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PubMed2003

Technology and the environment: supportive resource or barrier for people with developmental disabilities?

Findings from needs assessments and abandonment studies point to issues with health care providers, particularly in their ability to listen to the needs of the consumer and important others regarding AT-EI. Professionals need to listen to what people are telling them or, in many cases, what they are not telling them. Actions and nonverbal messages can speak very loudly. Strategies to communicate and collaborate with consumers need to be developed. Regardless of ability to communicate or the severity of the impairments the person may be experiencing, it is important to withhold judgments that may underestimate a person's potential or desire to be in control of life decisions. AT-EI service have often seen people labeled with severe or profound intellectual disabilities challenge that diagnosis after accessing a communication or access system. Likewise, a person with a severe disability has the right to supportive resources and to the same level of respect, dignity, and quality of life as any other member of society. Using the technology and adapting the environment to provide opportunities for consumers to "voice" their wishes and control their lives can be an effective strategy to collaborate. When focusing on a rights-based philosophy, recognizing the difference between physical independence (e.g., physical and/or cognitive ability to do a task by oneself) and self-care management (e.g., access to and power to manage the supportive resources to live in the community regardless of level of physical ability) is important. We all rely on supports in our lives, whether it be tools or technology to help us do a job or another person, yet when we evaluate people with disabilities, the expectation is for people to function independently [23,24]. They even receive lower scores on functional assessments if they are using a piece of technology to do an activity. By shifting the focus to management of and access to resources versus level of physical dependence or burden, health care professionals can play a role in linking people to such resources as AT-EI and related services and strategies to support community living. Such a shift in focus also enables professionals to validate interdependence; that is, the give-take relationships that people have with each other to support each other [25]. The use of AT-EI by people with developmental disabilities often involves an interdependent relationship in which another person may help set up the environment or technology and, in turn, the consumer can then reciprocate and engage in an activity or a relationship [1]. Health care professionals also need to better understand and take into consideration the social context, its influence on consumers' use or nonuse of AT-EI, and the long-term influence on community living and participation decisions [1]. Nurses can involve important others in the process by listening to and considering their needs, and ensuring that they are informed about options, the benefits of using AT-EI for the consumer and themselves, and how to set up and troubleshoot the AT-EI. In cases where important others are not supportive, health care professionals may be in a position to link the consumer with other consumers and advocacy groups such as Centers for Independent Living or Self Advocates Becoming Empowered that may offer that support as well as membership in a collective community engaged in systems change. Health care professionals can serve as a system interface by linking people to information and resources to make informed decisions [26]. Resources on developmental disability and health, common issues that may occur, and life course planning help people identify functional issues and early signs of accelerated aging and proactively use the environment and technology to stay in living situations of choice. Few health care professionals are well prepared to provide services to people with developmental disabilities as they age; a great need exists for providers of such specialized services and for proactive later-life screenings that can identify issues early and make the most use of AT-EI strategies to address aging issues [26,28]. At any given point in time in the life of people with developmental disabilities, many different professionals and systems may be involved in decisions that could include AT-EI. Medical, educational, vocational, independent living, and case management systems may all be working with the person; however, there is often limited or no communication between them, particularly as the person ages or transitions between settings. Health care professionals, even when they are working with an individual on a limited basis, can and should take on active roles in linking consumers and important others with other systems and should ensure that information about their AT-EI needs is transferred accurately between systems. Most likely, nurses may be in a role to refer a person to specialized services, whether they may be medical, rehabilitative, AT-EI-specific, or disability advocacy groups that can help support the person as they face barriers or seek out AT. Nurses may also be in a role to pass on important information about the person's health and medical status that can help to better inform AT-EI decisions to ensure the AT meets the person's needs across contexts. As an interface, nurses may assume a role as a supporting advocate for accessing resources, not as a gatekeeper who makes decisions for people. This includes referring individuals with developmental disabilities to people and groups that know how to get AT-EI, how to fund it, and how to troubleshoot it, and linking them to other people with disabilities who are sharing strategies in person and on-line. It also includes focusing beyond basic self-care and considers AT-EI strategies that enable a person to participate in high meaning activities and roles in the home and the community. Participation in activities identified as highly meaningful and important to the person, such as participating in a religious community, networking with other people on-line, gardening, or being a member of a community group, to name a few, can positively contribute to health, wellness, and quality of life; the challenge is to create and adapt the environment (social, physical, and societal) to support participation choices and control.

Adolescent↗

PubMed2001

The built environment and children's health.

The built environment embraces a wide range of concepts, from the design and integrity of housing, to land-use urban planning. A high-quality environment is essential for children to achieve optimal health and development. Building and land-use policies, including the quality and design of a child's physical environment, can cause or prevent illness, disability, and injury, and can degrade or preserve natural resources. Though many common pediatric conditions such as obesity, asthma, and lead poisoning, as well as injuries, are associated with risk factors within a child's built environment, this issue has received little attention from researchers or policymakers. This new field is ripe for etiologic and prevention research, and we need pediatric advocates to speak out for children's needs within this arena.

Child↗

PubMed2002

Effects of prior apparatus experience and novelty of testing environment on locomotor activity following MK-801.

Robust increases in locomotor activity are observed following administration of dizocilpine maleate (MK-801). The present study investigated the effects of prior apparatus experience and manipulation of the testing environment on locomotor activity following peripheral MK-801. Gerbils were given zero or nine sessions of apparatus exposure prior to testing with MK-801 (0.1 mg/kg ip) or saline. Sessions were 10 min in duration and separated by 24 h. As previously reported, naive animals treated with MK-801 were significantly more active relative to controls. Exposure to the apparatus for nine sessions resulted in a significant reduction in MK-801-induced activity, but did not alter the activity levels of control animals. To evaluate the effect of changes to the testing environment, animals previously evaluated in the familiar condition were retested in the identical apparatus relocated to a novel experimental room. MK-801-treated animals exhibited a significant increase in activity when tested in this novel environment while the locomotor activity of control gerbils was not significantly altered. The results illustrate the importance of repetitive testing and environmental changes as moderating variables in studies that evaluate locomotor activity. These data also indicate that the effects of MK-801 on activity are sensitive to prior experience with the apparatus and the novelty of the testing environment.

Animals↗

PubMed1998

The social environment during pregnancy and lactation affects the female offsprings' endocrine status and behaviour in guinea pigs.

This study investigated the influence of the social environment during pregnancy and lactation on the female offsprings' endocrine parameters and behaviour. The subjects studied were daughters whose mothers had either lived in a stable social environment (SSE) during pregnancy and lactation (SE-mothers) or in an unstable social environment (USE) during this period of life (UE-mothers). The SSE was made by keeping the group composition (one male, five females) constant; in the USE situation every third day two females from different groups were exchanged. After weaning, 3 groups of daughters from UE-mothers (UE-daughters) and 3 groups of daughters from SE-mothers (SE-daughters), consisting of four females each, were established. From their 60th through their 80th day of age the spontaneous behaviour of the daughters was recorded in their home cages. On the endocrine level, cortisol and testosterone (T) concentration in serum as well as adrenal tyrosinehydroxylase activities in both adrenals and their weight were determined. UE-daughters displayed significantly higher amounts of male-typical courtship and play behaviour than SE-daughters. This behavioural masculinization corresponded with significantly higher T in UE- than SE-daughters. Cortisol levels did not differ between both categories of females. Significantly higher tyrosinehydroxylase activities and adrenal weight in UE- than SE-daughters pointed, however, to higher degrees of stress response in UE-daughters. Thus, the instability of the social environment during pregnancy and lactation has distinct effects on the behaviour and endocrine system of the female offspring.

Adrenal Glands↗

PubMed1999

Effects of ovarian hormones and environment on radial maze and water maze performance of female rats.

The effects of gonadal hormones and environment on performance in an eight-arm radial maze and in the Morris water maze were determined in female rats. Long-Evans female rats were ovariectomized or sham ovariectomized at 35 days of age, and housed in complex environments or in isolation for the duration of the study. One month following surgeries, spatial working memory performance in the radial maze was assessed. Exposure to complex environmental conditions independently enhanced performance, as indicated by increased arm choice accuracy during 20 days of maze training. Additionally, gonadally intact females significantly outperformed ovariectomized females before cyclicity was disrupted by food deprivation. Following radial maze training, spatial reference memory performance was assessed in the same females utilizing the Morris water maze. Gonadally intact females housed in isolation performed significantly more poorly during 16 days of place training trials and displayed significantly shorter times in the platform quadrants and fewer target crossings during probe trials than gonadally intact and ovariectomized females housed in complex environments and ovariectomized rats housed in isolation. Consequently, acquisition and retention of the water maze was impaired by the presence of ovaries, and this impairment was counteracted by exposure to complex environments. Performance did not differ between groups on cued trials, indicating that sensorimotor and motivational functions did not differ between groups. Results of these experiments indicate that endogenous gonadal hormones can differentially affect performance on tasks of spatial working and spatial reference memory, and that environmental conditions can interact with gonadal hormones to affect behavior.

Animals↗

PubMed2003

The effect of work environment and heavy smoking on the social inequalities in smoking cessation.

OBJECTIVES: To investigate social differences with regard to smoking cessation in Denmark. METHODS: Social differences in smoking cessation were estimated from 3606 smokers from the Danish National Work Environment Cohort Study in 1990, 1995 and 2000. The differences were investigated using heavy smoking and four work environment factors as explanatory variables. RESULTS: The odds ratio for cessation was more than twice as high in social class I compared with social class V. When heavy smoking was controlled, this explained 28% of social differences, the work-environment factors alone explained 36% of social differences, and together the factors explained 55% of social differences. CONCLUSIONS: A large proportion of the social differences in smoking cessation could be explained by differences in work-environment exposures and smoking intensity.

Adolescent↗

PubMed2003

Establishment success and extinction risk in autocorrelated environments.

We consider establishment success (and extinction risk of small populations) in fluctuating environments, by means of an inhomogeneous branching process model. In this model it is assumed that individuals reproduce asexually during discrete reproduction periods. Within each period individuals reproduce independently and have random numbers of offspring. Expected numbers of offspring vary over reproduction periods due to random environmental changes. Previous simulation results indicated that there is a positive autocorrelation between the establishment probabilities of invaders in successive reproduction periods when environmental states are independently distributed. This result was never formally proved. In this paper we prove that this is indeed true, regardless of the form of the distribution of environmental states or the offspring distribution (under a monotonicity condition, which holds for biologically realistic models). Furthermore, we prove that it is also true for positively autocorrelated environmental states. We show by a counterexample that in environments with a strong negative autocorrelation establishment probabilities can be negatively autocorrelated. This was further examined through simulations. Our results imply that in independent, positively autocorrelated and weakly negatively autocorrelated environments the probability of success of invasion in different independently varying sites is the highest, followed by sequential invasion. For environments with a strong negative autocorrelation, sequential invasion has the highest probability of success. Effects of autocorrelation were further examined with simulations. From the results it appears that the expected length of 'runs of bad luck' is the most crucial factor for establishment success.

Algorithms↗

PubMed2002

The influence of childhood sexual abuse, physical abuse, family environment, and gender on the psychological adjustment of adolescents.

OBJECTIVE: The primary aim of the current study was to examine the contributions of sexual abuse, physical abuse, family cohesion, and conflict in predicting the psychological functioning of adolescents. Additional analyses were conducted to determine whether adolescent victims of child sexual abuse and physical abuse perceive their family environments as more conflictual and less cohesive than nonabused adolescents. METHOD: Participants were 131 male and female adolescents, ages 16 years to 18 years, receiving services at a residential vocational training program. Participants completed well established psychological assessment tools to assess abuse history, family environment characteristics, and current adjustment. RESULTS: Physically abused adolescent females perceived their family environments as more conflictual and less cohesive than females without physical abuse, and sexually abused females perceived their family environments as more conflictual and less cohesive than females without sexual abuse. Physically abused adolescent males reported more conflict than males without physical abuse, but did not differ with regard to cohesion. Adolescent males with and without a sexual abuse history did not differ on the family dimensions. Multiple regression analyses revealed that both conflict and cohesion, in addition to a history of sexual and physical abuse, predicted depression and distress. Separate analyses by gender revealed these variables differentially impact adjustment in male and female adolescents. Results of a power analysis indicated sufficient power to detect these differences. CONCLUSIONS: Findings indicate that in addition to child sexual abuse and physical abuse, family conflict and cohesion are risk factors for the development of psychological distress and depression in adolescence. Implications for treatment and directions for future research are discussed.

Adaptation, Psychological↗

PubMed1986

The effect of home or novel environment on the facilitation of passive avoidance by post-training ethanol.

Passive avoidance behavior of mice is improved when mice are injected with ethanol immediately after footshock training. Further study has shown that avoidance can be affected by ethanol injections given within 1 h, but not at 90 or 180 min, after training. The present study was conducted to investigate the possibility that events which occur in the homecage during this sensitive period may influence the effect of ethanol on subsequent avoidance. Male Swiss-Webster mice were housed either singly in a novel environment for 90 min or returned to their (group) homecage following one-trial, step-through, passive avoidance training (0.1 mA footshock) and intraperitoneal injection of 3.0 g/kg ethanol (15% v/v) or saline. As in previous studies, when ethanol-treated mice were returned to their homecage, avoidance was significantly increased at 24 h compared to the behavior of saline-treated mice. However, when mice were isolated in the novel environment for 90 min immediately following treatment, the memory facilitating effects of ethanol were not observed. The avoidance behavior of mice injected with saline was the same regardless of their post-training environment. Also, the number of mice (6 or 10) housed per homecage did not significantly influence the effects of ethanol or post-training environment on avoidance. These findings indicate that environmental factors may interact with the effects of ethanol to modify avoidance behavior. The possible influence of variables such as aggression, thermoregulation, and behavioral arousal on the effects of ethanol in this paradigm are discussed.

Animals↗

PubMed1997

Controlled environments alter nutrient content of soybeans.

Information about compositional changes in plants grown in controlled environments is essential for developing a safe, nutritious diet for a Controlled Ecomological Life-Support System (CELSS). Information now is available for some CELSS candidate crops, but detailed information has been lacking for soybeans. To determine the effect of environment on macronutrient and mineral composition of soybeans, plants were grown both in the field and in a controlled environment where the hydroponic nutrient solution, photosynthetic flux (PPF), and CO2 level were manipulated to achieve rapid growth rates. Plants were harvested at seed maturity, separated into discrete parts, and oven dried prior to chemical analysis. Plant material was analyzed for proximate composition (moisture, protein, lipid, ash, and carbohydrate), total nitrogen (N), nonprotein N (NPN), nitrate, minerals, amino acid composition, and total dietary fiber. The effect of environment on composition varied by cultivar and plant part. Chamber-grown plants generally exhibited the following characteristics compared with field-grown plants: 1) increased total N and protein N for all plant parts, 2) increased nitrate in leaves and stems but not in seeds, 3) increased lipids in seeds, and 4) decreased Ca:P ratio for stems, pods, and leaves. These trends are consistent with data for other CELSS crops. Total N, protein N, and amino acid contents for 350 ppm CO2 and 1000 ppm CO2 were similar for seeds, but protein N and amino acid contents for leaves were higher at 350 ppm CO2 than at 1000 ppm CO2. Total dietary fiber content of soybean leaves was higher with 350 ppm CO2 than with 1000 ppm CO2. Such data will help in selecting of crop species, cultivars, and growing conditions to ensure safe, nutritious diets for CELSS.

Carbon Dioxide↗

PubMed2002

Ethnicity, environment and health: putting ethnic inequalities in health in their place.

We set out to explore the influence of environment on ethnic inequalities in health. Studies exploring the relationship between environment and health have tended to ignore the role of ethnicity, and the health impact of the residential concentration of ethnic minority groups in disadvantaged areas. Those that have explored the role of ethnicity tend to focus on the way in which residential concentration may promote a sense of community among ethnic minority groups, and, consequently, may be protective of health (the 'ethnic density effect'). Again, they have tended to ignore the health impact of the concentration of ethnic minority groups in areas of social and economic disadvantage. We undertook a factor analysis to determine aspects of perception of 'quality' of the local environment, followed by multi-level analyses to explore the relationship between self-reported fair or poor health and individual- and ward-level characteristics among four ethnic groups (Caribbean, Indian, Pakistani and Bangladeshi, and white) in the UK. Results of the factor analysis suggested three underlying dimensions of perception of quality of the local area, related to the quality of the local environment, the provision of local amenities and local problems of crime and nuisance. These factors were entered into the multi-level models at level 2, along with indicators of ward-level ethnic density and Townsend's deprivation score, with age, gender and household social class entered at level 1. In general, there was a residual random ward-level effect suggesting an area influence on self-assessed health. However, on the whole, none of the ward-level indicators showed any statistically significant association with self-assessed health, making it difficult to precisely determine the mechanisms operating. These findings suggest, though, that there is no ethnic density effect on self-assessed health for ethnic minority groups.

Bangladesh↗

PubMed2003

Intracerebroventricular administration of endothelin-1 impairs the habituation of rats to a novel environment in conjunction with brain serotonergic activation.

The effects of i.c.v. administration of endothelin-1, at a low dose that does not produce abnormal behaviors such as barrel-rolling, on the emotional state of rats exposed to a novel environment were examined. Changes in the emotional state of rats with a novel environment were evaluated in terms of changes in exploratory activity in the hole-board apparatus, i.e., locomotor activity as well as the number and duration of rearing and head-dipping behaviors. Rats treated with i.c.v. saline showed marked exploratory behaviors immediately after exposure to the hole-board apparatus, but these exploratory behaviors decreased rapidly with time. On the other hand, the habituation of rats to a novel environment was prolonged by the i.c.v. administration of endothelin-1 (0.3 and 1 pmol). Furthermore, we also found that i.c.v. administration of endothelin-1 (1 pmol) significantly increased the serotonin (5-hydroxytryptamine) turnover in some brain regions, i.e., the cerebral cortex, hippocampus and midbrain, and the inhibition of brain 5-hydroxytryptamine synthesis by treatment with p-chlorophenylalanine (200 mg/kg/day, s.c.) for 2 days suppressed the behavioral effects of endothelin-1 (1 pmol, i.c.v.). In addition, i.c.v. administration of endothelin-1 (1 pmol) did not affect the spontaneous motor activity of rats. The present study demonstrated that i.c.v. administration of low doses of endothelin-1 impairs the habituation of rats to a novel environment in conjunction with brain 5-hydroxytryptaminergic activation. These results suggest that the central endothelin system may play a significant role in mediating emotionality.

Animals↗

PubMed2003

Influence of the postlesion environment and chronic piracetam treatment on the organization of the somatotopic map in the rat primary somatosensory cortex after focal cortical injury.

The influence of housing in an enriched or impoverished environment and anti-ischemic treatment (piracetam) on the organization of the intact regions of the somatosensory cortical maps adjacent to a focal cortical injury were investigated in adult rats. Response properties of small clusters of neurons were recorded in the area of the primary somatosensory cortex (SI) devoted to the contralateral forepaw representation. Electrophysiological maps were elaborated on the basis of the sensory "submodality" (cutaneous or noncutaneous) and the location of the receptive fields (RFs) of layer IV neurons. Recordings were made before, and 3 weeks after induction of a focal neurovascular lesion to the SI cortex. The main results were: 1) the focal ischemic injury induced a cellular loss which was less severe in the piracetam treated rats, regardless of the housing conditions; 2) the lesion resulted in a compression of the remaining forepaw map, a fragmentation of the representational zones serving the cutaneous surfaces (low-threshold inputs) and an enlargement of noncutaneous zones (high-threshold inputs) in the spared cortical sectors surrounding the lesion. These changes were found in all placebo rats, with the most detrimental effects in the animals exposed to an impoverished environment, and in the piracetam-plus-impoverished rats. In contrast, a limited compression of the forepaw map and a preservation of most representational sectors were observed in the piracetam-plus-enriched animals, 3) the size of the cutaneous RFs of the neurons within the intact cortical zones remained unchanged, regardless of environment or treatment; 4) consistent with the map changes, the skin surfaces lacking low-threshold cutaneous RFs increased after the lesion in all animal groups but the piracetam-plus-enriched rats; 5) cortical responsiveness as assessed with mechanical threshold evaluation was diminished in the placebo rats, whatever the environment, and in the piracetam-impoverished rats, but was not significantly affected in the piracetam-enriched animals. Our findings, based on the first double electrophysiological mapping in the rat SI cortex, highlight the protective effects of an environmental therapy associated with an anti-ischemic treatment on the neurophysiological properties of cortical neurons following a focal neurovascular injury to the neocortex.

Afferent Pathways↗

PubMed2003

The social environment affects behaviour and androgens, but not cortisol in pregnant female guinea pigs.

In guinea pigs the behaviour of male offspring is infantilized in adulthood, when their mothers had lived in an unstable social environment during pregnancy and lactation (Kaiser and Sachser, Psychoneuroendocrinology, 26 (2001) 503). The present study was conducted to elucidate the mechanisms bringing about this phenomenon. Therefore, the spontaneous behaviour and endocrine parameters of females were compared that either lived in a stable social environment (SSE) during pregnancy (SE-females) or in an unstable social environment (USE) during this period of life (UE-females). The SSE was made by keeping the group composition (one male, five females) constant; in the USE situation (one male, five females) every third day two females from different groups were exchanged. The spontaneous behaviour of the UE-females was recorded on three successive days: the day before, the day of and the day after the transfer from one group to another. The behaviour of the SE-females was recorded at corresponding times. In addition, serum concentrations of cortisol, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone-sulfate (DHEAS) concentrations were determined. After transfer to another group UE-females showed distinctly more orientation behaviour and they received significantly higher amounts of courtship and sexual behaviour from the males than SE-females which remained in their familiar groups. In turn, UE-females displayed significantly higher amounts of urine spray towards the male, a defensive aggressive behavioural pattern. No differences were found in offensive aggressive and socio-positive behaviours between UE- and SE-females. With respect to endocrine parameters the transfer to an unfamiliar group did not cause an increase of cortisol, that is UE- and SE-females did not differ significantly. DHEAS and in part DHEA concentrations, however, were significantly lower in UE- than SE-females. Thus, for the first time it is shown that the social environment during pregnancy has significant effects on the androgen concentrations in female guinea pigs. Moreover, a decrease of androgens in pregnant females may be related to the infantilization of their male offspring.

Androgens↗

PubMed2002

Sleep-wake patterns in preterm infants and 6 month's home environment: implications for early cognitive development.

AIMS: This study examined the relationship between early organization of sleep-wake states and developmental outcome at 6-month-old premature infants. STUDY DESIGN: This was a prospective randomized study that evaluated the sleep-wake states of healthy premature infants in the nursery environment for two successive 72-h periods, at 32 and 36 weeks gestational age. SUBJECTS: Thirty-four healthy premature infants. OUTCOME MEASURES: Three sleep-wake parameters: percent of quiet sleep, activity level and total amount of sleep, were studied with miniature activity monitors attached to the infant's ankles. The rearing environments of the infants were also assessed at 6 months of age, using the HOME Inventory. Finally, child developmental status was recorded by means of the Mental Development Index (MDI) of the Bayley Scales for Infant Development, at a chronological age of 6 months. RESULTS: Lower total time spent in night sleep, higher mean level of night activity level, and a later rich home environment were all predictive of higher Bayley scores (MDI) at a chronological age of 6 months. Regression analysis indicated that early biological maturity was more strongly related to the child's developmental status than later home environment, although both contributed to the prediction. CONCLUSIONS: These results suggest that biological factors may be significant predictors early in development, whereas the impact of environmental influences increases with development.

Child Development↗

PubMed2000

ICU bedside environment. A nursing perspective.

The physical design of most ICUs is a source of inadvertent and undesirable stress for patients, family, and staff. The importance of developing a healing environment will have a great impact on the ICU bedside environment of the future. Using the research on the effects of noise, light, and other environmental stressors on patient outcomes, the ICU bedside environments of the future will combine the "high tech" and "high touch" components of care in one setting. The patients and the care providers will benefit from this focus on the humane, healing environment.

Critical Illness↗

PubMed1992

The importance of exterior environment for Alzheimer residents: effective care and risk management.

Evidence shows that environments especially designed for cognitively impaired seniors can maintain or increase their level of functioning. Little emphasis has so far been placed on the prosthetic role that may be played by exterior environments. This study attempted to determine the value that specially designed exterior spaces may have in reducing undesired behaviours, thereby minimizing risks to the patients and potential liability to the institution. The researchers tested that (a) poor environments increase residents' frustrations and can precipitate catastrophic behaviour and (b) freedom of movement and opportunities to avoid crowding, noise and excess stimulation minimize the frequency of aggressive behaviour. The researchers found that the use of exterior environments reduced incidents of aggressive behaviour, and contributed significantly to a risk management program.

Aged↗

PubMedDate not supplied

Stability of measures of the home environment for families of children with severe disabilities.

The stability of home environment in families of children with severe disabilities was investigated. Sixty-four families were assessed at three time points regarding aspects of their home environment. Family environment scale, home quality rating scale (HQRS) and home observation for measurement of the environment scores were collected at 7 and 9 years after the initial assessment. A remarkable degree of stability was observed, particularly for the FES. The median change score was zero for most subscales; no correlations differed significantly between the 7- and 9-year retests. A repeated measures MANOVA found a significant change in scores over time for only one subscale of the HQRS but none of the 10 FES subscales. Results suggest that, for the FES, administration of these measures every 2 years, perhaps less often, would be sufficient in longitudinal studies of this population. Internal consistency reliability of the FES was lower for these families than in the standardization samples, emphasizing the need to validate measures used with special populations.

California↗