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Results for “Developmental Disabilities”

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PubMed2003

National survey of sexual behavior and sexual behavior policies in facilities for individuals with mental retardation/developmental disabilities.

To obtain information regarding sexual behavior and related policies in state residential facilities for individuals with mental retardation/developmental disabilities, we sent surveys to 168 members listed in the Association of Public Developmental Disabilities Administrators 1998-1999 directory. Response rate was 68.5%. For the 46 facilities where 50% or fewer of clients had profound retardation, sexual relations between clients was reported to occur "sometimes" or "often" by 29 (63%). Six of 115 (5.2%) administrators reported at least one client with a sexually transmitted disease (STD) in the past year. Of 110 instances of sexual abuse reported, the perpetrator was another client in 63% of cases. Ninety-six percent of administrators (n = 110) reported their facility had written guidelines concerning sexual abuse. Careful monitoring of STDs and the effectiveness of sex education will be instrumental in preventing HIV/STDs and helping prevent sexual abuse in this vulnerable population.

Adolescent↗

PubMed2006

Games that "work": using computer games to teach alcohol-affected children about fire and street safety.

Unintentional injuries are a leading cause of death and disability for children. Those with developmental disabilities, including children affected by prenatal alcohol exposure, are at highest risk for injuries. Although teaching safety skills is recommended to prevent injury, cognitive limitations and behavioral problems characteristic of children with fetal alcohol spectrum disorder make teaching these skills challenging for parents and teachers. In the current study, 32 children, ages 4-10, diagnosed with fetal alcohol syndrome (FAS) and partial FAS, learned fire and street safety through computer games that employed "virtual worlds" to teach recommended safety skills. Children were pretested on verbal knowledge of four safety elements for both fire and street safety conditions and then randomly assigned to one condition. After playing the game until mastery, children were retested verbally and asked to "generalize" their newly acquired skills in a behavioral context. They were retested after 1 week follow-up. Children showed significantly better knowledge of the game to which they were exposed, immediately and at follow-up, and the majority (72%) was able to generalize all four steps within a behavioral setting. Results suggested that this is a highly effective method for teaching safety skills to high-risk children who have learning difficulties.

Child↗

PubMed2003

Effectiveness of the ISAAC cognitive prosthetic system for improving rehabilitation outcomes with neurofunctional impairment.

Cognitive rehabilitation has the capacity to empower persons with brain-injuries and help them achieve heightened functional, personal, and social interactions within their environments. Interventions aimed at compensation for deficits and adaptation to cognitive disability can be aided through the use of assistive technology devices (ATD's). ATDs allow for their users to experience greater levels of independence, as well as social and vocational participation, which leads to a higher quality of life. The ISAAC system is a small, individualized, wearable cognitive prosthetic assistive technology system. Being fully individualized and very easy to use makes this system adaptable to, and appropriate for, patients with a wide variety of cognitive disabilities ranging from individuals with developmental disabilities to high functioning survivors of brain injury. The current article will discuss two cases that illustrate the effectiveness of the ISAAC system in assisting patients with generalization of rehabilitation to their home environments. Both patients incurred significant cognitive impairment, for which they were able to successfully compensate with the assistance of their ISAAC systems. These two case studies are typical examples of the functional independence that can be achieved through the use of the ISAAC system. When patients are properly selected for use of this system, appropriate content is authored, and sufficient training on the system is provided, the ISAAC system can prove very effective at improving patients' functional independence.

Adult↗

PubMed1977

Sensorimotor organization in reach and prehension: a development model.

A model is presented to depict the organization of the reflex, visual, voluntary motor, and perceptual-cognitive systems in the development of reach and prehension during the first year of life. Five components of hand skills are identified based upon a review of infant scales and observational studies, and the sequential occurrence of behaviors leading to the development of these components is graphically presented. These sequences are juxtaposed to enable the reader to view the temporal relationship of the systems at various stages in the development of reach and prehension in the infant. Items in the models are operationally defined. An explanation is included to clarify the nature and the sequence of events involved in the culmination of mature hand skills. The model should be useful in the identification, analysis, and remediation of deficits in reach and prehension often noted in children with developmental disabilities.

Child Development↗

PubMed1997

An economic analysis of developmental detection methods.

OBJECTIVE: To assess the costs and benefits of various approaches to early detection of developmental disabilities. DESIGN: Cost-benefit analyses based on data from previously published studies of developmental screening tests. SETTING: General pediatric practices and day care centers. PATIENTS AND OTHER PARTICIPANTS: A total of 247 parents and their 0- to 6-year-old children-103 from day care centers and 144 from pediatric practices. MAIN OUTCOME MEASURES: Licensed psychological examiners administered a screening test of parents' concerns about children's development and one or two direct screening tests: the Denver-II and/or the Battelle Developmental Inventory Screening Test. For the day care sample, examiners also administered to each child measures of intelligence, adaptive behavior, and language. In the pediatric sample, children were administered additional assessments. At the same time, diagnostic measures were administered to a randomly selected subsample to make determinations about developmental status. Each screening method was evaluated for its short-term costs (administration, interpretation, diagnosis, and treatment) and long-term benefits (impact of early intervention on adult functioning as inferred from longitudinal studies by other researchers). RESULTS: When the long-term costs and benefits were considered, none of the approaches emerged as markedly superior to another. When viewing the short-term costs, the various screening approaches differed markedly. The use of parents' concerns was by far the least costly for physicians to administer and interpret. CONCLUSION: Physicians can incur tremendous expenses when attempting to detect children with developmental problems. Although the benefits of early detection and intervention are substantial, physicians are not well-compensated for providing a critical service to society. Health policymakers and third-party payers must reconsider their minimal investment in early detection by health care providers. Nevertheless, our findings have encouraging implications for practice, because the use of parents' concerns as a screening technique offers substantial savings over and above other methods.

Child↗

PubMed2005

Very preterm birth is associated with disabilities in multiple developmental domains.

OBJECTIVE: Follow-up studies in very preterm children usually present outcome for separate developmental domains. Presence of disabilities in more than one developmental domain will show a more serious outcome picture for extreme preterm infants and may be related to a different degree of perinatal problems. METHODS: At 5.5 years corrected age, outcome in the neurological, motor, cognitive, and behavioral domain was studied in 157 children born < 30 weeks gestation. The children were divided into a normal, a single, or a multiple disability group. Group differences in background, clinical characteristics, and neurodevelopmental outcome at 2 years were evaluated. RESULTS: Thirty-nine percent had a normal developmental outcome, 17% had a single disability, and 44% had multiple disabilities. Multiple disabilities were associated with lower birth weight, BPD, and difficulties according to neurodevelopmental assessments at 2 years. CONCLUSION: Assessments of different developmental domains show that most very preterm children had multiple disabilities.

Achievement↗

PubMed1994

Screening test battery for assessment of psychosocial development.

A multicentric cross-sectional collaborative study was undertaken in 3 centres in India with the main aim of developing simple and reliable indicators for the early detection of developmental disabilities in children under 6 years of age and to compare the age of attainment of developmental milestones in children in the three regions. The study provided a simple low-cost and culture-appropriate psychosocial developmental screening test battery which can be used with ease by trained public health grass-roots functionaries. This instrument was standardized on a large rural, tribal and urban sample comprising more than 13,000 children from 3 regions in India. The procedure for sampling, selection of items and methodology for standardization of the instrument in the Hyderabad region detailed in this paper were replicated in other centres as well. Quality control of data was ensured through inter-rater and test-retest measures of reliability. During pre-testing, 66 culture-appropriate milestones were selected finally from a larger item pool. The 50th centile age reference values of the Hyderabad study children and those obtained by other 2 centres were comparable.

Aptitude Tests↗

PubMedDate not supplied

Nurses' utilization of parent questionnaires for developmental screening.

In the United States it is estimated that 16% of children are affected by developmental disabilities (American Academy of Pediatrics, 2001). Unfortunately, national statistics indicate that fewer than 30% of children with developmental or behavior problems are identified prior to entering kindergarten (Glascoe & Macias, 2003). Early Intervention studies and research on brain development have demonstrated the short and long-range benefits of early identification of developmental delays and intervention in the preschool years (Glascoe & Macias, 2003). During the past decade several studies have validated the use of parent questionnaires that screen for developmental delays. The nurse in a clinic, private office, or community health center should become familiar with the vast array of developmental screening tools. With this knowledge, the nurse can become the champion of change in selecting and incorporating the best tools for the systematic screening of children for developmental delay, as part of the well-child check-up.

Child, Preschool↗

PubMedDate not supplied

Nonorganic failure to thrive: developmental outcomes and psychosocial assessment and intervention issues.

Serious growth problems, such as Nonorganic Failure to Thrive (NFTT), place an infant/toddler at significant risk for poor developmental outcomes. Evidently, an NFTT child's malnutrition and subsequent poor growth and development are accentuated by a family context of impoverishment, dysfunctional relationships, inadequate education, and a dearth of developmentally enriching experiences. The purpose of this review is to describe NFTT, to present development outcomes, and to discuss psychosocial assessment and intervention issues relevant to this developmental disability of early childhood. An ideographic approach to case conceptualization, evaluation, and treatment is suggested to achieve successful developmental outcomes and to guide research endeavors.

Adolescent↗

PubMed1989

Developmental problems in children with HIV infection.

The majority of children with symptomatic HIV infection present with a variety of neurodevelopmental impairments, including mental retardation and motor abnormalities. Their clinical courses vary widely, with some infants showing progressive deterioration during the first year of life whereas some children follow a static course until adolescence. Rehabilitative services must be established to meet the complex needs of this growing population of children with developmental disabilities.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Health needs of adults with intellectual disability relevant for the family physician.

People with developmental disability, mental retardation, or intellectual disability are living longer and becoming prone to age-related health problems and diseases of old age much like the general population. This worldwide trend is also seen in Israel, where today 39.8% of persons with intellectual disability in residential care are 40 years old and above. There is a need for service and staff providers to receive training; a need for more research and better service for this aging population. This review presents health concerns for older persons with different levels of intellectual disability, health concerns in persons with Down syndrome, and persons with epileptic seizures and cerebral palsy in relation to general practice and family medicine. The review is concluded with recommendations on health and aging in adults with intellectual disabilities and the call for formalized training in the topic for specialists in family medicine.

Adult↗

PubMed1987

Measuring infant movement. Clinical and technological assessment techniques.

Assessment of infant movement patterns is an important evaluation component in the early identification and management of high-risk and handicapped infants. Differences in infant movement patterns may provide early clues to the diagnosis of cerebral palsy and other developmental disabilities. The ultimate goal of early identification of movement disorders is the provision of early intervention services, such as developmental physical therapy. Qualitative analysis of infant movement differences can assist the clinician in developing treatment strategies aimed at facilitating normal movement patterns during the critical period of early central nervous system plasticity. This article presents four measurement strategies for quantifying such qualitative differences. Three clinical assessment tools--the Movement Assessment of Infants, the Bayley Motor Scale, and the Peabody Developmental Motor Scales--are described. Finally, new technological advances for kinematic analysis of infant movement are presented.

Child Development↗

PubMed2002

Developmental anomalies and disabilities associated with hypospadias.

PURPOSE: The incidence of developmental anomalies and disabilities associated with hypospadias is still a matter of controversy and data on this issue are sparse. We describe our experience with and evaluation of developmental anomalies and disabilities in a population in which posterior hypospadias was the most common anomaly. MATERIALS AND METHODS: We reviewed the records of 356 patients who underwent hypospadias repair from January 1986 through April 2000. Collected data included the Barcat classification of the hypospadias anomaly, anatomical penile variants, associated urogenital and extra-urogenital anomalies, and associated disabilities of physical and mental development. RESULTS: Of the 356 patients 234 (65.7%) had posterior, 88 (24.7%) anterior and 34 (9.6%) mid hypospadias. Anatomical variants, including penoscrotal transposition, bifid scrotum and micropenis, occurred predominantly in patients with posterior hypospadias, while penile torsion was present exclusively in the other 2 groups. Inguinal hernia, which was the most common urogenital anomaly, was distributed evenly among the 3 groups with a prevalence rate of 12.4%. Undescended testis in 26 cases (7.3%) was most often associated with posterior hypospadias. In order of frequency associated extra-urogenital anomalies included congenital heart disease in 19 cases (5.3%), musculoskeletal anomalies in 11 (3.1%), anorectal malformation in 6 (1.7%), cleft palate in 3 and other in 7. In 21 patients (5.9%) associated disorders were related to physical and mental development, including growth retardation in 6, cerebral palsy in 2 and psychological disorders that significantly impaired patient bodily function, behavior and performance in 11. Most extra-urogenital anomalies or disorders were associated with posterior hypospadias. CONCLUSIONS: Posterior hypospadias was the most common anomaly in this study. It was associated with a high rate of extra urogenital anomalies, and physical and psychosocial disabilities. The significance of the latter findings with respect to the development of affected patients needs further clarification.

Abnormalities, Multiple↗

PubMed1999

Responding to the developmental consequences of genetic conditions: the importance of pediatric primary care.

This article characterizes the critical role of the primary care physician in the identification, initial evaluation, and management of children with developmental disabilities. Problems of definition and epidemiology are reviewed and linked to issues of referral and eligibility for services and supports. Developmental screening methods afford opportunities for early identification, whereas chronic condition management in primary care defines a more explicit role for the pediatric primary care provider.

Child↗

PubMed1998

Promoting good health in adolescents with disabilities.

The recent attempts to implement the 1990 Americans with Disabilities Act underscore the necessity for promoting good health in adolescents with disabilities. This article addresses the reasons why this concern has not been recognized and explores the concepts of good health, habilitation, and the effects of assistance in encouraging independence for youths with developmental disabilities. The article discusses how mobility, education, family adjustment, social relationships and sexuality, and emotional adjustment to adolescence influence health adjustment. Social work implications suggest a holistic approach emphasizing the concepts of youth and family empowerment and quality of life as the key professional endeavors in practice with youths with disabilities.

Adolescent↗

PubMed2005

The PAS-ADD Checklist: independent replication of its psychometric properties in a community sample.

BACKGROUND: The development of reliable, valid measures of psychopathology in people with intellectual disabilities is an important task. However, independent replication studies are rarely reported. AIMS: To report data on the psychometric properties of the Psychiatric Assessment Schedule for Adults with Developmental Disabilities (PAS-ADD) Checklist. METHOD: The PAS-ADD Checklist was completed for 226 adults as part of the assessment process for a specialist mental health service for people with intellectual disabilities. RESULTS: Internal consistency was acceptable. Factor analysis revealed one main factor that was characterised by items related to mood. The Checklist was sensitive to differences between diagnostic groups and had an overall sensitivity of 66%; its specificity was 70%. CONCLUSIONS: The PAS-ADD Checklist is a quick and easy to use screening tool. Although at present it is the best measure available, it should not be the only method used to identify psychiatric disorders in people with intellectual disabilities.

Adult↗

PubMedDate not supplied

The E.K. Shriver Center at the University of Massachusetts Medical School.

The UMMS Shriver Center promotes an understanding of typical and atypical neurological, cognitive, and behavioral development, emphasizing mental retardation. To accomplish its mission, the Center conducts basic and applied research to determine the biological and environmental factors that influence development and provides training and service programs that directly benefit people with developmental disabilities and their families.

Academic Medical Centers↗

PubMed1985

The diagnostic value of the neurodevelopmental examination.

The neurodevelopmental examination is a pediatric approach to developmental diagnosis that relies on evaluation of multiple streams of development. The value of the neurodevelopmental examination for the early diagnosis of cerebral palsy and mental retardation was studied by a retrospective analysis of prospectively (longitudinally) collected data. Both conditions were found to be accurately diagnosed in the first year of life. For cerebral palsy, sensitivity was 0.81 and specificity 1.00; for mental retardation, sensitivity was 0.56 and specificity 0.96. The trained pediatrician can make early diagnoses of developmental disabilities.

Cerebral Palsy↗