SEARCH · PubMed Health

Results for “Developmental Disabilities”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,567 records · Page 87Linked to original sources

PubMed1992

The impact of a family-centered case management approach.

Two urban programs of family-centered case management services were established for families of children with both a developmental disability and a chronic health condition. These are children who present significant caregiving demands due to the long-term and severe nature of their disabilities. Thirty-two mothers were interviewed within the family's first month in the project and reinterviewed approximately one year later. The results indicate that more families received respite care, nursing services, training in the care of the child, educational services and transportation to school at follow-up than had been receiving those services at baseline. However, families still indicated high service needs for recreational activities, life planning, regular day care, legal services, and speech therapy at follow-up. Mothers indicated that program services were helpful in obtaining services, financing, information, support, and advocacy. Although maternal life satisfaction improved with program participation, non-handicapped siblings continued to have difficulties coping. The model employed is described and the practice and policy implications of the findings discussed.

Adolescent↗

PubMed2006

Some determinants of changes in preference over time.

Results of longitudinal studies suggest that the stability of preferences varies across individuals, although it is unclear what variables account for these differences. We extended this work by conducting periodic assessments of preference for leisure activities over 3 to 6 months with 10 adults with developmental disabilities. Although previous research has collectively shown that preferences identified via repeated assessment are highly variable, our results showed that preferences were relatively stable for the majority (80%) of participants. In an attempt to identify some environmental determinants of shifts in preference, we provided extended daily access to high-preference items (preference-weakening manipulation) and paired access to low-preference items with social and edible putative reinforcers during brief sessions (preference-strengthening manipulation). Preference assessments continued over the course of these manipulations with 2 participants. Results showed that changes in preference across time could be produced systematically and suggest that naturally occurring changes in establishing operations or conditioning histories contribute to temporal shifts in preference. Implications for preference assessments, reinforcer usage, and planned attempts to change preferences are discussed.

Adult↗

PubMedDate not supplied

Efficacy of a parent-implemented early language intervention based on collaborative consultation.

A group of five preschool children with developmental disability and their mothers participated in a study into the efficacy of a parent-implemented language intervention. Each parent was included in the team as a consultee, with a speech pathologist and special educator acting as consultants within a collaborative consultation process. Treatment for each child was developed using this process, with specific strategies to increase language production skills decided by the team. Strategies were used within an interactive model of early language intervention. The effectiveness of treatment was determined within a multiple baseline design. For three children, the impact of treatment was evident, but the results were not replicated for the other two children. Descriptive analysis of mothers' communicative behaviours indicated that, following treatment, they tended to direct more utterances to their children, used more models, fewer questions and directives, and more (although limited) teaching strategies.

Child, Preschool↗

PubMed2002

An analysis of physical guidance as reinforcement for noncompliance.

Physical guidance is a strategy commonly used for noncompliance. In two experiments, we evaluated reinforcing effects of physical guidance. Experiment 1 include three individuals with developmental disabilities who were noncompliant with tasks. Anecdotal observations indicated physical contact was highly reinforcing, and a functional analysis identified attention as a reinforcer for problem behavior. Two conditions compared physical guidance following noncompliance and no physical guidance following noncompliance. Results showed noncompliance increased for all three participants when physical guidance followed noncompliance. The second experiment empirically evaluated the function of noncompliance prior to examining the effect of physical guidance on noncompliance. A functional analysis, conducted with two participants, indicated noncompliance served an escape function for one and an attention function for the other. Comparisons of physical guidance and no physical guidance indicated physical guidance resulted in decreased noncompliance for the participant with an escape function but increased noncompliance for the participant with an attention function.

Activities of Daily Living↗

PubMed2002

An application of the matching law to severe problem behavior.

We evaluated problem behavior and appropriate behavior using the matching equation with 4 individuals with developmental disabilities. Descriptive observations were conducted during interactions between the participants and their primary care providers in either a clinical laboratory environment (3 participants) or the participant's home (1 participant). Data were recorded on potential reinforcers, problem behavior, and appropriate behavior. After identifying the reinforcers that maintained each participant's problem behavior by way of functional analysis, the descriptive data were analyzed retrospectively, based on the matching equation. Results showed that the proportional rate of problem behavior relative to appropriate behavior approximately matched the proportional rate of reinforcement for problem behavior for all participants. The results extend prior research because a functional analysis was conducted and because multiple sources of reinforcement (other than attention) were evaluated. Methodological constraints were identified, which may limit the application of the matching law on both practical and conceptual levels.

Adolescent↗

PubMed2005

Chronic conditions, functional limitations, and special health care needs of school-aged children born with extremely low-birth-weight in the 1990s.

CONTEXT: Information on the school-age functioning and special health care needs of extremely low-birth-weight (ELBW, <1000 g) children is necessary to plan for medical and educational services. OBJECTIVE: To examine neurosensory, developmental, and medical conditions together with the associated functional limitations and special health care needs of ELBW children compared with normal-birth-weight (NBW) term-born children (controls). DESIGN, SETTING, AND PARTICIPANTS: A follow-up study at age 8 years of a cohort of 219 ELBW children born 1992 to 1995 (92% of survivors) and 176 NBW controls of similar sociodemographic status conducted in Cleveland, Ohio. MAIN OUTCOME MEASURES: Parent Questionnaire for Identifying Children with Chronic Conditions of 12 months or more and categorization of specific medical diagnoses and developmental disabilities based on examination of the children. RESULTS: In logistic regression analyses adjusting for sociodemographic status and sex, ELBW children had significantly more chronic conditions than NBW controls, including functional limitations (64% vs 20%, respectively; odds ratio [OR], 8.1; 95% confidence interval [CI], 5.0-13.1; P<.001), compensatory dependency needs (48% vs 23%, respectively; OR, 3.0; 95% CI, 1.9-4.7; P<.001), and services above those routinely required by children (65% vs 27%, respectively; OR, 5.4; 95% CI, 3.4-8.5; P<.001). These differences remained significant when the 36 ELBW children with neurosensory impairments were excluded. Specific diagnoses and disabilities for ELBW vs NBW children included cerebral palsy (14% vs 0%, respectively; P<.001), asthma (21% vs 9%; OR, 3.0; 95% CI, 1.6-5.6; P = .001), vision of less than 20/200 (10% vs 3%; OR, 3.1; 95% CI, 1.2-7.8; P = .02), low IQ of less than 85 (38% vs 14%; OR, 4.5; 95% CI, 2.7-7.7; P<.001), limited academic skills (37% vs 15%; OR, 4.2; 95% CI, 2.5-7.3; P<.001), poor motor skills (47% vs 10%; OR, 7.8; 95% CI, 4.5-13.6; P<.001), and poor adaptive functioning (69% vs 34%; OR, 6.5; 95% CI, 4.0-10.6; P<.001). CONCLUSION: The ELBW survivors in school at age 8 years who were born in the 1990s have considerable long-term health and educational needs.

Child↗

PubMed2005

Volumetric, connective, and morphologic changes in the brains of children with chromosome 22q11.2 deletion syndrome: an integrative study.

Chromosome 22q11.2 deletion syndrome is a highly prevalent genetic disorder whose manifestations include developmental disability and sometimes mental retardation. The few studies that have examined brain morphology in different samples from this population have found similar general patterns, mostly using region of interest measures. We employed voxel-based techniques to concurrently examine specific morphologic changes in multiple brain tissue measures. Results were similar to previous findings of volumetric reductions in the posterior brain. They also extended them in two ways. First, our methods provided greater specificity in the localization of changes detected. Second, the combination of our measures of gray and white matter along with cerebrospinal fluid volume and fractional anisotropy, which indicates the structure of white matter, showed a posterior displacement of and morphologic changes to the corpus callosum in affected children.

Adolescent↗

PubMed1999

Health supervision and anticipatory guidance of individuals with Wolf-Hirschhorn syndrome.

Wolf-Hirschhorn syndrome (WHS) is a well-known malformation syndrome due to microdeletion of the short arm of chromosome 4 (4p-). Almost 120 cases have been reported so far, yet there is still limited information on its natural history. It is generally thought that these children have severe developmental disabilities and tend to be mere survivors devoid of personality. It is evident to us [Battaglia et al., 1999a, 1999b], however, that individuals with WHS are capable of greater psychomotor development than previously suggested [Guthrie et al., 1971]. Thus, it is even more important to establish guidelines for health supervision and anticipatory guidance of such patients. This would help professionals and families in developing the most appropriate individualized plan for each child, in order to allow the maximum achievement possible. In the present article we propose guidelines for health supervision and anticipatory guidance of individuals with WHS. These guidelines derive from our experience with the natural history of several children, adolescents, and adults with WHS, gained through the literature, personal observation, and contacts with the national support groups in North America and Italy.

Abnormalities, Multiple↗

PubMed1991

Area and volume measurement of posterior fossa structures in MRI.

This study was undertaken to determine the extent to which area measures of posterior fossa structures can be used confidently to represent structure volumes. MRI scans were obtained from three groups: fragile X males, males with other developmental disabilities, and males with normal IQ. The areas of the midbrain, pons, medulla, cerebellar vermis, and fourth ventricle were measured in midsagittal sections. Volumes of midbrain, pons, medulla, cerebellum, fourth ventricle, and third ventricle were obtained by measuring these structures in contiguous axial slices. In addition, the largest axial area for each structure was identified. Analysis revealed that midsagittal area measures for pons, medulla, and fourth ventricle were significantly correlated with structure volumes, and that all of the largest axial area measures were significantly correlated with structure volumes. However, only the midsagittal area measure of fourth ventricle and the largest axial area measures of fourth ventricle and cerebellum were correlated with volume measures with an r of .80 of greater. Results of this study suggest that area measures may not accurately represent three-dimensional structure size.

Adolescent↗

PubMed1987

Behavioral and postural changes observed with use of adaptive seating by clients with multiple handicaps.

Adaptive seating devices (ASDs) are used in the treatment of children with multiple handicaps. This longitudinal study evaluated, through direct observation and parent-guardian assessment, the behavioral changes seen with the use of ASDs and programming. Nineteen individuals with multiple handicaps and developmental disabilities, aged 1 to 6 years, participated as subjects. Data were collected by a trained observer from eight on-site evaluations and from parent-guardian responses to a preequipment and postequipment questionnaire. Evaluations were made every six weeks, starting about three months before and ending about six months after receiving the seating devices. The activities observed were head control, controlled sitting posture, visual tracking, reach, and grasp. Rating scale data were analyzed using an analysis of variance and a Friedman's test. Other data were analyzed descriptively for frequencies and central tendencies. Sitting posture, head control, and grasp improved significantly. Parent perceptions of the equipment indicated that the chairs freed parents from the need to provide support for their children's activities of daily living, which enabled them to participate in other activities with the children and around the home.

Adolescent↗

PubMed1997

Equivalence reliability of the functional independence measure for children (WeeFIM) administration methods.

OBJECTIVE: This study examined the equivalence reliability of two administration methods for the Functional Independence Measure for Children (WeeFIM). The two methods were direct observation of child performance and parental interview. METHOD: Thirty children between the ages of 19 months and 71 months with identified developmental disabilities were included in this study. The direct observation and interview methods were administered in random order to each subject within a 3-week period. The direct observation was completed in the educational setting, and the WeeFIM interview was obtained by either in-person interview or telephone interview with the parent. RESULTS: The intraclass correlation coefficient (ICC) for total WeeFIM ratings was .93, indicating consistency between the two administration methods. Analysis of the WeeFIM Motor (13 items) and Cognitive (5 items) domains yielded ICC values of .93 and .75, respectively, suggesting greater consistency for items measuring motor-related skills. CONCLUSION: The results demonstrate good agreement for total ratings when the WeeFIM is administered by direct observation and by interview with a parent. The findings establish the clinical usefulness of information collected by clinical interview.

Activities of Daily Living↗

PubMed2002

[Aspects of the development of autistic children].

Autism is attributed to a complex developmental disability. Child development is pervasively impaired in many mental functioning spheres. This study aims to investigate the impact of the autistic features to the physical development of the autistic children. Most attention was paid to the nutrition and sleeping habits of the autistic children including communicational and behavioral aspects related to the mentioned functions. The results were compared with the healthy controls. Differences between the groups were analysed. Low appetite, narrow range of assortment of preferable dishes, digestive autonomic nervous system reactions were significantly more common in the autistic group. Sleep of the autistic children was significantly more often disrupted by waking up caused not by physiological needs when comparing with the control group. Tallness and weight of the autistic children were compared with the Lithuanian norms, physical growth autistic children was delayed and not harmonious. Further investigations in the field are needed.

Age Factors↗

PubMed1998

Maternal responsivity predicts the prelinguistic communication intervention that facilitates generalized intentional communication.

Family systems theory posits that the relative effectiveness of early interventions will vary depending on various aspects of the family. This study tested whether maternal responsivity would predict the extent to which Prelinguistic Milieu Teaching (PMT) facilitated generalized intentional communication better than a contrast treatment that was conducted in a small group by a responsive adult (i.e., Responsive Small Group, RSG). Fifty-eight children with developmental disabilities in the prelinguistic communication period of development were randomly assigned to one of the two staff-implemented treatment groups. Thirty were assigned to RSG; 28 were assigned to PMT. Mothers were kept naive to the intervention methods, hypotheses, and measures. In families with mothers who responded to a high percentage of the children's communication acts at the pre-treatment period, the children in the PMT group used more frequent intentional communication in post-treatment generalization sessions with a trainer and mothers than did children in the RSG group. In the families with mothers who responded to fewer than 39% of their children's communication acts, children in the RSG intervention used more frequent intentional communication in post-treatment generalization sessions with the mothers than did children in the PMT intervention. Other family variables and no child variables that we measured could account for these findings.

Child↗

PubMed1998

Evaluation of a brief stimulus preference assessment.

We evaluated the utility of a brief (5-min) stimulus preference assessment for individuals with developmental disabilities. Participants had noncontingent (free) access to an array of stimuli and could interact with any of the stimuli at any time. Stimuli were never withdrawn or withheld from the participants during a 5-min session. In Experiment 1, the brief preference assessment was conducted for 10 participants to identify differentially preferred stimuli, and reinforcer assessments were conducted to test the reinforcing efficacy of those stimuli identified as highly preferred. In Experiment 2, a comparison was conducted between the brief preference assessment and a commonly used paired-stimulus preference assessment. Collectively, results demonstrated that the brief preference assessment identified stimuli that functioned as reinforcers for a simple operant response, identified preferred stimuli that were differentially effective as reinforcers compared to nonpreferred stimuli, was associated with fewer problem behaviors, and required less time to complete than a commonly used paired-stimulus preference assessment.

Adolescent↗

PubMedDate not supplied

Predictive value of the Bayley mental scale in the early detection of cognitive delays in high-risk infants.

One of the most elusive developmental disabilities to diagnose during infancy is cognitive delay. Although infant intelligence tests have been identified repeatedly as poor predictors of future IQ, these predictions have typically been based on interage correlations. This retrospective study examined the sensitivity, specificity, and positive and negative predictive values of the Mental Scale of the Bayley Scales of Infant Development in detecting cognitive delay (IQ < 85) among a sample of 196 high-risk, mostly low birth weight, premature infants who were assessed initially at 4 months' corrected age and followed longitudinally to between 3 and 8 years' corrected age. As hypothesized, the Bayley Mental Scale was better at correctly identifying children with future normal IQs (specificity = 91.9%) than it was at identifying infants who would later show cognitive delays (sensitivity = 38.9%). The positive and negative predictive values were 51.9% and 87.0% respectively. Results of this study support recent assertions that cognitive delay, particularly in the mildest forms, is difficult to detect during early infancy.

Cognition Disorders↗

PubMed1991

Scaling and attainment of goals in family-focused early intervention.

Evaluating the impact of early intervention as a means to prevent or ameliorate developmental disabilities has been a long standing problem and the issue of effectiveness continues to be debated. This study explored the utility of Goal Attainment Scaling as a planning and evaluation tool whereby intervention outcomes for infants and families could be documented. The 23 families in this study were participants in a larger research effort evaluating the implementation of community based, family-focused intervention. An average of 5.9 goals were written for each family, with approximately 60% of goals written for infants and 40% for families. Attainment of goals was evident in a mean T-score of 51.9 for post-test values and in documentation that approximately two-thirds of all goals were attained at least at the expected level. The practical features of Goal Attainment Scaling and the correspondence of goal attainment scores with other measures of change suggest that it may be a valuable approach to complement traditional evaluation strategies.

Child↗

PubMed2005

An evaluation of strategies to maintain mands at practical levels.

In order to teach individuals with developmental disabilities to request stimuli they are motivated to obtain (mand), it is often necessary to initially deliver the item requested immediately and frequently. This may result in an undesirably high rate of mands that is impractical to maintain. The purpose of the current investigation was to extend the findings of previous research on the maintenance of low-rate mands within a communication-training context for children diagnosed with autism by evaluating the efficacy of two procedures: (1) signaled delay-to-reinforcement and (2) multiple schedules. The results of our evaluation of multiple schedules replicated those of previous research; this arrangement was found for all participants to be effective in maintaining mands at low rates under multiple schedules with a 270-s extinction component and 30-s reinforcement component. For all participants, signaled delay-to-reinforcement was ineffective in maintaining mands at the terminal criterion, a 270-s delay.

Autistic Disorder↗

PubMed2001

Functional analysis and treatment of problem behavior evoked by noise.

We conducted a four-part investigation to develop methods for assessing and treating problem behavior evoked by noise. In Phase 1, 7 participants with developmental disabilities who were described as being hypersensitive to specific noises were exposed to a series of noises under controlled conditions. Results for 2 of the participants verified that noise was apparently an aversive event. In Phase 2, results of functional analyses indicated that these 2 participants' problem behaviors were maintained by escape from noise. In Phase 3, preference assessments were conducted to identify reinforcers that might be used during treatment. Finally, in Phase 4, the 2 participants' problem behaviors were successfully treated with extinction, stimulus fading, and a differential-reinforcement-of-other-behavior (DRO) contingency (only 1 participant required DRO). Treatment effects for both participants generalized to their home environments and were maintained during a follow-up assessment. Procedures and results were discussed in terms of their relevance to the systematic assessment of noise as an establishing operation (EO) and, more generally, to the identification of idiosyncratic EO influences on behavior.

Adult↗