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PubMed1989

Behavior classification system for children with developmental, psychiatric, and chronic medical problems.

Derived a new behavior classification system based on Missouri Children's Behavior Checklist (MCBC) ratings. Using an accumulated MCBC data base on 854 children, 4-14 years of age, with developmental disabilities (n = 471), psychiatric problems (n = 155), chronic illnesses (n = 184), and nonreferred controls (n = 44), raw scale scores were transformed into T scores and then factor analyzed. Three factors emerged: Internalizing, Externalizing, and Sociable. Hierarchical cluster analysis of factor scores yielded six behavior profile clusters that replicated. Classification rules, based on T scores, were derived for each of the six clusters and for unclassified profiles to yield seven behavior patterns. There were four behavior problem patterns: Internal, External, Mixed Internal and External profiles, and Undifferentiated Disturbance. There were three behavior problem free patterns: Low Social Skills, Problem-free, and Sociable profiles. The distribution of these seven behavior patterns differed significantly across children with developmental, psychiatric, and medical problems and nonreferred controls. Furthermore, the new system provides more refined behavior pattern delineation than previously developed systems.

Adolescent↗

PubMed2005

Assessing object-to-picture and picture-to-object matching as prerequisite skills for pictorial preference assessments.

Tangible and pictorial paired-stimulus (PPS) preference assessments were compared for 6 individuals with developmental disabilities. During tangible and PPS assessments, two edible items or photographs were presented on each trial, respectively, and approach responses were recorded. Both assessments yielded similar preference hierarchies for 3 participants who could match pictures and objects but different hierarchies for 3 participants who could not. Reinforcer assessments verified that items identified as high preference on PPS assessments functioned as reinforcers only for participants with matching skills.

Adolescent↗

PubMed1984

Diagnostic and Statistical Manual-III: a perspective from family court.

The third edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III) is evaluated from the standpoint of forensic science experience in a family court setting. The importance of diagnosis in developing pertinent recommendations within an adversarial system is discussed, with particular emphasis on difficulties in coordinating the Manual with the mental disorders frequently found in such a population. The limitations of the current criteria of the developmental disabilities are noted, and problems of reconciling incest and child abuse with the nomenclature are investigated. Some inconsistencies in the conceptualization of the conduct disorders and antisocial personality disorder are explored in terms of the needs of the juvenile justice system. An additional coding procedure is proposed for DSM-III, in order to identify more easily prodromal or emerging disorders of clinical significance.

Adolescent↗

PubMed1998

State institutions: thirty years of depopulation and closure.

Over the past 30 years, a number of social, political, and economic forces have influenced public policy decisions regarding residential services for persons with mental retardation and other developmental disabilities (MR/DD). One of the most striking outcomes of these forces has been a steady decrease of persons with MR/DD residing in state institutions. In this paper we show the changes over the past 30 years in state institutional populations, interstate variability, movement of individuals into and out of state institutions, costs of state institutional care, and state institution closures as a result of social policy.

Deinstitutionalization↗

PubMedDate not supplied

Variability in staff reports of the frequency of challenging behavior.

Information was collected from 88 staff about their observations of the occurrence and frequency of challenging behaviors in 22 individuals with developmental disabilities with whom they worked. Staff reports suggested considerable variability in challenging behavior in the presence of different staff and, from day to day, in the presence of the same staff. Variability was greater for stereotyped than for aggressive/destructive behavior, and for more frequent behavior. Managers reported generally less challenging behavior than their staff. The validity of the findings was discussed and their implications for research and practice considered.

Adolescent↗

PubMed2006

Integrative review of parenting in nursing research.

PURPOSE: To synthesize and critically analyze parenting research in nursing. DESIGN: Qualitative, integrative review of nursing research studies about parenting 1993-2004. METHODS: Studies published by nurse researchers in peer-reviewed journals were systematically searched using CINAHL and Medline databases. Data were organized and analyzed with a sample of 17 nursing research studies from core nursing journals. FINDINGS: The majority of parenting research has been focused on mothers, primarily about parenting children with physical or developmental disabilities. Research about fathers as parents is sparse. Parenting across cultures, parenting in the context of family, and theoretical frameworks for parenting research are not well developed. CONCLUSIONS: The scope of nursing research on parenting is limited. The roles, functions, and contexts of parenting are not well defined. Further research is required to describe parenting and how parenting affects the health of individuals and families.

Adaptation, Psychological↗

PubMedDate not supplied

Foster youth emancipating from care: caseworkers' reports on needs and services.

This article presents findings from a survey mailed to caseworkers, who answered questions about special needs, independent living skills, educational attainment, and services for 416 randomly selected foster youth in Illinois. A third of the adolescents had a mental health disorder, developmental disability, or other special need that their caseworkers believed would interfere with their ability to live independently. Additionally, urban youth were underserved relative to other youth. Youth with more behavior problems and educational and job skill deficits were less likely than other youth to continue to receive child welfare services past age 18, suggesting that services must be provided throughout adolescence to meet the needs of the most vulnerable clients.

Adolescent↗

PubMed2006

Functional assessment of challenging behavior: toward a strategy for applied settings.

The development of experimental functional analysis and more recently functional analysis checklists have become common technologies for evaluating antecedent events and the consequences of problematic behaviors. Children and developmentally disabled persons across the life span with challenging behaviors have been the primary focus of this research. The primary purpose of this paper is to present an overview the developments in this rapidly expanding research literature, particularly as it involves the application of the functional assessment paradigm in applied settings where resources and time are scarce. Implication of the functional assessment research for clinical practice are discussed along with strengths and weakness of the current technology.

Adult↗

PubMed2000

Behavioral health expenditures and state organizational structure.

The authors present a study on expenditures by state mental health, substance abuse, and developmental disability agencies in the United States for the period between 1981 and 1993. The relationship between agency spending and organizational structure of state bureaucracy was examined. Results indicate that organizational structure is a determinant of agency spending. The more independent an agency, the higher its spending; conversely, the more independent its competitor, the lower the agency's spending. The number of levels between an agency and the governor's office was not significant in explaining agency expenditures.

Data Collection↗

PubMed1994

Toluene embryopathy: delineation of the phenotype and comparison with fetal alcohol syndrome.

OBJECTIVE: To determine if maternal toluene abuse produces any structural or developmental disabilities in the developing fetus, a cohort of toluene-exposed infants was ascertained and examined. METHODOLOGY: Eighteen infants with a history of in utero toluene exposure were examined at birth. Nine of these infants were reexamined 3 to 36 months after their initial evaluations. The clinical findings in these patients were compared with those of similarly exposed children from the literature and with patients who had the fetal alcohol syndrome. RESULTS: Thirty-nine percent of all toluene-exposed infants described in this and other studies were born prematurely, and 9% died during the perinatal period. Fifty-four percent were small for gestational age, and 52% exhibited continued postnatal growth deficiency. A 33% incidence of prenatal microcephaly, a 67% incidence of postnatal microcephaly, and an 80% incidence of developmental delay were observed. Eighty-three percent of the patients had craniofacial features similar to the fetal alcohol syndrome, and 89% of these children had other minor anomalies. CONCLUSIONS: Data from the patients herein described and the available scientific literature suggest that the mechanism of alcohol craniofacial teratogenesis may be nonspecific, with a variety of teratogens, including toluene, giving rise to phenotypic facial abnormalities similar to those of the fetal alcohol syndrome. We propose a common mechanism of craniofacial teratogenesis for toluene and alcohol, namely a deficiency of craniofacial neuroepithelium and mesodermal components due to increased embryonic cell death.

Abnormalities, Drug-Induced↗

PubMedDate not supplied

Self-injurious behaviour: a kindling phenomenon?

Self-injurious behaviour continues to be a drain on the resources for rehabilitation of the children with developmental disabilities. Pathogenesis and therapy seems fragmentary, with virtually every major neurotransmitter system being identified as the putative substrate for self-injurious behaviour. This phenomenon as it cuts across the diagnostic boundaries, although it is suggestive of a heterogeneous neurochemical basis, should call for the exploration of the biological event preceding the neurochemical cascade resulting in the behaviour. The authors argue that kindling is the preceding neurophysiological event resulting in self-injurious behaviour and, thus, can be effectively prevented pharmacologically.

Child↗

PubMed1991

The Apgar score: evolution, limitations, and scoring guidelines.

The Apgar score has been useful for nearly four decades in focusing on five physiological signs (heart rate, respiratory effort, reflex irritability, muscle tone, color) that denote the condition of an infant during the first critical minutes of life. Before the development of the system, narcotic analgesia and sedation during labor, and general anesthesia for vaginal deliveries were commonly used. Research of the scoring method has focused on the effects of these interventions on the fetus and newborn and has been a major impetus for change in obstetric practices. The Apgar score has been used as a predictive index for neonatal mortality and morbidity and for later neurologic or developmental disability. Both the one- and five-minute scores are predictors of mortality in normal-birthweight infants, whereas in high-risk low-birthweight infants their score is limited. The score is an insensitive predictive index of long-term neurologic or mental handicap, and lacks both sensitivity and specificity to reflect accurately the degree of acidosis. It can be used effectively, however, if these limitations are understood and considered.

Apgar Score↗

PubMed2001

Down syndrome and Alzheimer's disease: a link between development and aging.

A subset of aged individuals with Down syndrome (DS) exhibits the clinical features of Alzheimer's disease (AD) but our ability to detect dementia in this population is hampered by developmental differences as well as the sensitivity of existing test tools. Despite the apparent clinical heterogeneity in aged individuals with DS, age-associated neuropathology is a consistent feature. This is due to the fact that trisomy 21 leads to a dose-dependent increase in the production of the amyloid precursor protein and subsequently the production of the amyloidogenic fragments leading to early and predominant senile plaque formation. A review of the existing literature indicates that oxidative damage and neuroinflammation may interact to accelerate the disease process particularly in individuals with DS over the age of 40 years. By combining clinical information with measures of brain-region specific neuropathology we can "work backwards" and identify the earliest and most sensitive clinical change that may signal the onset of AD. For the past 50 years, investigators in the fields of mental retardation, developmental disabilities, and aging have been interested in the curious link between AD and DS. The morphologic and biochemical origins of AD are seen in the early years of the lifespan for individuals with DS. Study of the process by which AD evolves in DS affords an opportunity to understand an important link between development and aging. This review will focus on advances in the molecular and clinical basis of this association.

Adult↗

PubMed2001

An experimental analysis of aggression.

Iwata, Dorsey, Slifer, Bauman, and Richman developed an assessment method to identify the operant functions of self-injurious behavior. In this study, a similar method was used to assess the operant functions of aggression displayed by children and adolescents with developmental disabilities. Although previous research has shown that aggression is an operant behavior, there has been no comprehensive analysis of aggression using analog functional analysis method. Eight children and adolescents participated. The experimental conditions involved attention, escape, materials, no interaction, and control. Results for 7 of the 8 participants identified clear operant functions (positive or negative reinforcement) for aggression. For 1 child, subsequent analyses suggested that aggression was possibly sensitive to peer attention as reinforcement.

Adolescent↗

PubMedDate not supplied

Hydrotherapy combined with Snoezelen multi-sensory therapy.

The aim of this article is to present a new and challenging model of treatment that combines two therapeutic interventions: hydrotherapy and Snoezelen or controlled multisensory stimulation. The combination of the two therapeutic approaches enhances the treatment effect by utilizing the unique characteristics of each approach. We believe that this combined model will further enhance each media to the benefit of the clients and create a new intervention approach. This article relates to a hydrotherapy swimming pool facility that has been established at the Williams Island Therapeutic Swimming and Recreation Center, Beit Issie Shapiro, Raanana in Israel, after acquiring many years of experience and gaining substantial knowledge both in the field of hydrotherapy and Snoezelen intervention. Beit Issie Shapiro is a non-profit community organization providing a range of services for children with developmental disabilities and their families. The organization provides direct services for nearly 6,000 children and adults each year. This article provides an overview of hydrotherapy and Snoezelen and presents a case study, which will demonstrate the new model of treatment and show how this new and innovative form of therapy can be used as a successful intervention. We believe it will open a path to enriching the repertoire of therapists helping people with special needs. This article is also addressed to researchers to provide ideas for further studies in this area.

Adolescent↗

PubMedDate not supplied

A method for evaluating parameters of reinforcement during parent-child interactions.

We conducted functional analyses and identified reinforcers for problem behavior for three individuals with developmental disabilities. Based on results of the functional analysis, we evaluated the rate, probability, delay, and duration of reinforcement for problem and appropriate behavior during descriptive parent-child observations. Results showed that parameters of reinforcement, including rate, probability, delay, and duration may interact, and that evaluations of a single reinforcement parameter may be insufficient in describing response allocation. Hence, this study represents a movement toward a method for analyzing reinforcer dimensions, other than rate and probability, in a descriptive analysis.

Aggression↗

PubMed2006

Songs composed for use in music therapy: a survey of original songwriting practices of music therapists.

While researchers have documented the efficacy of clinical songwriting in music therapy, limited research has been conducted on songs composed by music therapists that address clinical goals. The purpose of this research was to examine the original songwriting practices of music therapists. Professional music therapists (N = 1,364) received a 14-question survey via email asking each to identify client populations and clinical goals addressed by original songs, their length of time in clinical practice, and specifics about their acquisition of songwriting skills. The data collected from 302 completed surveys revealed that respondents who used original songs were most likely to work with children and adolescents in schools or the developmental disability field and wrote songs in order to individualize treatment. Music therapists working with persons over 65 years of age in long term care or assisted living programs were the least likely to use original songs in clinical practice, opting for interventions utilizing the client's familiar music. Most music therapists found songwriting generally easy, but only 37% indicated that they acquired this skill during their undergraduate degree. Additional research on the clinical efficacy of original songs and therapist's compositional processes is needed to identify best practices models for strategic songwriting.

Adolescent↗

PubMed1976

A model interdisciplinary diagnostic and treatment nursery.

A model interdisciplinary diagnostic and treatment nursery program for developmentally disabled children is objectively described to enable documentation of effectiveness and replication. The major components of the program were the parent-professional partnership and the objective specification by the interdisciplinary team of problems, treatment plan, and treatment methods for each youngster. The concept of efficiency index is used to document and compare program effectiveness for four treatment cases, one of which is presented in detail. Reasons for program effectiveness and potential problem areas are discussed.

Child↗