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PubMed2002

[Might the cooperation with neuropediatricians improve the treatment of hearing impaired children: retrospective analysis of a small group of children with hearing aids].

QUESTION: Present analysis was performed to test the hypothesis, that cooperation with neuropediatricians might improve the treatment of hearing impaired children. STUDY-DESIGN: In a retrospective study 31 children (21 females, 10 males) with impaired sensorineural hearing (27 binaural, 4 monaural) and hearing aids were analyzed: - 12 children with profound and severe hearing loss (HL), median diagnostic age (mda): 8 months; - 15 children with moderate and mild HL, mda: 58 months and - 4 children with monaural HL, mda: 29 months. Neuropediatric examination included physical examination as well as psychometric testing. RESULTS: 1. Despite various medical efforts hearing impaired children are diagnosed very late in Germany. 2. About 65 % of the children exhibited neurodevelopmental deficits; about 25 % showed profound disabilities: 7 children with an IQ < 80, 1 child with ADHD (Attention Deficit Hyperactivity Disease) and 1 child with cerebral seizures. Analysis indicates that especially in children with developmental disabilities and only mild/ moderate hearing impairment the risk for additional neuropediatric diseases is increased. CONCLUSION: In the present study a high portion of hearing impaired children exhibited additional neuropediatric diseases. Thus the regular cooperation with a neuropediatrician might be helpful for diagnosis and further treatment. The risk for additional neuropediatric disabilities might be enhanced especially in those children, which have been diagnosed late or in cases with mild/moderate hearing impairment and profound developmental disabilities.

Age Factors↗
PubMed2002

Developmental language learning impairments.

Developmental language learning impairments (LLI) are one of the most prevalent of all developmental disabilities, can occur in children for a wide variety of reasons, and have been shown to co-occur frequently with other developmental social, emotional and behavioral disorders, as well as with academic achievement problems. Research pertaining to developmental LLI of unknown origin, with an emphasis on the continuum between oral and written language impairment, is the focus of this review. Given the complexity of language learning, research has focused on multiple levels of analysis, including linguistic, neuropsychological, genetic, neurobiological, and remediation studies. To date, the vast majority of data on LLI derive from studies focused on a single level of analysis. Although attempts have been made to integrate data across studies and multiple levels of analysis, this has proven to be problematic, given the heterogeneity of the subject populations used to study LLI, as well as the differences in ages, degree of impairment, and types of impairment included in each study. Given that LLI is a complex developmental disability, it is suggested that future research would benefit from taking a multiple levels of analysis approach with the same individuals, incorporating mathematical models designed to analyze dynamically changing complex systems, and studying individual differences in language learning, prospectively and longitudinally, throughout the most dynamic stages of the process.

Brain↗
PubMed2006

Patterns of aberrant eating among pre-adolescent children in foster care.

The paper reports epidemiological and phenomenological investigations of aberrant eating among 347 pre-adolescent children in court-ordered foster and kinship care, in New South Wales, Australia. A quarter of children displayed clinically significant aberrant eating problems, with no evidence of gender or age effects. Two distinct patterns were identified. The first is a pattern of excessive eating and food acquisition and maintenance behaviors without concurrent obesity (termed Food maintenance syndrome), resembling the behavioral correlates of Hyperphagic Short Stature (Psychosocial Dwarfism). Various data suggest this pattern is primarily triggered by acute stress, including maltreatment in care, against a background of complex psychopathology and developmental disabilities. The second is a cluster of pica-type eating behaviors that correlates with self-injurious behavior, and is closely associated with developmental disabilities. The paper includes recommendations for clinicians working with pre-adolescent children in care.

Child↗
PubMed2005

[An exploration of developmental screening tests for children].

Nurses are the first group of professionals to come into contact with infants. If they can use developmental screening tests effectively, they can be expected to make early identification of developmental disabilities in children. This review discusses developmental screening tests that have been developed in Taiwan to serve as a reference for nurses. It found that most of the developmental screening tests used in Taiwan have been modified from tools developed in Western countries and the norms are not suitable for current Taiwanese children. Even in the same country, it is still necessary to develop local norms in order to address cultural differences. A Taiwanese developmental test, the comprehensive Developmental Inventory for Infants and Toddlers, with norms developed through work on Taiwanese children, was published in 2002. But some well-known international tools are valid and easy to administer, and have been standardized in many countries. If the norms for Taiwanese children could be established for use with these international tools, then these tools could be used to compare developmental outcomes in different countries.

Child↗
PubMed1994

Behavioral momentum and stimulus fading in the acquisition and maintenance of child compliance in the home.

The provision of a series of requests to which compliance is highly likely (high-probability requests) immediately antecedent to low-probability requests has been used to establish behavioral momentum of compliance. We evaluated a fading procedure for maintaining high levels of compliance obtained with high-probability requests. Fading involved a systematic reduction in the number of high-probability requests and an increase in the latency between the high- and low-probability requests. High levels of compliance for both "do" and "don't" requests were maintained for 16 weeks in a 5-year-old boy with developmental disabilities after the high-probability request sequence was faded. Similar maintenance was obtained for "do" requests in a 15-year-old girl with developmental disabilities. For this subject, however, the high-probability request sequence was ineffective with "don't" requests. When "don't" requests were phrased as "do" requests, the high-probability request sequence produced high levels of compliance to the low-probability request. High levels of compliance to these "do" requests were maintained for 16 weeks after the high-probability request sequence was faded.

Journal Article↗
PubMedDate not supplied

Top researchers and institutions in mental retardation: 1979-1999.

The identification of leading researchers and institutions is important in clarifying expert resources in the area of developmental disabilities. We assessed productivity of authors and research institutions in this area. Journals were peer-reviewed, published in the English language, and were focused on developmental disabilities. Researchers were tabulated without regard to order of authorship. Results identified prominent leaders in research, the top 3 researchers accounting for a significant portion of research completed over the last 20 years. The majority of researchers identified were male and affiliated with university settings. Results also revealed a need for an increase in productivity across service delivery settings.

Female↗
PubMed1997

Mental retardation and domestic violence: an ecological approach to intervention.

The public and health and law enforcement professionals have finally become aware of the problem of domestic violence among community-dwelling women with developmental disabilities such as mental retardation. This article presents an ecological approach to analyzing factors that contribute to and maintain such abuse. Service needs of women with developmental disabilities who experience domestic violence as well as assumptions that should underlie treatment are addressed within an ecological framework. Assessment and individual and group intervention are discussed, including the development of a personal safety plan. A case example is provided.

Adult↗
PubMed1993

Elderly persons with mental retardation: an exceptional population with special needs.

The passage of recent legislation has ensured special service provisions for a previously overlooked population, elderly persons with mental retardation. This article presents a broad overview of current research studies on this topic and focuses on identification of the population, residential options, and service needs of elderly persons with mental retardation. Similarities and differences between older persons with developmental disabilities and the non-retarded elderly, and service need requirements of this particular population are also included. Finally, the importance of developing collaborative services of developmental disability agencies and aging services is discussed as well as recommendations for future research needs.

Aged↗
PubMed2005

Variation by disability in state predictors of Medicaid 1915c waiver use and expenditures.

PURPOSE: States are increasingly using the Medicaid 1915c waiver program to provide community-based long-term care. A substantially greater share of long-term-care dollars supports community-based care for individuals with intellectual and developmental disabilities, relative to older and working-age persons with primarily physical disabilities. DESIGN AND METHODS: We used state-level data for the period from 1992 to 2001 to estimate fixed-effects panel models. We compared state predictors of waiver utilization and expenditures for waivers serving both older and working-age individuals (O/WAIs) relative to waivers serving individuals with intellectual and developmental disabilities (IDDs). RESULTS: We found community-based-care capacity to predict use and expenditures for both target groups. Although regulation of institutional supply was positively related to expenditure measures for IDDs, it was not related to use or expenditures for O/WAIs. Demand variables (e.g., the size of a state's African American population) predicted use and expenditures for IDD waivers, but they were less consistent for O/WAI waivers. State resources were a robust predictor of use and expenditures for both groups. IMPLICATIONS: Increased community-based-care capacity appears to be an important factor in efforts to expand the availability of Medicaid community-based care. Federal policies that address state resource issues may also spur growth in community-based long-term care.

Community Health Services↗
PubMed2004

[Cooperation between medicine and education].

In cooperation between medicine and education, a reciprocal understanding is important. For this reason, we researched the needs of medical and educational professionals by questionnaires. Many child neurology specialists agreed that their medical profiled are unveiled in public about attending developmental disabilities. Some educational professionals felt it necessary to be given to offer medical informations of students such as treatments and/or diagnosis of their disease, to attend to seminars and lectures on developmental disabilities, and to obtain consultations of doctor more easily. From the above results, we propose an ideal cooperation between medicine and education.

Cooperative Behavior↗
PubMed1986

Issues in the treatment of mentally retarded patients in the community mental health system.

Developmental disability, particularly mental retardation, both affects a person's cognitive functioning and places that person on an alternative track of development which, when combined with social, political and economic pressures, places the developmentally disabled person at increased risk for mental illness. The presenting symptoms of mental illness will be modified by the mentally retarded person's cognitive impairment, personality development, and massively different life experience, as will the nature of his interactions with helping agencies. Evaluation, diagnosis and treatment must evolve from an alliance with the mentally retarded persons, not with caretaking agencies, and must be modified to take into account the retarded person's powerlessness. The therapist must be prepared to act as both advocate and bridge-builder for the patient, with the patient's increasing participation. The therapist must be prepared to steer between the Scylla of ignorance about the diagnosis and treatment of mental illness in the mentally retarded and the Charybdis of financial disincentives for human service agencies to collaborate in their care. The advantages of inter-agency cooperation in the treatment of dually-diagnosed individuals is described and illustrated.

Adult↗
PubMed1991

Establishing operations and reinforcement effects.

Positive reinforcement procedures have had a major impact on educational programs for the developmentally disabled; nevertheless, variation in reinforcer effectiveness both within and across individuals is a common phenomenon. This study examined one class of variables--establishing operations--that might influence the effectiveness of reinforcers. Five developmentally disabled adult males participated. Responding on one of two motor tasks--switch closure or block placement--was assessed during baseline, satiation, and deprivation conditions with respect to three classes of consequences: small food items, music, and social praise. Deprivation and satiation conditions were constructed so as not to alter significantly the normal course of events in a subject's day. For example, food deprivation entailed scheduling sessions just prior to a subject's regular lunch, and social deprivation involved limiting a subject's access to social interaction for 15 minutes, during which time the subject had access to an assortment of other activities. Results showed that each stimulus class functioned as reinforcement with different degrees of effectiveness during satiation versus deprivation conditions. These results are discussed in light of previous research on enhancement of reinforcer efficacy as well as the assessment and identification of functional reinforcers, and implications are presented for future research and client habilitation.

Adult↗
PubMed1991

Autistic features in Joubert syndrome: a genetic disorder with agenesis of the cerebellar vermis.

Recent reports in the literature have suggested a link between abnormalities of the cerebellar vermis and the behavioral syndrome of autism. Joubert syndrome is an autosomal recessive disorder characterized by partial or complete agenesis of the cerebellar vermis. However, there is little behavioral or psychiatric description of patients with this genetic condition. In this report, the neuropsychiatric characteristics of two children with Joubert syndrome are described in detail. One child met DSM-III-R diagnostic criteria for autistic disorder, while the other displayed autistic features. The female child displayed stereotypic behavior and impairments in social interaction and communication, had a markedly restricted repertoire of interests, and showed distress over changes in the environment. The male child demonstrated perseveration and preoccupation with sounds and textures, but had no abnormalities in social interaction. Although both children showed developmental disabilities, the degree of cognitive delay was significantly less than that described in previous reports of children with Joubert syndrome. This report adds to the growing body of evidence implicating cerebellar involvement in developmental disabilities and autistic behavior.

Autistic Disorder↗
PubMed1998

Institutional Review Board issues related to special populations.

The present article begins with an introduction to the role of Institutional Review Boards (IRBs) in research activities in general and proceeds to issues IRBs face with relation to special populations, including children and terminally ill individuals, as well as developmentally disabled and cognitively impaired persons. A historical overview of research with these special populations is included, and the report concludes with a real-world example of how IRB-related issues with developmentally disabled and cognitively impaired individuals are discussed and resolved.

Child↗
PubMed1999

Reliability of the Matson Evaluation of Social Skills in Individuals with Severe Retardation (MESSIER).

Recently, the concepts of social competence and social skills have become important aspects of the evolving definitions of mental retardation. However, no psychometrically sound instruments exist for assessing social skills in lower functioning developmentally disabled people. This study examined the psychometric properties of the Matson Evaluation of Social Skills for Individuals with Severe Retardation (MESSIER)--a new scale designed to measure social skills in adults with severe developmental disabilities. The authors conducted a preliminary evaluation of the test-retest and interrater reliability of the MESSIER. It was determined that the MESSIER has high stability across raters and good stability over time. In addition, good internal consistency was established with coefficient alpha. Potential uses for the scale and directions for future research are discussed.

Adult↗
PubMed2005

Between 'desperation' and disability rights: a narrative analysis of complementary/alternative medicine use by parents for children with Down syndrome.

This paper presents a narrative analysis of complementary/alternative medicine (CAM) use by parents for children with Down syndrome (DS), based on interviews conducted with thirty families. Critics often presume that CAM use for children with developmental disabilities reflects parental desperation in the face of limited biomedical options. Integrating insights from anthropological studies of CAM with narrative analyses in disability studies, we constructively complicate this interpretation in two ways. First, we suggest that the appeal of CAM may lie in its discursive consonance with the broader narrative strategies through which parents construct alternatives to conventional definitions of DS as a condition with a fixed, universal, and essentially pathological course. Second, we submit that the process of seeking and evaluating information about CAM is consonant with how parents construct their identities as 'good' parents through describing their roles as committed advocates and service coordinators for their children. In these ways, CAM can be conceptualized as a new discursive resource that parents engage in their culturally and historically specific efforts to articulate the essential human rights of their children, and to assert the moral soundness of their own parenthood. These findings provide a new conceptualization of parents' motives for choosing CAM, thereby posing new questions for further research about CAM use for developmental disabilities.

Anxiety↗
PubMedDate not supplied

Re-evaluation of constant versus varied punishers using empirically derived consequences.

Charlop, Burgio, Iwata, and Ivancic [J. Appl. Behav. Anal. 21 (1988) 89] demonstrated that varied punishment procedures produced greater or more consistent reductions of problem behavior than a constant punishment procedure. More recently, Fisher and colleagues [Res. Dev. Disabil. 15 (1994) 133; J. Appl. Behav. Anal. 27 (1994) 447] developed a systematic methodology for predicting the efficacy of various punishment procedures. Their procedure identified reinforcers and punishers (termed "empirically derived consequences" or EDC) that, when used in combination, reduced the destructive behavior of individuals with developmental disabilities who displayed automatically maintained destructive behavior. The current investigation combines these two lines of research by comparing the effects of constant versus varied punishers on the self-injury of two individuals with developmental disabilities. The punishing stimuli were selected via the procedures described by Fisher et al. and were predicted to be at varying levels of effectiveness. The varied presentation of punishers resulted in enhanced suppressive effects over the constant presentation of a punisher for one of two individuals, but only in comparison to a single stimulus predicted to be minimally effective. Even then, the differences were small. These results suggest that the additive effects of varied punishment are negligible if clinicians use stimuli predicted to be effective and are discussed in terms of the conditions under which stimulus variation could potentially enhance the effects of punishers.

Adolescent↗