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PubMedDate not supplied

Grandparents of children with developmental disabilities: perceptions, beliefs, and involvement in their care.

This exploratory study evaluated the perceptions and beliefs of grandparents regarding their grandchild with a developmental disability and their involvement in his/her care and the impact of the child's disability on their lives and on their relationship between them. The sample included 16 grandparents of children with a severe developmental disability ranging in age from 5-10 who were studying in a special school. Data was collected by using semistructured interviews in the home of the grandparents. The findings indicated that grandparents' involvement and satisfaction with their role were a function of their attitudes towards disabilities in children in general and their relationship with their adult children, as well as their own life experiences. Their involvement with their grandchild with developmental disability served to strengthen the relationship between the grandparents. An important implication of the study is that professionals should plan interventions to support and encourage grandparents to be more involved in the care of the child with developmental disability.

Aged↗
PubMed2006

Personality, coping style and well-being of parents rearing children with developmental disabilities.

BACKGROUND: Parents with children with developmental disabilities (DD) encounter a variety of stressors associated with rearing their children and must develop effective coping mechanisms in order to adapt successfully to these challenges. Previous research has failed to establish the role of parental individual differences in the reported use of different coping strategies. The current study explores parental personality and whether children with DD were adopted or born into the families and their influence on the coping strategies used by mothers and fathers. METHODS: A total of 97 mother-father dyads rearing at least one child with DD were participants. They narrated stressful situations related to their child and completed the Ways of Coping Questionnaire twice. Data were also collected with regard to personality, depression and subjective well-being (SWB). RESULTS: Both adoptive and birth mothers and fathers used more problem-focused than emotion-focused strategies. Personality factors, Neuroticism especially, were predictive of coping strategy use. Higher levels of Positive Reappraisal were associated with higher levels of SWB, whereas higher levels of Escape-Avoidance were associated with lower levels of SWB, but only for mothers. Results were consistent with a dispositional model of strategy use in that frequency of use was associated with personality characteristics, was consistent over time, and for different children in the same families. Future research should focus on the persistence of the associations between strategy use and well-being and whether they hold true at different stages of the lifespan when coping contexts may change quite dramatically.

Adaptation, Psychological↗
PubMed1991

Educating physicians for contemporary responsibilities in the field of developmental disabilities.

In 1977, an academic division concerned with developmental disabilities was established in the Department of Psychiatry at Queen's University in Kingston, Ontario. This paper describes the division's educational programs for undergraduate and post-graduate students. Reference is made to the resources (i.e. faculty, practicum settings) and the curricula required. Both are considered in relation to published information on such endeavours. The contemporary public policy for shifting the care of persons with developmental disabilities from institutions to the community is noted. Successful implementation of this policy depends in part on preparing physicians to meet the challenges of providing medical and psychiatric care in mainstream health care services.

Child↗
PubMed2006

Health outcomes of midlife and older Latina and black American mothers of children with developmental disabilities.

The impact of caring for a child with a developmental disability on the physical and mental health of Latina and Black American women was examined. We used the National Health Interview Survey to compare the health of older mothers who were co-residing with a child who had a developmental disability to the health of same age mothers without caregiving responsibilities. Findings show that for both groups, older adult caregivers were more likely to report having limitations from arthritis than their noncaregiving counterparts. Caregiving was associated with more depressive symptoms for Latinas, but this relationship was not found for Black American women. Findings suggest that physical and mental health of caregivers need more attention in research and practice.

Adolescent↗
PubMedDate not supplied

Using participant observation to study the meaning of occupations of young children with autism and other developmental disabilities.

Understanding the individual meaning of daily activities for children with developmental disabilities such as autism is both important and challenging for researchers and practitioners. Rigorous participant observation offers a method for developing this knowledge base by including the child's perspective. Through literature and examples from an ethnography of young children with autism, this article illustrates the application of participant observation to children with developmental disabilities. Specific strategies can promote valid interpretations despite developmental, linguistic, and perceptual differences between adult researchers and child participants.

Adult↗
PubMedDate not supplied

The quality of health care for adults with developmental disabilities.

OBJECTIVE: The purpose of this study was to determine the health status of adults with developmental disabilities residing in community settings and the quality of the preventive, medical, dental, and psychiatric services they receive. METHODS: Data were collected on a sample of 353 adults residing in Los Angeles, California, in 1997. Historical data were obtained from study subjects or caregivers, physical and dental examinations were performed, blood was drawn for analysis, and a psychiatrist reviewed medical records for reports of psychiatric diagnoses and consultations. RESULTS: Health markers, such as rates of obesity, and laboratory test results of routine screening panels including blood cell counts, hemoglobin, and hematocrits; blood concentrations of liver enzymes and other enzymes, cholesterol, and tryglycerides; and urinalyses were within normal limits for an adult population. However, preventive services were notably lacking, especially for individuals living at home. Fewer than half of the study subjects had received influenza vaccine; only a third of those living alone or with family or friends had received this vaccination. Chart audits revealed that about a third received psychotropic medications, but only 24% of these individuals had psychiatric consultations noted in their record. Further, 36% of this medicated group received psychotropic drugs without any identifiable diagnosis, and simultaneous receipt of two or more antipsychotics was not uncommon. CONCLUSIONS: Given that the U.S. health care system fails to ensure the provision of preventive services for all people, including the developmentally disabled, a systematic overhaul is necessary to establish an effective quality assurance program that will provide preventive medical, dental, and psychiatric services for people with developmental disabilities.

Activities of Daily Living↗
PubMed2004

Behavioral interventions to reduce the pica of persons with developmental disabilities.

The consumption of nonfood items (i.e., pica) frequently occurs in persons with developmental disabilities. Pica may result in the puncture or blockage of the digestive tract, infestation by gastrointestinal parasites, and can interfere with an individual's daily learning, occupational performance, and quality of life. Twenty-six published studies have examined the efficacy of behavioral-intervention packages (e.g., differential reinforcement of other behavior, noncontingent attention, or overcorrection) on the pica of persons with developmental disabilities. This article reviews those studies and discusses the effectiveness, generality, and acceptability of the various intervention packages used to reduce pica. Additionally, this article highlights the recent clinical advancements that have been made in the treatment of the pica of persons with developmental disabilities.

Behavior Therapy↗
PubMed2002

Rehab rounds: training professionals in use of positive methods for community integration of persons with developmental disabilities.

Mainstream psychiatry has all but ignored the clinical needs of persons with developmental disabilities. With some notable exceptions, individuals in this group have been served in the community by behaviorally oriented psychologists or relegated to long-term institutional care. However, effective interventions are available, beginning with a functional analysis of the antecedents and consequences of targeted problem behaviors. Procedures for building adaptive coping and functional skills or compensating for their deficiency have been developed that are based on skills training, wraparound supports for employment and community living, stimulus control, and contingencies of reinforcement. Applied behavior analysis using task analysis, stimulus control, and contingencies of reinforcement also spawned some of the first techniques--including the token economy--shown to improve functioning and reduce psychopathology among persons with schizophrenia. One of the premier organizations to have documented the efficacy of person-centered, behavior-analytic, and community-based wraparound support services for persons with developmental disabilities is the Institute for Applied Behavior Analysis in Los Angeles. The institute was founded 20 years ago and has served more than 1,000 children, adolescents, and adults with developmental disabilities. Its staff have designed and empirically validated nonaversive techniques for modifying the behaviors that place their clients or others at risk of harm or injury and that often lead to the clients' ejection or isolation from community life. In this Rehab Rounds column the authors describe and evaluate the institute's training and consultation activities.

Adolescent↗
PubMedDate not supplied

A longitudinal study of employment and skill acquisition among individuals with developmental disabilities.

Recent legislation, especially the Americans with Disabilities Act in 1990, generated the closure of institutions for people with disabilities and inclusion into community residences and employment. It has been well documented that individuals with developmental disabilities often experience difficulties with employment including both obtaining and maintaining jobs, and many researchers have looked for ways to make employment more successful [McConkey, R. & Mezza F. (2001). Employment aspirations of people with learning disabilities attending day centers. Journal of Learning Disabilities, 5(4), 309-318; Stevens, G. (2002). Employers' perceptions and practice in the employability of disabled people: a survey of companies in south east UK. Disability and Society, 17(7), 779-796; Capella, M., Roessler, R., & Hemmeria, K. (2002). Work-related skills awareness in high-school students with disabilities. Journal of Applied Rehabilitation Counseling, 33(2), 17-23; Ingraham, K., Rahimi, M., Tsang, H., Chan, F., & Oulvey, E. (2001). Work support groups in state vocational rehabilitation agency settings: a case study. Psychiatric Rehabilitation Skills, 5(1), 6-21; Gosling, V. & Cotterill, L. (2000). An employment project as a route to social inclusion for people with learning difficulties? Disability and Society, 15(7), 1001-1018; Neitupski, J. & Hamre-Nietupski, S. (2000). A systematic process for carving supported employment positions for people with severe disabilities. Journal of Developmental and Physical Disabilities, 12(2), 103-119]. While research has accumulated that has examined predictors of successful employment, this research assessed longitudinal outcomes of employment. Data were obtained from an existing data set of all known persons receiving services from the Developmental Disabilities Division of the Oklahoma Department of Human Services (N=2760). Results indicated that as people moved to employment, scores on adaptive skills increased, that as people moved from employment, adaptive skills decreased, and that as employment status remained constant, adaptive skills also remained unchanged. No consistent impact was found on challenging behaviors. Type of employment (sheltered, supported, and competitive) was then examined, and the same pattern of changes in adaptive skills was found; i.e., changes in employment to more/less competitive was accompanied by more/less adaptive skills. This suggests that employment itself, especially work in the competitive workforce, may be a significant source of enhancing adaptive skills for people with developmental disabilities and, thus, greatly adding to the success of community living.

Adult↗
PubMedDate not supplied

A conceptual model for care in developmental disability services.

The aim of this paper is to develop a personal conceptual framework with which to examine the nature of care for people with developmental disabilities in group homes. It examines the nature of care and its corollary self-care, both in general terms as well as those specific to the field of developmental disability. It also analyses the nature of nursing and its relationship to the care and training of people with developmental disabilities. From this, a conceptual framework is constructed based upon the dynamics of care which stem from the personal experience of developmental disability.

Group Homes↗
PubMed1982

The character of developmental disabilities in New York State: preliminary observations.

Preliminary information about the population characteristics of developmentally disabled persons in the State of New York is presented. The information was derived through a "rate-under-treatment" survey approach using the Developmental Disabilities Information Survey (DDIS). The results are based upon statewide data, derived from 36,334 cases, composed of 34% children and 66% adults. The findings revealed that the subject populations socio-demographics were consistent with those of the general population in the areas of age and ethnic distribution, but not in gender ratio. Developmentally disabled persons were located primarily in community settings; only 24% of the children and 45% of the adults were found to reside within various institutional settings. Most were mentally retarded, however more children than adults were identified as having a secondary condition such as autism, cerebral palsy, epilepsy or some other neurological impairment. About half were reported to also have some type of physical disability. The majority were free of ambulation difficulties. Only half had basic self-care skills, and a third were facile in communication skills. Learning capabilities were found to be affected by maturation and experience. It was suggested that a "rate-under-treatment" approach is effective, within certain constraints, in capturing reliable information about a population that could be used for planning and developing public policies.

Activities of Daily Living↗
PubMed1980

Pediatric practitioners' knowledge of developmental disabilities.

The purpose of this study was to assess the level of knowledge and attitudes of pediatric practitioners about developmental disabilities and compare their level to the performance of pediatric residents before and after a 1-month rotation about developmental disabilities. The level of knowledge was measured using a 50-question multiple choice examination and the attitudes were measured utilizing a hypothetical question about allocation of funds, a scale which measured prognostic abilities about mental function and the Attitude Towards Disabled Persons Scale. The results showed that the practitioners' mean scores were near the resident pretest mean scores with the exception of knowledge of developmental landmarks and school behavior and learning problems. Only slight changes in the residents were seen on the attitudinal measures, and the practitioners tended to have less optimistic attitudes than other professionals. The results help document that residency training in developmental disabilities improves knowledge about the area and that practitioners without that training have not acquired it on their own.

Adult↗
PubMed1997

Coordinated care model for developmentally disabled improves care, saves money.

Coordinated care model for developmentally disabled dramatically cuts inpatient LOS, costs. Learn how this hospital coordinates care for the developmentally disabled using specially trained nurse practitioners--and is cutting LOS and costs while assuring quality for this often-overlooked group. With the surge in managed Medicaid contracts, this approach should catch on with HMOs and providers.

Case Management↗
PubMedDate not supplied

Parental perceptions of unmet dental need and cost barriers to care for developmentally disabled children.

PURPOSE: The purpose of this investigation was to describe and assess the disparities, if any, in parental perceived cost barriers to oral health care among developmentally disabled children using a national data set. METHODS: Data from the 1997 National Health Interview Survey (NHIS) were analyzed using a SUDAAN statistical package. RESULTS: After adjusting for age and sex, parental perception of unmet need was significantly associated with developmentally disabled children 2-17 years in lower socioeconomic groups. CONCLUSIONS: Though most children from lower socioeconomic groups are eligible for Medicaid coverage, parents of these children perceive cost barriers to dental care. Children with developmental disabilities face even more perceived barriers to care based on family income.

Adolescent↗
PubMed2006

Addressing physical inactivity among developmentally disabled students through visual schedules and social stories.

INTRODUCTION: This project tested visual schedules and social stories in a physical education setting in order to increase the physical activity of developmentally disabled students. METHOD: This cohort study design involved 17 physical education teachers in a training course with an initial survey and 7-month post-survey. The initial survey assessed participant experience with developmentally disabled students, visual schedules and social stories. The post-survey assessed usage of, effectiveness of, and satisfaction with visual schedules and social stories in a physical education setting. RESULTS: On the initial survey, 100% of the participants reported that they work with developmentally disabled students and 24% reported little to no training in working with this population. On the post-survey, 75% of the participants reported using visual schedules in their teaching and 64% found them to be "effective" or "very effective". Six percent used social stories in their teaching, reporting them as 100% "very effective". CONCLUSION: There is an indication that visual schedules and social stories are effective learning tools in the physical education setting, increasing opportunities for developmentally disabled students to be physically active. However, additional resources and training are needed in order for physical education teachers to implement these tools widely in their classes.

Adult↗
PubMed2001

The natural history of hepatitis D virus infection in Illinois state facilities for the developmentally disabled.

OBJECTIVE: We sought to define the natural history of hepatitis D virus infection in an institutionalized, developmentally disabled population and to identify other prognostic factors. METHODS: A retrospective cohort study was conducted on 231 hepatitis B virus carriers, 65 of whom were also infected with hepatitis D virus, at thirteen Illinois state facilities for the developmentally disabled. Demographic, clinical and laboratory data from 1986 to 1998 were obtained by chart review. Cox regression analysis was used to compare those with and without hepatitis D virus infection in terms of overall mortality, mortality from hepatic disease, and risk of developing chronic hepatitis and cirrhosis and to identify other potential prognostic factors. RESULTS: Residents with hepatitis D virus infection were more likely to die of liver disease than uninfected residents (11% vs 0.6%, respectively; relative hazard, 15.2; 95% confidence interval, 1.8-126.6), although there was no significant difference in overall mortality. Twenty-one percent of residents with hepatitis D virus infection were diagnosed to have cirrhosis or chronic hepatitis compared with 9% of those uninfected (relative hazard 2.5, 95% confidence interval 1.2-5.2). Among the other variables tested, none was predictive of risk of dying of liver disease, and only seropositivity for hepatitis B e antigen was predictive of risk of developing cirrhosis or chronic hepatitis. CONCLUSIONS: In an institutionalized, developmentally disabled population of hepatitis B virus carriers, hepatitis D virus infection is associated with a greater risk of liver-associated mortality and of developing chronic liver disease than that associated with hepatitis B virus carriage alone.

Adult↗
PubMed1996

Chlorhexidine spray effects on plaque accumulation in developmentally disabled patients.

Chlorhexidine gluconate has been studied as an adjunct to standard oral hygiene techniques in developmentally disabled patients in reducing plaque accumulation. The purpose of this double blind crossover study was to determine the efficacy of two concentrations of chlorhexidine spray (0.12% and 0.06%) on plaque accumulation in developmentally disabled patients. Informed consent was obtained for 8 developmentally disabled patients 12 to 33 years of age. Patients were randomly assigned to one of two groups of four each. One group received twice daily 0.12% chlorhexidine spray while the other received the 0.06% chlorhexidine spray for 30 days, followed by twice daily chlorhexidine spray (0.12% and 0.06%) alternating groups, for a period of 30 days. Final plaque indices were determined. Normal oral hygiene practices continued throughout the study. Significant plaque reduction occurred with the 0.12% and 0.06% spray solutions. No significant differences occurred between the two concentrations. The results of this study suggest that twice daily chlorhexidine spray at a concentration of 0.06% is as effective in reducing plaque accumulation as a 0.12% chlorhexidine concentration.

Adolescent↗