled persons were described. The survey sample included 154 families who placed their disabled family member and 377 families who provided care at home. Empirical findings suggest that among families who place, the disabled persons are more impaired and have more severe behavior problems than do disabled persons being cared for at home. Families who place are more likely to be larger, headed by a single parent, suffer greater disruption of family life, and receive fewer direct client services. The policy implications of these findings were discussed.
Feeding is a complex physiologic process that is further complicated by social and cultural influences. Feeding development, although dependent on structural integrity and neurologic maturation, is a learned progression of behaviors influenced by sensory motor development and experience. Children learn how to eat. Children with developmental disabilities frequently develop problems with feeding that can lead to malnutrition and respiratory symptoms. Feeding disorders are often the result of multiple interacting variables that have disrupted feeding development and the feeding relationship. The pediatrician who has a solid understanding of these variables can understand the problems, sort out the contributing causes, and intervene effectively.
There is mounting evidence that employer-provided health insurance is an important factor in recruiting and retaining a competent and motivated direct support workforce within health and human services occupations. A review of the literature in this area, including new information related to the developmental disabilities field, is presented to assist nonprofit employers and government officials in designing initiatives to address increasing health care costs. Approaches to financing health coverage for frontline staff and a new program in New York that will provide subsidies to agencies to enhance existing coverage are discussed.
Using the Typology Model of Adjustment and Adaptation, a family stress model, relationships among family hardiness, family stressors, family appraisal, coping, social support, and satisfaction with family functioning were examined in a sample of 57 families of children with developmental disabilities. Family hardiness was associated with family appraisal, social support, parental coping related to maintaining family integration, and satisfaction with family functioning. Higher satisfaction with family functioning was correlated with coping-integration, network support, functional support, and hardiness. Lower satisfaction with family functioning was associated with higher family stressor scores, social support loss, and increased parental age. Over 42% of the variance in family functioning was accounted for by family hardiness, functional support, family stressors, and parental age. The results highlight the value of continued investigations of hardiness in families.
The special concerns of the child welfare community regarding pediatric HIV infection were described. These include appropriate use of foster care, preparation and commitment of personnel, and assurance of access to necessary services. There are both contrasts and common interests in work with this population between child welfare systems and the developmental disabilities network. The need for collaboration is broad and immediate.
A cross-sectional study of the prevalence of psychiatric problems among 26 children each with a learning disability (mental retardation) and specific speech disorder was conducted in an Arab population using the Rutter Behavioural Scale, and compared with a community sample of 100 control children matched for age. The prevalence of psychiatric problems, as identified by both the parents and the teachers was 35, 19 and 4 per cent respectively, in the learning disabled, speech impaired and control groups. Children with global disability or mental retardation showed significantly higher rates of psychiatric morbidity than those with specific speech disorder, both of which were significantly higher than that in the control group. Higher rates of psychiatric problems noted in the developmentally disabled children may be the result of specific socio-demographic and cultural factors in addition to neurodevelopmental factors and low IQ.
This study examined how accommodative coping via flexible goal adjustment affects the wellbeing of midlife parents. Using data from the Wisconsin Longitudinal Study, a population-based study of midlife adults, the authors compared parents who have a child with a severe mental health problem, a child with a developmental disability, or a child with no chronic illness or disability. Overall, parents had better well-being (i.e., lower levels of depressive and physical symptoms, higher levels of environmental mastery and self-acceptance) if they used accommodative coping. This effect was stronger for parents of individuals with a severe mental health problem than for the comparison group.
The Arab family in Israel is still embedded in the traditional society with extended family support systems, but we see a population in transition influenced by the surrounding society. This paper looks at the different religious attitudes toward the exceptional people in our society (i.e., the family reaction to a child born with intellectual or developmental disability), reviews recent studies on the Arab and Bedouin families in Israel, and presents data on the Arab population in residential care centers. Today, out of 57 residential care centers in Israel for persons with intellectual disability, 13 (22.8%) are providing service to the non-Jewish population. The Arab population constitutes 12-13% of the total residential care population, lower than the 19-20% in the total population. In residential care, the Arab population is characterized by younger children with severe and profound intellectual disability. The informal family support system is still a very important factor in the Arab family in Israel, a fact that we believe should be strengthened by implementing the British and Danish model of nurse home visitation.
Independence and self-determination are long established goals for developmentally disabled persons. Some aspects of independence depend upon the ability to to gain access to resources in the local community. As a result, the acquisition of independent travel skills has received much attention over the years. However, most attempts to teach travel skills to this population have been limited in scope. This paper advocates a more comprehensive approach based upon the principles used to teach orientation and mobility to blind and visually impaired people.
There is growing evidence of an association between physical illness and problem behavior in children with developmental disabilities. Such behavior can compromise school performance. Therefore, the purpose of the present study was to evaluate, using a group design, the effectiveness of medical intervention alone (N = 11) versus behavioral plus medical intervention (N = 10) for illness-related problem behavior in a school setting. Following intervention, the behavioral plus medical intervention group showed lower levels of problem behavior and completed more academic tasks than did the medical intervention alone group. The results are discussed with respect to the concept of illness and pain as a setting event for problem behavior. The need for research to develop algorithms that allow one to select the best combination of medical and behavioral interventions for specific illnesses and contexts is noted.
This study examined the generalization effects of a training program for parents of oppositional, mildly developmentally disabled preschool children. Specifically, the study sought to determine the possible differential generalization effects of treatment to high and low risk parenting settings. Treatment comprised child management and planned activities training procedures specifically designed to enhance generalization effects. A multiple baseline design across subjects that incorporated a non-treatment control subject was employed. Dependent measures included deviant child behavior, accuracy of parent implementation of treatment procedures, and specific measures of aversive and non-aversive parent behaviors. Three of the treated families showed marked reductions in levels of deviant behavior, as well as increases in parental implementation of treatment procedures in both the training setting and the low risk generalization setting. Two of these three families showed comparable improvements in the high risk setting. The control subject showed little improvement in either generalization setting. It was concluded that the treatment program was effective in producing generalization effects in parent training.
We compared immediate and delayed error correction during sight-word instruction with 5 students with developmental disabilities. Whole-word error correction immediately followed each error for words in the immediate condition. In the delayed condition, whole-word error correction was provided at the end of each session's three practice rounds. Immediate error correction was superior on each of the four dependent variables.
Converging evidence from a number of neuroimaging studies, including our own, suggest that fluent word identification in reading is related to the functional integrity of two consolidated left hemisphere (LH) posterior systems: a dorsal (temporo-parietal) circuit and a ventral (occipito-temporal) circuit. This posterior system is functionally disrupted in developmental dyslexia. Reading disabled readers, relative to nonimpaired readers, demonstrate heightened reliance on both inferior frontal and right hemisphere posterior regions, presumably in compensation for the LH posterior difficulties. We propose a neurobiological account suggesting that for normally developing readers the dorsal circuit predominates at first, and is associated with analytic processing necessary for learning to integrate orthographic features with phonological and lexical-semantic features of printed words. The ventral circuit constitutes a fast, late-developing, word identification system which underlies fluent word recognition in skilled readers.
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This study examines the age of referral and the effect of early intervention for the physically handicapped child. Fifty children were referred before 9 months of age, and they were compared with 55 children referred after 9 months of age. At 18 months of age, the children in the earlier referred group showed greater developmental progress in acquisition of skills in all of the six areas tested: perceptual-fine motor (P less than 0.0003), cognition (P less than 0.0001), language (P less than 0.0004), social-emotional (P less than 0.0001), self-care (P less than 0.0001), and gross motor (P less than 0.0002). The results show that, at least in the short term, there is a critical age for onset of intervention to achieve the most benefit for the developmentally disabled child. Family physicians should be alert to early warning signs of neurological deficits in order to obtain early treatment for these children.