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PubMed1991

Disabilities, developmental handicaps, and substance misuse: a review.

Although increased attention has been directed toward the special risks for substance misuse of persons with disabilities, there continues to be a paucity of epidemiologic data detailing prevalence and potential etiologies for use. This review describes the research problems contributing to the limited findings in the field. The risk factors of special relevance to persons with disabilities are discussed, and the data related to specific disabilities are presented. A hierarchy of research needs is suggested, along with several working hypotheses concerning substance use/misuse and persons with disabilities. Finally, current issues impacting intervention and treatment services in this field are discussed.

Alcoholism↗
PubMed1992

Clomipramine treatment of stereotypic behaviors and self-injury in patients with developmental disabilities.

The authors report an open clinical trial of clomipramine for chronic stereotypic and self-injurious behaviors in 11 consecutive patients with concomitant developmental disorders. Ten patients (91%) had marked decreases in rates of target behaviors. No seizures occurred despite the inclusion of six patients with previous histories of epileptic events, and improvement was evident regardless of level of mental retardation. These findings support both the clinical use of serotonergic medications in this population and the need for further research.

Adolescent↗
PubMed1983

Oral sensorimotor therapy in the developmentally disabled: a multiple baseline study.

The efficacy of a program of sensorimotor facilitation procedures to improve oral motor function and feeding behaviors in students with severe developmental delay was explored. Four severely handicapped students were administered the oral habilitation program using a multiple baseline across-subjects design with staggered introduction of the treatment. Graphic analysis and the split middle method of trend estimation revealed that one subject evidenced an increase in weight and improved oral motor evaluation as a result of the intervention. Two other subjects displayed partial improvement. The correlates of treatment effectiveness are briefly discussed and the need for continued investigation is emphasized.

Adult↗
PubMed1987

The use of Trivial Pursuit in teaching community living skills to adults with developmental disabilities.

The use of gaming provides variety, motivation, and renewed interest in activities developing community living skills. In this study, Trivial Pursuit, a popular adult game, was adapted for use with 16 adults with mental retardation attending a developmental center day treatment program. Game questions were developed for six categories of independent living based on the McCarron-Dial Street Survival Skills Questionnaire (SSSQ) and Curriculum Guide. A two-group, pretest-posttest design was used to evaluate the effectiveness of the game in teaching independent living skills. An analysis of variance on the measurement scale and for the total score on the SSSQ indicated significant differences in improvement rate after eight sessions with the game. Additionally, subjects found the Trivial Pursuit format interesting and absorbing. Results suggest that the gaming approach can be a valuable adjunct to traditional independent living training programs.

Activities of Daily Living↗
PubMedDate not supplied

Screening developmentally disabled male populations for fragile X: the effect of sample size.

The fra(X) or Martin-Bell syndrome is the most common cause of inherited mental retardation (MR) in males. It is also associated with a variety of unusual behavioral and developmental disorders. Recent studies found great variability in the estimated strength of association between "autism" and the fra(X) syndrome, but not between MR and fra(X). We examined 31 studies which investigated the association of fra(X) syndrome with either MR or "autism" and found that the conclusion of those researchers could be significantly affected by sample size. Different behavioral and cytogenetic protocols will also influence the strength of association between fra(X) and autism.

Autistic Disorder↗
PubMed1994

Relations among maternal stress, cognitive development, and early intervention in middle- and low-SES infants with developmental disabilities.

Relations between maternal stress and the development of infants with handicaps was examined in 72 middle-SES and 72 low-SES families who attended a weekly early intervention program. Measures of maternal stress and development of infants were obtained 10 months apart. Regression analyses predicted 81% of variance in later developmental level with initial Bayley MA, initial Mental Development Index (MDI), SES, initial stress, early intervention participation, and SES x Initial Stress x Attendance interaction. Subsequent maternal stress was predicted (42% variance explained) by initial stress, attendance, initial MDI, number of intervention agencies and MDI x SES x Attendance. Results were interpreted in terms of a transactional model.

Adaptation, Psychological↗
PubMed1988

Prenatal lead exposure and its potential significance for developmental disabilities: a preliminary study of umbilical cord blood lead levels.

It has been reported that between 1976-1980 the mean blood lead level in American preschool children was 16 micrograms/dl. The Centers for Disease Control (CDC) recently set a blood level of 25 micrograms/dl as the highest acceptable level for children. However, current research findings have provided evidence that detrimental effects on development can occur when lead levels are below this acceptable value. In particular, recent work has shown a relationship between early (prenatal) exposure to lead and delayed cognitive development. Because the developing fetus is particularly vulnerable to insult, it is of critical importance to obtain information about the developmental effects of prenatal exposure to lead and about those factors that may influence this exposure. This report presents initial findings of an ongoing investigation pertaining to issues surrounding early lead exposure. To date umbilical cord blood samples have been measured in 802 infants born at Children's Hospital of Buffalo between November 1987 and April 1988. These infants' residence span approximately 50 townships with most residing in Buffalo proper. Approximately 60 percent of the infants had measurable cord blood lead levels in the range of 4 to 20 micrograms/dl.

Cognition Disorders↗
PubMedDate not supplied

Secretin is an ineffective treatment for pervasive developmental disabilities: a review of 15 double-blind randomized controlled trials.

In 1998, Horvath et al. [Horvath, K., Stefanatos, G., Sokolski, K. N., Wachtel, R., Nabors, L., & Tildon, J. T. (1998). Improved social and language skills after secretin administration in patients with autism spectrum disorders. Journal of the Association of the Academy of Minority Physicians, 9, 9-15] reported an uncontrolled trial of secretin with three participants with autism, which apparently resulted in significant behavioral improvement. Subsequently, secretin was widely used. Sandler et al. [Sandler, A. D., Sutton, K. A., SeWeese, J., Girardi, M. A., Sheppard, V., & Bodfish, J. W. (1999). Lack of benefit of a single dose of synthetic human secretin in the treatment of autism and pervasive and developmental disorder. The New England Journal of Medicine, 341, 1801-1806] reported the first double-blind trial of secretin with negative results. This article is a review of 15 double-blind trials of secretin. Almost none of the studies reported any significant effects and none concluded that secretin was effective. Transient effects of secretin, including both minor benefits and behavioral deterioration were reported, probably due to multiple statistical tests. Four papers reported data on differential responding in sub-groups of participants, including those with gastrointestinal symptoms. These effects were not replicable. At this time there is no robust evidence that secretin is an effective treatment for pervasive developmental disorders.

Adolescent↗
PubMed1999

A genome-wide search strategy for identifying quantitative trait loci involved in reading and spelling disability (developmental dyslexia).

Family and twin studies of developmental dyslexia have consistently shown that there is a significant heritable component for this disorder. However, any genetic basis for the trait is likely to be complex, involving reduced penetrance, phenocopy, heterogeneity and oligogenic inheritance. This complexity results in reduced power for traditional parametric linkage analysis, where specification of the correct genetic model is important. One strategy is to focus on large multigenerational pedigrees with severe phenotypes and/or apparent simple Mendelian inheritance, as has been successfully demonstrated for speech and language impairment. This approach is limited by the scarcity of such families. An alternative which has recently become feasible due to the development of high-throughput genotyping techniques is the analysis of large numbers of sib-pairs using allele-sharing methodology. This paper outlines our strategy for conducting a systematic genome-wide search for genes involved in dyslexia in a large number of affected sib-pair familites from the UK. We use a series of psychometric tests to obtain different quantitative measures of reading deficit, which should correlate with different components of the dyslexia phenotype, such as phonological awareness and orthographic coding ability. This enable us to use QTL (quantitative trait locus) mapping as a powerful tool for localising genes which may contribute to reading and spelling disability.

Alleles↗
PubMed1986

Rett syndrome at an institution for the developmentally disabled.

Rett syndrome (RS) is a condition apparently limited to females characterized by normal early development followed by the abrupt loss of acquired function and beginning autistic behavior in late infancy. Manifestations in RS include decelerating head growth, unusual "hand-writing" movements, gait apraxia, neuromuscular tone disturbance, and seizures. No biochemical, hematologic, cytologic, or cytogenetic procedures have been shown to confirm the diagnosis of RS. With the exception of one family with 2 affected half-sisters, all cases have been sporadic. Six profoundly retarded residents of Central Wisconsin Center have manifestations of RS. Three are microcephalic and 3 have head circumferences at or below the 10th centile. All have seizures or abnormal EEG findings and all were ascertained on the basis of characteristic hand movements. No case of precocious puberty was observed. Two patients had severe scoliosis which was surgically treated. Detailed neuropathologic examination should be sought for every case of RS. The development of clearly defined minimal diagnostic criteria and the establishment of an international registry are desirable.

Adolescent↗
PubMed1993

One community's response to the multi-system service needs of individuals with mental illness and developmental disabilities.

Individuals with mental illness and mental retardation often fall between system and agency service cracks. This paper describes some of the barriers individuals and communities confront in developing new or expanding existing services to meet the needs of this population. It then describes how one community initiated multi-system collaboration in its delivery of crisis intervention services, community mental health center services and specialized short-term residential living. By increasing the multi-system services available to individuals with dual diagnosis at the community level, fewer individuals encountered placement failure and re-institutionalization.

Community Mental Health Centers↗
PubMed1978

Sensory extinction: a procedure form eliminating self-stimulatory behavior in developmentally disabled children.

This study was designed to investigate the role of sensory reinforcement in the motivation of self-stimulation. If self-stimulatory behavior is maintained by its sensory consequences, such as the proprioceptive, auditory, or visual stimulation it produces, then such behavior should extinguish when those sensory consequences are not permitted. The present study introduces a new procedure, Sensory Extinction, in which certain sensory consequences are masked or removed, to examine whether self-stimulation is operant behavior maintained by sensory reinforcement. The effectiveness of Sensory Extinction was assessed by a reversal design for each of three autistic children, and the results showed the following. First, self-stimulation reliably extinguished when a certain sensory consequence was removed, then increased when that consequence was permitted. This was replicable within and across children. Second, different Sensory Extinction procedures were required for different self-stimulatory behaviors, since the sensory reinforcers supporting them were idiosyncratic across children. Finally, regarding clinical gains, the data suggest that Sensory Extinction may be a relatively convenient and rapid alternative for the treatment of self-stimulation. The present findings extend the efficacy of extinction as a behavior-modification technique to instances in which the reinforcer is purely sensory. The implications of these results for the treatment of other forms of deviant behavior are discussed.

Autistic Disorder↗