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PubMed2006

Clinical effects and adverse reactions of off-label use of aripiprazole in children and adolescents with developmental disabilities.

OBJECTIVE: The aim of this study was to report on the clinical efficacy and side effects of aripiprazole in treating behavioral symptoms of children with a developmental disability (DDs). DESIGN/METHODS: A retrospective chart review of the first 32 children treated with aripiprazole at an urban clinic for children with DD was conducted. RESULTS: Ages ranged from 5 to 19 years; 9 (28%) were female. Twenty four had diagnoses within the autistic spectrum and 18 had mental retardation (MR). Other disorders included: attention-deficit/hyperactivity disorder/disruptive behavior disorders (n = 13), mood disorders (n = 7), reactive attachment (n = 2), and sleep disorders (n = 2). Target symptoms included aggression, hyperactivity, impulsivity and, self-injurious behaviors. Twenty eight of the children were switched from another antipsychotic. The mean daily aripiprazole starting dose was 7.1 +/- 0.32 mg (0.17 mg/kg/day) and the mean daily maintenance dose was 10.55 +/- 6.9 mg (0.27 mg/kg/day). Aripiprazole had been used for a period between 6 and 15 months. Improvement in target symptoms was found in 56%. When treating a child with MR, the concomitant presence of an autistic spectrum diagnosis predicted a worse outcome. Side effects were reported in 16 (50%), with the most frequent being sleepiness (n = 6). Mean body mass index (BMI) rose from 22.5 to 24.1 (p = 0.003) over the follow up period, with changes in the BMI z scores. These changes were more pronounced in children younger than 12 years. CONCLUSIONS: These results with aripiprazole in this difficult-to-treat population suggest that this medication warrants controlled studies of its effectiveness and safety.

Adolescent↗
PubMed1990

Planning processes and outcomes for an aging population with developmental disabilities.

Needs analysis research and planning projects were reviewed for the purpose of identifying planning concepts, processes, outcomes, and issues regarding the growing population of older adults with developmental disabilities. Themes and issues identified through a content analysis of planning reports and documents were presented along with goals for future planning and public social policy development efforts.

Aged↗
PubMed1993

Relative effects of whole-word and phonetic-prompt error correction on the acquisition and maintenance of sight words by students with developmental disabilities.

We used an alternating treatments design to compare the effects of two procedures for correcting student errors during sight word drills. Each of the 5 participating students with developmental disabilities was provided daily one-to-one instruction on individualized sets of 14 unknown words. Each week's new set of unknown words was divided randomly into two groups of equal size. Student errors during instruction were immediately followed by whole-word error correction (the teacher stated the complete word and the student repeated it) for one group of words and by phonetic-prompt error correction (the teacher provided phonetic prompts) for the other group of words. During instruction, all 5 students read correctly a higher percentage of whole-word corrected words than phonetic-prompt corrected words. Data from same-day tests (immediately following instruction) and next-day tests showed the students learned more words taught with whole-word error correction than they learned with phonetic-prompt error correction.

Child↗
PubMed1989

Lifetime antipsychotic-drug exposure, dyskinesia and related movement disorders in the developmentally disabled.

The relationship between dyskinesia and related movement disorders was examined as a function of cumulative exposure to antipsychotic drugs (APD). Lifetime drug-exposure histories were obtained for 162 developmentally disabled (DD) persons; drug-exposed groups were compared to nondrug-exposed groups. There were no statistically significant relationships between dyskinesia and the amount of lifetime APD exposure, nor between dyskinesia and the number of long-term APDs, mean exposure, peak exposure, recency of exposure, duration of exposure, changes in medication levels, number of drug interruptions, age, gender, cerebral palsy, epilepsy, or IQ. Of the other movement disorders, a positive relationship was noted only between akathisia and long-term APD exposure; the increased prevalence of akathisia persisted beyond four years after APD withdrawal.

Adolescent↗
PubMed2000

Promoting independent task performance by persons with severe developmental disabilities through a new computer-aided system.

This study involved two experiments. In Experiment 1, a computer-aided system for promoting task performance by 6 persons with severe developmental disabilities was compared with a card system. The computer-aided system was portable and presented pictorial task instructions (one instruction per step) and prompts. In Experiment 2, the same system was used, but the number of instruction occasions was reduced. In one condition, the system presented all the instructions used in Experiment 1 but mostly in clusters rather than individually. In another, the system presented part of the Experiment 1 instructions. Three Experiment 1 participants also served in Experiment 2. Experiment 1 results indicated all 6 participants had higher percentages of correct steps with the computer system and preferred it to the card system. Experiment 2 results indicated that the condition in which the instructions were clustered was more effective for maintaining correct task performance. Implications of the findings were discussed.

Activities of Daily Living↗
PubMed1993

Effects of active student response during error correction on the acquisition, maintenance, and generalization of sight words by students with developmental disabilities.

We used an alternating treatments design to compare the effects of active student response error correction and no-response error correction during sight word instruction. Six students with developmental disabilities were provided one-to-one daily sight word instruction on eight sets of 20 unknown words. Each set of 20 words was divided randomly into two equal groups. Student errors during instruction on one group of words were immediately followed by the teacher modeling the word and the student repeating it (active student response instruction). Errors on the other group of words were immediately followed by the teacher modeling the word while the student attended to the word card (no-response instruction). For all 6 students, the active student response error-correction procedure resulted in more words read correctly during instruction, same-day tests, next-day tests, 2-week maintenance tests, and generality tests (words read in sentences).

Child↗
PubMed1993

Compensation and turnover of direct-care staff in developmental disabilities residential facilities in the United States. I: Wages and benefits.

This study was based on a representative national sample of more than 1,600 residential facilities serving individuals with developmental disabilities in all 50 states and the District of Columbia. The mean starting wage for direct-care workers in publicly operated institutions in FY 1990 was approximately 31% more than the wage for similar workers in privately operated facilities. The mean starting wage in private facilities was only about 3% above the poverty level for a family of three. Wages, in real economic terms, have declined significantly during the last decade. The wage differential between public and private facilities has doubled during the past 10 years. Implications of these findings for the field and for future research were discussed.

Caregivers↗
PubMed1991

Hormonal influences in developmental learning disabilities.

Developmental language and learning disabilities in children can take many different forms and can result from a variety of causes. Research to date has focused primarily on specific disabilities in learning, which are characterized by a significant delay or disorder in one aspect of learning against a background of otherwise normal development. Learning disabilities affecting language and/or reading acquisition (developmental dysphasia and dyslexia) have been studied most thoroughly. Verbal learning disabilities occur more frequently in boys than in girls, and there is a higher than expected incidence of left-handedness among affected children. Although there are many reasons why a child may have delayed or disordered language development, differential diagnosis of specific developmental language or reading disorders calls for ruling out mental retardation, peripheral auditory or visual dysfunction, autism, frank neurological impairments such as hemiplegia or seizure disorder, and severe social deprivation or lack of educational opportunity. The typical profile of a developmentally dysphasic or dyslexic child is one who shows a marked discrepancy between nonverbal (performance) IQ and verbal IQ, with a history of delayed or disordered speech, language and/or reading development. Such a child usually performs quite normally on visual spatial tasks, while demonstrating severe deficits in tasks of auditory temporal processing, motor sequencing, phonological processing and memory, language, reading and spelling. This characteristic neuropsychological profile may suggest left hemisphere dysfunction or a failure to develop normal cerebral lateralization. The etiology of these developmental learning disorders is unknown, but there is evidence of familial aggregation, indicating a potential genetic basis. Although these children respond to remediation, longitudinal studies have shown that the symptoms often persist into adulthood (see Tallal, 1988, for a more detailed discussion).

Female↗
PubMed2006

Meaning of homeownership for individuals with developmental disabilities: a qualitative study.

In-person semi-structured interviews were conducted with 7 homeowners selected by 6 state homeownership programs as representing good examples of homeownership by individuals with developmental disabilities. Recurring themes were found in the choice of a home, advantages and disadvantages of homeownership, handling problems, community relationships, finances, supports, future plans, and homeownership advice. Although the process of purchasing the home was described as lengthy and difficult and ownership brought unexpected problems, these were outweighed by the financial, social, and psychological benefits of owning one's own home. A variety of external factors, including some undue control of the process by service providers and family members, appeared to add to the difficulties homeowners faced. Implications for improvements in homeownership assistance programs are discussed.

Adult↗
PubMed1990

Balancing the right to habilitation with the right to personal liberties: the rights of people with developmental disabilities to eat too many doughnuts and take a nap.

In the pursuit of efficient habilitation, many service providers exercise a great deal of control over the lives of clients with developmental disabilities. For example, service providers often choose the client's habilitative goals, determine the daily schedule, and regulate access to preferred activities. This paper examines the advantages and disadvantages of allowing clients to exercise personal liberties, such as the right to choose and refuse daily activities. On one hand, poor choices on the part of the client could hinder habilitation. On the other hand, moral and legal issues arise when the client's right to choice is abridged. Recommendations are offered to protect both the right to habilitation and the freedom to choose.

Adolescent↗
PubMed1999

The Effect of Music on the Self-Injurious Behavior of an Adult Female with Severe Developmental Disabilities.

This study compared the effects of contingent blocking, music listening, water play, and instrument playing on self-injurious behavior. The subject was a 23-year-old female with severe developmental disabilities, including communication deficits, motor deficits, and visual impairment. A single subject reversal design with four conditions (ABACADA) was used. Subject was videotaped 10 minutes before and 10 minutes after the interventions to study changes in rate and variability of three behaviors: teeth-grinding, mouth-scratching, and head-hitting. Visual analysis showed a strong downward trend after music listening for teeth-grinding, and no change over all conditions for mouth-scratching. Subject did not exhibit any preintervention head-hitting during both music conditions, and therefore showed no change in behavior. Subject responded to water play and contingent blocking by reducing head-hitting.

Journal Article↗
PubMed1983

Perceived behavioral changes observed with adaptive seating devices and training programs for multihandicapped, developmentally disabled individuals.

The purpose of this study was to assess, by analyzing survey responses, the perceived behavioral changes that were observed when adaptive seating devices and training programs were provided to multihandicapped, developmentally disabled individuals. Results for 41 clients were analyzed. Statistical analysis revealed that significant changes in social interaction, positioning, tracking, grasping, and self-feeding were perceived by parents, guardians, or trainers. The necessity of a prospective study to analyze data about the influence of behavior programs used with adaptive seating devices is discussed.

Adaptation, Psychological↗
PubMed2004

Changes in performance over time on the Bayley Scales of Infant Development II when administered to infants at high risk of developmental disabilities.

PURPOSE: The purpose of this study was to analyze changes in performance over time on the Bayley Scales of Infant Development II (BSID-II) in a sample of infants at high risk of developmental disabilities. METHODS: Cognitive and motor performance of 53 infants, 34 with prenatal drug exposure (DE group) and 19 with perinatal medical concerns (PMC group), was measured at under one year of age (mean = 6.99 months) and again at 17-22 months of age (mean = 18.24 months). Changes in performance on both the Mental and Motor Scales over time were analyzed. RESULTS: Over time, cognitive performance decreased for both groups (p < 0.05). Rate of change in motor performance increased for the PMC group and decreased for the DE group (p < 0.01). CONCLUSIONS: Developmental changes over time should be studied separately for infants prenatally exposed to drugs and infants with perinatal medical concerns. Longer term follow-up with several repeat assessments would be desirable.

Journal Article↗
PubMed1989

Provision of respite care for children with developmental disabilities: changes in maternal coping and stress over time.

Changes were examined in maternal coping resources and stress over time as a consequence of the provision of respite care for their children with developmental disabilities. Users and nonusers of home-based respite services were matched and compared. Results showed that services were associated with an immediate significant reduction in maternal stress. Even though there were changes over time in coping resources and stress reported by mothers, the respite care group showed overall consistent benefits as compared to those not receiving services. Findings were interpreted with respect to their implications for research and interventions.

Adult↗
PubMed1985

[Changes in maternal stress with the age of her developmentally disabled child--comparison between mentally retarded and autistic children using cross-sectional data].

In order to explore a transitional pattern of mother's psycho-social stress accompanying the age of developmentally-disabled child, we analized the stress patterns obtained from 1 036 mothers of mental retarded and autistic children by means of 10 stress scales consisted of four or five items for each scale. Mothers of 3 to 15 yrs old children, classified by cross-sectional method, were divided by their child's age into seven groups, and multiple-range tests were applied to the mean stress scores of mothers in the seven groups for each of two disability. In the results, we found three kinds of transitional patterns of stress. They were named as follows: No change type, Decreased type, and increased-at-first, but later-decreased type. These transitional patterns are common to two disabilities in the same scale, and furthermore it is worthy of notice that the stage of changing point of increase or decrease of the amount of stress coincides with the periods of child's entrance to primary school and/or junior high school at almost all scales.

Adolescent↗
PubMed1978

A comparison of an ITPA estimated psycholinguistic quotient and WISC-R IQS for developmentally disabled children.

Compared an estimated Psycholinguistic Quotient, based on Cronkhite and Penner's (1975) revised scoring procedure for the ITPA Psycholinguistic Age, to the WISC-R Verbal, Performance, and Full Scale IQs of developmentally disabled children. The Quotient entered into strong relationships with the WISC-R Verbal and Full Scale IQs. The diagnostic significance of these correlations was discussed. The data indicated that the estimated Psycholinguistic Quotient was a valid measure for screening intellectual status in this population.

Adolescent↗
PubMed1989

Effects of redesigning the physical environment on self-stimulation and on-task behavior in three autistic-type developmentally disabled individuals.

A study was conducted to assess the effects of redesigning the physical environment (i.e., the classroom) on the occurrence of self-stimulation, on-task behavior, inappropriate behavior, and inactivity. Three developmentally disabled males, diagnosed as autistic-type, participated. Data were collected using a withdrawal design. Results showed a decrease of self-stimulation and inactivity and an increase of on-task behavior. Inappropriate behavior remained unchanged across experimental conditions.

Adolescent↗