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PubMed1983

Naloxone attenuates self-abusive behavior in developmentally disabled clients.

The opiate antagonist naloxone was effective in reducing self-abusive behavior in two mentally retarded clients with an extensive history of such behavior. Three doses of naloxone (0.1, 0.2, 0.4 mg) were compared with a vehicle solution in a double-blind, crossover design. Naloxone greatly attenuated self-abusive episodes in one client and eliminated them entirely in the second client. In addition, use of self-restraining behavior by one client was reduced. The findings suggested that some clients with self-injurious behavior may have disturbances of the endogenous opiate system. Maintenance of self-abuse by tonically elevated pain threshold and/or by the putative addictive characteristics of such behavior was discussed.

Adult↗
PubMed1986

Differential diagnosis of epileptic versus pseudoepileptic seizures in developmentally disabled persons.

One-hundred and twenty-four mentally retarded persons with behaviors suggestive of epilepsy were monitored with an 8-channel radiotelemetered electroencephalograph-video recording system (TEEG-VR). Target behaviors were identified by the clinical description of the primary care providers before the TEEG-VR sessions. Whenever possible, the known antecedents of those behaviors were replicated. The target behaviors were considered epileptic when they were observed simultaneously with epileptiform EEG patterns, and pseudoepileptic when nonepileptiform patterns were observed. Twenty persons were classified as epileptic, 50 as pseudoepileptic, 11 as both epileptic and pseudoepileptic, and 43 as inconclusive. Among the pseudoepileptics there were 15 with abnormal EEGs and 4 with epileptiform EEGs. The most frequent topographies of behavior were not significantly related to diagnosis. These included myoclonus, eye blink, head drop, cessation of ongoing activity, and hand and arm automatisms. The diagnosis of epilepsy in mentally retarded persons, on the basis of clinical description, interictal EEG, and medical history, may be inaccurate. TEEG-VR is extremely useful for obtaining a definitive diagnosis of each target behavior.

Adolescent↗
PubMedDate not supplied

Self-injurious behavior and sleep disturbance in adults with developmental disabilities.

Sleep patterns of 30 individuals with self-injurious behavior and mental retardation were compared with those of 30 matched controls residing in the same residential facility that did not self-injure. Individuals were recorded as asleep or awake during 30 min intervals for eight hours per night. The results of a Wilcoxon signed-ranks test (p < .05) indicated that individuals with self-injury slept significantly less than individuals without self-injury. chi2 analyses (p < .01) indicated significantly greater variability in the number of intervals recorded as asleep among individuals with self-injury than their matched controls. These results are congruent with previous findings of sleep disturbance among persons with mental retardation and behavior problems. The possibility of neurochemical dysregulation in sleep disturbance among individuals with daytime self-injury is discussed.

Adult↗
PubMedDate not supplied

Assessing the acquisition and generalization of two mand forms with adults with severe developmental disabilities.

The purpose of this study was to determine whether manual sign or the Picture Exchange Communication System (P.E.C.S.) (Frost and Bondy, 1994) would be more effective in teaching mand skills to adults with mental retardation in the severe and profound range. Four participants were taught to mand for four reinforcing items using both communication modalities, in an alternating treatments design. Three of four participants demonstrated criterion performance across all four mands using P.E.C.S. first. Two of those three participants later demonstrated criterion performance for the mands using manual sign. The fourth participant was removed from the study during training due to illness, but her progress indicated greater acquisition with P.E.C.S. Generalization probes conducted at participants' respective residences showed that three participants demonstrated generalization across settings using P.E.C.S., and two participants demonstrated generalization across settings using manual sign. Participants were also more likely to mand for reinforcing items not present using P.E.C.S. than using manual sign.

Adult↗
PubMedDate not supplied

Assessment of aberrant behavior maintained by wheelchair movement in a child with developmental disabilities.

A child that used a wheelchair was anecdotally observed to display little aggressive behavior when being pushed in his wheelchair, but higher rates of aggressive behavior when movement was terminated. A functional analysis was conducted to systematically assess the relationship between aggression and wheelchair movement. The functional analysis results revealed elevated rates of aggression when it resulted in being briefly pushed in the wheelchair. This functional hypothesis was subsequently validated by teaching the child to request movement through appropriate means and demonstrating that aggression decreased under treatment conditions. These results extend prior research on functional analysis by demonstrating a previously unreported behavioral function particular to individuals with motor deficits.

Adolescent↗
PubMed1994

The diversity of epilepsy in adults with severe developmental disabilities: age at seizure onset and other prognostic factors.

There is usually a causal relationship between epilepsy and mental retardation when they coexist. The pathogenetic period of the underlying brain disorder and the time of seizure onset may, however, be widely separated. In 63 institutionalized mentally retarded epilepsy patients, 41% had seizure onset prior to the age of 2, 30% between the age of 2 and 20, and as many as 29% after the age of 20. Whereas uncontrolled epilepsy and cerebral palsy were frequently present in the group of early onset, most patients with adult onset had well controlled epilepsy, and none had cerebral palsy. Five of the 18 patients with adult onset epilepsy had Down's syndrome; in three of them, concomitant dementia was evident. In most patients with adult onset, however, no recent or current etiological factors for seizures were evident, except for their stable intellectual deficits. The incidence of adult onset epilepsy in the institution in 10 years markedly exceeded the expected rate. Twenty-three patients had achieved a prolonged remission of seizures and discontinued antiepileptic treatment. Sixty per cent of them remained seizure-free after at least two years. The mentally retarded should not unduly be subjected to drugs with potential central nervous side-effects.

Adolescent↗
PubMed2002

Behavioral assessment in mentally retarded and developmentally disabled patients with epilepsy.

Behavioral disturbance is common in many individuals with mental retardation. Its presence in those with coexisting epilepsy provides a further challenge to the individual, caretakers, and family members. In particular, concerns that antiepileptic medication is causing such behavioral disturbances are often raised. For the clinician, assessment is crucial to minimize morbidity by appropriately identifying the cause of the behavioral disturbance. The assessment should aim to delineate whether the disturbance is due to a direct effect of epilepsy, its treatment, social impact, or factors unrelated to the epilepsy. However, before being able to make this differentiation, the clinician needs to understand the behavior itself. Assessing behavior in people with mental retardation requires a multifactorial approach. These factors include an objective and reliable description of the behavior and an assessment of its function. Detailed description requires a functional analysis of behavior. Such analysis may indicate the behavior is associated with epilepsy treatment or represents a seizure disorder in itself. In the majority of cases, though, it is likely that any disturbance seen is independent of epilepsy or its management.

Journal Article↗
PubMed2002

Perception of human and nonhuman facial age by developmentally disabled children.

Human and nonhuman faces were shown to clinical controls, autistic, mentally retarded, and language-disordered children to assess their ability to detect and draw inferences about facial age. Children were asked to select from sets of three faces the one that appeared youthful or to select faces that would be associated with some age-related characteristic. In two studies, it was found that, relative to other children, autistic children had more difficulty perceiving youthfulness in nonhuman faces compared with human faces. These data are discussed with respect to differences in mechanisms and processes that may underlie facial information processing in autistic and nonautistic children.

Aging↗
PubMed2001

Physician unwitting participation in abuse and neglect of persons with developmental disabilities.

The vast majority of birth parents and foster parents for children with special needs do the best they can in challenging circumstances. Many describe the frustrating circumstance of knowing more than their physicians about their child's unusual medical conditions. In general, physicians are well-advised to listen carefully to the reports of observant, caring parents and foster parents, and to give these observations at least as much weight as their own. However, in the work of our traveling clinic we have observed a number of situations of abuse and neglect which were perpetrated by parents or foster parents, and where the actual acts of abuse and/or neglect were wholly or in part endorsed, in writing, by the treating physician.

Adolescent↗