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Results for “Developmental Disabilities”

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PubMed1994

Seroprevalence of hepatitis A antibodies among residents of a centre for people with developmental disabilities.

BACKGROUND: In February 1993, 11 cases of hepatitis A virus (HAV) were identified in permanent residents of a centre for young people with developmental disabilities. AIMS: To define the extent of the outbreak in the centre, to determine the seroprevalence of hepatitis A antibodies (anti-HAV) in permanent residents, and to ascertain risk factors for serological evidence of HAV infection. METHODS: A cross-sectional serological survey of 270 permanent residents, aged eight to 40 years, in a centre for people with developmental disabilities, was conducted in western Sydney. Using a radioimmunoassay technique, sera were tested for anti-HAV (IgM and total antibody). We used logistic regression to determine risk factors for presence of anti-HAV. RESULTS: Blood samples were collected from 259 permanent residents (96%). Serological testing revealed anti-HAV in 128 residents tested (49%). Presence of anti-HAV was associated with living in specific residential units, and with residents' age and length of stay at the centre, but was not associated with reported behavioural factors. CONCLUSIONS: More than half of the residents of the centre were susceptible to HAV infection. Behavioural characteristics of the residents and their close contact with each other make HAV transmission difficult to control. HAV vaccine should be promoted in communities at risk, such as those with developmental disabilities.

Adolescent↗

PubMedDate not supplied

A family systems look at the developmentally disabled.

In summary, families of the developmentally disabled need to be looked at in terms of their system wholeness. Interacting elements of the subsystems have unique concerns and coping styles. Psychiatric nurses are in a key position in the mental health scene to assess these coping styles and to offer compassion, understanding, knowledge, and needed resources to assist these overburdened families to move in the direction of openness, growth, and health.

Adaptation, Psychological↗

PubMed1991

Friendship among adults who have developmental disabilities.

The difference between people with developmental disabilities who did and did not have peer-group friends was investigated by interviewing 36 adults attending day centers. Those with a friend were significantly more likely to describe themselves positively on all dimensions. Results showed that people without a peer-group friend were similar to lonely people without disabilities on two of the three factors explored. Qualitative analysis of subjects' descriptions of their friends suggested that most of the people interviewed had relatively shallow relationships.

Adult↗

PubMed1995

An evaluation of care coordination in controlling inpatient hospital utilization of people with developmental disabilities.

All admissions of people with developmental disabilities to a community hospital over 3 years were examined to evaluate the impact of a coordinated care model on length of stay and hospital charges. Admissions were divided into two groups, those receiving either coordinated care (program group) or routine care by community physicians (usual care group). The program group had shorter average lengths of stay and lower hospital charges than did the usual care group, especially when charges were adjusted for case mix. Similarity of severity across the groups was measured by number of discharge diagnoses and Medicaid case weights. Over the 3 years, for the 115 admissions in the program group, these differences amounted to more than $200,000 in potentially unnecessary hospital charges. Implications of care coordination services for community-based health care planning were presented.

Adolescent↗

PubMed1979

The effect of developmental disabilities on mental health.

Behavioral abnormalities in the developmentally disabled child are usually ascribed to parental mismanagement of a child perceived as abnormal. (Review of the available data points to the existence of primary behavioral abnormalities due directly to the cerebral dysfunction.) This has important implications for parental counseling and management.

Autistic Disorder↗

PubMed1997

A nutritional rehabilitation program for persons with severe physical and developmental disabilities.

Our purpose was to design and implement a nutritional rehabilitation program for persons with severe developmental disabilities who resided in a long-term-care facility or a group home. We used weight for height (WH) to classify residents of both facilities into three groups: group 1 (n=32), WH less than 5th percentile (Z scores < or = -1.650), goal=gain weight; group 2 (n=21), WH between the 5th and 85th percentile (Z scores ranging from -1.645 to +1.030), goal=maintain present rate of weight gain; and group 3 (n=8), WH greater than 85th percentile (Z scores > or = +1.036), goal=slow down rate of weight gain. The challenge in all groups was to bring about these changes without increasing the quantity of food (as assessed by 3-day food records) fed to the residents and to increase their fluid intake. For each subject, the project dietitian developed individualized menus that specified quantities and consistencies of food. Foodservice delivery was changed to a centralized system in the long-term-care facility to allow for closer control of the subjects' intake. A dietitian monitored the program with biweekly visits to the wards and frequent consultation with staff. Only a limited increase in fluid intake was noted; however, after 6 months of the program, the other goals were met. Our results suggest that nutritional rehabilitation of residents with developmental disabilities is enhanced by the involvement of a dietitian.

Adolescent↗

PubMed1985

Nutrition intervention in developmental disabilities: an interdisciplinary approach.

The nutritional status of developmentally disabled persons is influenced by variables infrequently encountered in normal nutrition. The multitude of factors requires an approach to care that must incorporate information and assistance from a variety of disciplines. A model for viewing the network of variables is proposed as a tool for identifying voids in nutrition care and for developing appropriate plans that include interdisciplinary interactions for those persons with special needs.

Adolescent↗

PubMed1999

Gynecological health care for adolescents with developmental disabilities.

The gynecological health care of adolescents with developmental disabilities presents a unique challenge to care providers. Adolescence is a time of turmoil for many girls and for adolescents with special needs it may seem overwhelming. Patients, their parents and their caregivers need special attention during these changes in their lives. This chapter focuses on how to perform a reproductive health evaluation focusing on the history and physical exam, especially the pelvic exam. Menstrual hygiene and menstrual abnormalities are discussed in detail. Other topics include abuse and abuse prevention, contraception, and cyclical behavior changes. Patience, persistence, and adaptation of the usual examination techniques can lead to a thorough and balanced assessment of the patient and help her, her parents, and her caregivers with the challenges of adolescence.

Adolescent↗

PubMed1999

Amnestic syndrome presenting as malingering in a man with developmental disability.

The authors report an unusual presentation of amnestic syndrome mislabeled as malingering in a man with mild developmental disability. The case highlights the challenges to medical personnel in treating persons who visit emergency rooms often, particularly individuals with mental retardation. Diagnostic overshadowing was a primary factor in the failure to diagnose amnestic syndrome. Overshadowing occurs when a patient's problematic behaviors are attributed to mental retardation, and no attempt is made to search for the root causes of the problem. The case also highlights the need for emergency room personnel to maintain links with agencies involved in the day-to-day care of persons with developmental disabilities.

Amnesia↗

PubMed1993

Survey of community adjustment of previously institutionalized developmentally disabled persons.

A survey was conducted of the community adjustment of 108 developmentally disabled (mentally retarded) persons who had spent at least three years in an institution in southeastern Ontario. On average, they had resided 3.5 years in the community, were 40 years of age, with a mental age of five years and a median IQ of 41, and most had one or more moderate to severe physical disabilities. During their most recent year living in the community it was found that their daily living skills remained unchanged compared with their skill level in the year prior to community placement. As well, the community staff rated them as average in level of performance and amount of supervision required compared with others of similar ability. About one third were found to have a moderate to severe behavioural/psychiatric problem with aggressive disruptive behaviour being most frequent. Of the two-thirds capable of being interviewed, over three-quarters expressed satisfaction with their present living, work, education and recreation environment and had no desire to return to the institution. Most had few if any meaningful relationships with non developmentally disabled persons other than caregivers. Support agency staff and psychiatric consultants identified additional service needs for those with behavioural/psychiatric problems who may be placed in the community.

Activities of Daily Living↗

PubMed1992

Hepatitis C virus seroprevalence in the developmentally disabled.

BACKGROUND: Hepatitis C virus (HCV) is the principal cause of nonenteric non-A, non-B hepatitis worldwide. While it has been well documented that people with developmental disabilities are at an increased risk for infections with hepatitis B virus, little is known of the prevalence of HCV infection among this population. METHODS: Serum samples obtained from 113 evaluable outpatients with developmental disabilities at one center in suburban New York City (NY) were tested for antibodies to HCV and hepatitis B core antibody. RESULTS: None of the 113 samples tested positive for HCV antibody by enzyme-linked immunosorbent assay, whereas 24 (21%) showed serologic evidence of past hepatitis B virus infection on the basis of hepatitis B core antibody positivity. Three (2.7%) were also positive for hepatitis B surface antigen. CONCLUSIONS: In contrast to hepatitis B virus, HCV infection is uncommon among outpatients with developmental disabilities in suburban New York City. Further testing for HCV is indicated to determine if these results can be generalized to individuals within institutions, or to individuals in other geographic locations.

Adult↗

PubMed1992

Teaching child-care skills to mothers with developmental disabilities.

The present study identified and remediated child-care skill deficits in parents with developmental disabilities to reduce their risk of child neglect. Eleven mothers with developmental disabilities who were considered by social service and child welfare agencies to be providing neglectful child care were found in baseline to have several important child-care skill deficits (e.g., bathing, diaper rash treatment, cleaning baby bottles) compared to nonhandicapped mothers. Parent training (consisting of verbal instructions, pictorial manuals, modeling, feedback, and reinforcement) resulted in rapid acquisition and maintenance of child-care skills in all mothers. Mean percentage correct scores increased from 58% in baseline to 90% in training and 91% in follow-up (M = 31 weeks). The latter two scores compare favorably to the mean score (87%) of 20 nonhandicapped mothers on the same skills. Where observable, parent training was associated with corresponding benefits to the children (e.g., elimination of diaper rash and cradle cap, increased weight gain, successful toilet training). These results indicate that parent training may be a viable option to the removal of the child from the home when parenting skill deficits place the child's well-being in jeopardy.

Adult↗

PubMed1999

[A study on incidence of developmental disabilities in Higashi-Osaka City, Japan, 1988-1992].

A population based statistical analysis was performed of the incidence of developmental disabilities in Higashi-Osaka, a city in Osaka Prefecture with a population of about 500,000. The number of live births during 1988-1992 was 24,980, of whom those with cerebral palsy (CP), severe motor and intellectual disability syndrome (SMIDS), infantile autism, mental retardation (MR) and Down syndrome numbered 30, 21, 26, 268 and 25, respectively. And the respective incidence rates per 1,000 were 1.20, 0.84, 1.04, 10.7 and 1.0. For CP, the percentage of premature children was 63%, higher than in previous reports. Extremely low-birth-weight premature children (< 999 g birth weight) were especially notable at 20% of the CP total. For SMIDS, it is more important to understand the significance of medical care to support sufferers' social lives. High functional autistic children could not be evaluated at our center, though autism accounted for 8.6% of mental retardation. The medical functions of community institutions enable them to perform continuous, population based study of the incidence and situation of developmental disabilities.

Community Health Services↗

PubMed1989

The developmentally disabled elderly: concerns of service providers.

We examined the availability of services for the developmentally disabled elderly and the concerns expressed by the service provider. We compared agencies which traditionally served individuals with developmental disabilities versus those serving the elderly populations. Although both types of agencies recognized the need for services, concern was raised as to who would provide them and how the two groups would blend.

Aged↗

PubMed1996

Measurement of growth in children with developmental disabilities.

The clinical assessment of growth is a challenging, but essential, aspect of managing the health care of children with developmental disabilities. However, with standard equipment, modest training and some patience, almost all children can be measured reliably. Once reliable measurements are obtained, the interpretation or 'clinical meaning' of the measurements depends on their comparison with reference data from normal populations or, when available, with condition-specific reference data. More research is needed to improve our understanding of the clinical meaning of obtained measurements. The range of normal growth for some children with disabilities, particularly CP, remains to be defined. Research in the next ten years will, hopefully, lead to the development of growth charts for children with CP, and perhaps children with other conditions, which will facilitate the clinical interpretation of growth data and lead to improved management of health care for children with developmental disabilities.

Adolescent↗

PubMed1999

Twelve years later: adjustment in families who adopted children with developmental disabilities.

In most studies positive outcomes for families who have adopted children with developmental disabilities have been described. In this previous research, however, investigators have examined primarily short-term adjustment. In contrast, in the current longitudinal investigation 9 years after an initial interview, we assessed the adjustment and functioning of families who have adopted children with developmental disabilities. Results indicate that nearly 12 years after their adoptions, families remaining in the study reported generally positive outcomes and good adjustment to their adopted children. Whereas there were changes in these families, especially as the children approached adolescence and early adulthood, these changes were perceived as potential sources of reward as well as sources of stress.

Adaptation, Psychological↗

PubMed1999

Quality of health care for people with developmental disabilities: the challenge of managed care.

Health care quality issues for people with developmental disabilities under managed care were explored. Health-related quality was defined in terms of four domains: structure, process, outcome, and satisfaction. Three general problems in the assessment of health care quality were identified: lack of quality measures, patient response problems, and lack of system elements. Selected current measurement systems were described in relation to their use for people with developmental disabilities. An approach to developing quality measures was outlined using Healthy People 2000, Health Plan Employer Data Information Set, and clinical practice issues. The movement toward quality improvement was examined and recommendations presented for steps in developing and measuring health care quality.

Forecasting↗

PubMed1982

Integration of the plantar grasp reflex as an indicator of ambulation potential in developmentally disabled infants.

The integration or lack of integration of the plantar grasp reflex, as tested in supported standing, was investigated in 26 developmentally disabled infants and was related to the attainment of independent ambulation without assistive devices. All infants who displayed integration of the plantar grasp reflex later developed independent ambulation. Thirteen infants did not display integration of the reflex during three to five years of follow-up. Of those 13 infants, only 1 achieved independent ambulation. This preliminary clinical investigation provides evidence of the prognostic value of the presence or absence of the plantar grasp reflex as an indicator of ambulation potential in developmentally disabled infants.

Developmental Disabilities↗