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PubMedDate not supplied

Evaluating parent use of functional communication training to replace and enhance prelinguistic behaviours in six children with developmental and physical disabilities.

PURPOSE: To evaluate parent use of functional communication training (FCT) to replace and enhance prelinguistic behaviours in six young children with developmental and physical disabilities. METHOD: Initially, the communicative functions of the children's prelinguistic behaviours were assessed by parent interviews. Three communication functions were identified for each child and intervention goals to replace or enhance the child's existing prelinguistic behaviours were developed in consultation with parents. After a baseline phase, parents received training on implementation of FCT. Intervention was staggered across the three communicative functions in a multiple-probe design. RESULTS: Intervention was associated with increases in the replacement communication behaviour. Treatment gains were generally maintained at the monthly follow-ups. CONCLUSION: The results suggest that parents can use FCT to enhance communication skills in children with developmental and physical disabilities.

Abnormalities, Multiple↗

PubMed2000

Workplace culture, social interactions, and supports for transition-age young adults.

The role of the workplace and its culture in supporting social inclusion and workplace support for employees with disabilities is discussed and results of a qualitative study of the workplace experiences of 8 young adults with developmental disabilities presented. Data were collected using participant observation and semi-structured interviews. Four characteristics of supportive workplaces were identified: (a) multiple context relationships, (b) specific social opportunities, (c) a personal and team-building management style, and (d) interdependent job designs. The more supportive workplaces had all of these characteristics, suggesting that collectively they represent key features of a supportive workplace culture. Implications for job development and job creation are identified.

Adolescent↗

PubMed1981

Mental illness and mental retardation: cause or coincidence?

A sample of 93 patients admitted to an inpatient psychiatric unit for emotionally disturbed, developmentally disabled adolescents was studied in an attempt to clarify the relationship between intellectual functioning and psychoses occurring in the developmental period. The severity and duration of the psychosis, the presence of hallucinations, and the degree of isolation of the child from his or her environment appear to be important factors influencing the occurrence of decreased psychometric test scores in the individuals studied.

Adolescent↗

PubMed1998

Case management and supported employment: a good fit.

Individuals with severe disabilities have often been denied the full range of vocational opportunities. Because of discrimination and oppression, and false beliefs regarding their skills, capacities, capabilities, and interests, individuals with disabilities have often been relegated to nonwork activities or sheltered work opportunities. Passage of legislation, such as the Developmental Disabilities Assistance and Bill of Rights Act of 1984 and Title VI, Part C of the Rehabilitation Act Amendments of 1986, in combination with systems change grants funded through Title III of the Rehabilitation Act, provided the basis for the initiation of a series of federal- and state-funded demonstration projects designed to provide opportunities and supports for individuals with severe or significant disabilities to work at competitive sites in the community. This model of vocational services, called supported employment, while initially conceived as a vocational program for individuals with mental retardation, has been modified to successfully provide services to individuals with mental illness, acquired brain injury, autism, cerebral palsy, physical disabilities, and other disabilities. A key to the success of these programs is the complementary working relationship between the case manager and the job coach. While there may be some overlap in what each brings to the person with a disability, each professional plays distinctive and critical roles in the carrying out of supported employment.

Case Management↗

PubMed1997

The oral health of Indiana's independent, disabled adults.

This epidemiological study was conducted to measure the oral health and related variables of one of Indiana's special population groups: adults who are developmentally disabled, work in sheltered workshops and do not live in staffed residential facilities. Fifteen sheltered workshops in ten Indiana counties cooperated with this study in which 393 individuals were interviewed and received oral screening. Information was gathered regarding oral health status, history of utilization of dental services, availability of dental insurance or Medicaid and use of tobacco products. This study was conducted by the Indiana Foundation of Dentistry for the Handicapped and was funded by the Indiana State Department of Health.

Adult↗

PubMed1992

Measuring processes of caregiving to physically disabled children and their families. I: Identifying relevant components of care.

This study was undertaken to determine the relative importance of components of caregiving for children with developmental disabilities. Health-care professionals and parents rated the importance and relative priority of 22 aspects of caregiving. Among the seven highest-ranked aspects of care, both parents and professionals identified Parent involvement, Education/information, Treatment, Accessible/available care and Co-ordination. Parents also ranked Continuity/consistency and Family-centred care as being particularly important to them. The components' relevance to the organization of services for children with disabilities and their application to further studies of processes of caregiving are discussed.

Adolescent↗

PubMed1992

A comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities.

The development of effective training programs for persons with profound mental retardation remains one of the greatest challenges for behavior analysts working in the field of developmental disabilities. One significant advancement for this population has been the reinforcer assessment procedure developed by Pace, Ivancic, Edwards, Iwata, and Page (1985), which involves repeatedly presenting a variety of stimuli to the client and then measuring approach behaviors to differentiate preferred from nonpreferred stimuli. One potential limitation of this procedure is that some clients consistently approach most or all of the stimuli on each presentation, making it difficult to differentiate among these stimuli. In this study, we used a concurrent operants paradigm to compare the Pace et al. (1985) procedure with a modified procedure wherein clients were presented with two stimuli simultaneously and were given access only to the first stimulus approached. The results revealed that this forced-choice stimulus preference assessment resulted in greater differentiation among stimuli and better predicted which stimuli would result in higher levels of responding when presented contingently in a concurrent operants paradigm.

Child↗

PubMed2006

Fatty acid compositions of red blood cell phospholipids in children with autism.

We compared the compositions of fatty acids including n-3, n-6 polyunsaturated fatty acids, trans- and cis-monounsaturated fatty acids, and saturated fatty acids in the red blood cell membranes of 40 children with autism (20 with early onset autism and 20 with developmental regression) and age-matched, 20 typically developing controls and 20 subjects with non-autistic developmental disabilities. The main findings include increased levels of eicosenoic acid (20:1n9) and erucic acid (22:1n9) in autistic subjects with developmental regression when compared with typically developing controls. In addition, an increase in 20:2n6 and a decrease in 16:1n7t were observed in children with clinical regression compared to those with early onset autism. Our results do not provide strong evidence for the hypothesis that abnormal fatty acid metabolism plays a role in the pathogenesis of autism spectrum disorder, although they suggest some metabolic or dietary abnormalities in the regressive form of autism.

Autistic Disorder↗

PubMed1999

Seizure disorders in people with intellectual disability: an analysis of differences in social functioning, adaptive functioning and maladaptive behaviours.

The present study is an investigation into the effects of seizure disorders/epilepsy on psychopathology, social functioning, adaptive functioning and maladaptive behaviours using a sample of 353 people diagnosed with a seizure disorder, and either severe or profound intellectual disability. People with a diagnosis of seizure disorder were found to have significantly less social and adaptive skills when compared to developmentally disabled controls with no seizure disorder diagnosis. Additionally, patterns of maladaptive behaviours were identified for individuals with seizure disorders and found to be similar to those found in people without seizure activity. The implications of the present findings are discussed.

Activities of Daily Living↗

PubMed2006

A two-year follow-up on risk status identified by the checklist for autism in toddlers.

We examined the characteristics of children at 4 to 5 years of age who were correctly and incorrectly classified as "at risk" for an autism spectrum diagnosis using the Checklist for Autism in Toddlers (CHAT) at age 2 to 3 years. Information is provided on the stability of risk/disorder status over a 2-year period of early development. Participants were 19 children with autism and 11 children with other developmental disabilities who had all been administered the CHAT between 2 and 3 years of age (Time 1) and received diagnostic and developmental re-evaluations between 4 and 6 years of age (Time 2). The risk status of children was discussed based on the original CHAT authors' criteria for risk of autism and the Denver modification for risk. High levels of stability in risk/diagnostic status from Time 1 assessments to Time 2 assessments were noted. Specifically, the original CHAT criteria for medium to high risk of autism applied at Time 1 predicted Time 2 diagnostic classification for 83% of the sample, and the Denver modification of the CHAT risk criteria predicted Time 2 diagnostic classification for 93% of the sample. Implications of the findings are discussed as they relate to early screening and identification of autism spectrum disorders.

Adaptation, Psychological↗

PubMed1997

The importance of smoking education and preventative health strategies for people with intellectual disability.

Tobacco smoking is a major health problem within our community. To date, little attention has been focused on determining the prevalence of smoking in people with disabilities or in developing appropriate strategies to assist them to stop smoking. Funding from the Victorian Health Promotion Foundation enabled the Developmental Disability Unit at Monash University, Box Hill, Victoria, Australia, to undertake a project investigating smoking in a population of people with intellectual disability. In the first part of the project, the smoking rate among a geographically defined group of people with mild intellectual disability was investigated. A smoking prevalence of 36% was found within the sample group, as compared to a prevalence of 26% within the general Victorian adult population. An association was found between the motivation to quite and the recall of advice to stop smoking. The second part of the project comprised the development and piloting of a smoking education course for people with intellectual disability. The pilot sample was small, but the results were encouraging. Fifty-five per cent of the group either quit smoking or cut down their intake significantly. Seventy-three per cent expressed a desire to stop smoking at the completion of the course, and all participants expressed an increased concern and knowledge about the effects of smoking on their health after completing the course.

Adult↗

PubMed2006

Intellectual disability and mental illness in the NSW criminal justice system.

There has been increasing international, national and local recognition of the need for more appropriate responses and services for individuals who come in contact with the criminal justice system and who have an intellectual disability and mental health issues. This article provides an overview of prevalence data that indicates a significant over representation of people with intellectual disabilities in correctional facilities and reviews the problems facing this population. Findings from two specific evaluation studies undertaken by the Centre for Developmental Disability Studies are presented, along with recommendations for future provision based on these results. One of these projects trialled a case management approach to supporting offenders with an intellectual disability upon their release from prison. The 20-month follow-up found that a number of serious barriers were encountered within the overall system of provision for this population; the most serious of which related to lack of adequate accommodation upon release. The second project involved a two-stage evaluation of one model of provision for individuals with intellectual disabilities who are sex offenders, only some of whom were on parole. This service provided both residential and therapy services in a small group home located in the community. Residents were found to have high levels of emotional and behavioural difficulties, in addition to offending behaviour, that continue to require support and supervision. Critical issues, including guardianship involvement, restrictive practices and retrieval, therapy provision, and risk management issues are discussed in relation to overall clinical and lifestyle outcomes.

Adult↗

PubMed2003

Life's a switch. Experiences in NSF undergraduate design projects.

During the summer of 2002 Stephanie Popp and Jennifer Barnes developed a manual, "Life's a Switch," through a project funded by the National Science Foundation. This manual teaches people how to build their own cost effective assistive switches. Assistive switches are a form of assistive technology which includes any device that enhances a person's quality of life by improving the individual's mobility, ability to perform daily activities, enhancing communication, or allowing participation in education, vocational activities and recreation. One main goal of assistive technology is to provide opportunities for children with disabilities to explore, play, learn, and communicate with others. Switches are essential tools used to provide these opportunities. When a child with developmental disabilities understands the connection between the activation of a switch and the resulting action it triggers, the knowledge of cause and effect is gained. Therefore, the basis for all future learning is established [1]. One of the current problems facing assistive switch users is the cost of available items. This project provides more affordable solutions for switch users by teaching the families and educators of switch users how to make their own switches and adaptors in the "Life's a Switch" manual. For example, some assistive technology vendors sell large button switches from $25.00 to $45.00, tread switches for $40.00, and pillow switches for $35.00 [2]. Amazingly, all parts and tools used to make these assistive switches can be bought and made into personally designed assistive devices averaging a cost of around $10.00 [3]. A workshop to teach this manual was also developed. This workshop will spread awareness of the more affordable options this project sets forth. In September of 2002, the first workshop was held in a laboratory classroom at the University of Wyoming's College of Engineering. Each attendant was provided with a kit that included all essential tools and components needed to make an assistive switch. Workshops scheduled into 2003 will provide educational opportunities for participants as well as opportunities for improvement of the manual.

Biomedical Engineering↗

PubMed2000

Measures of social outcomes in disability research.

OBJECTIVES: To describe instruments that have been developed to quantify (aspects of) social outcomes in research on persons with a disability, and to evaluate the clinimetric characteristics of some of the more prominent and promising measures. DATA SOURCES: Literature in social health, social psychiatry, developmental disabilities, independent living, gerontology, medical rehabilitation, and quality of life studies. STUDY SELECTION: Social outcomes are defined as those changes or differences in the social functioning (broadly defined) of persons with disabilities that result directly or indirectly from impairments and functional limitations. Excluded were measures that focus on purely physical or psychologic aspects of functioning, apply to children only, or quantify 1 social domain only. DATA EXTRACTION: For 16 instruments the distribution of items across the participation domains of the International Classification of Impairments, Activities, and Participation is presented, as well as a distribution of items by metrics used. For 5, clinimetric information from published studies were reviewed and summarized in letter grades. DATA SYNTHESIS: Several instruments have broad coverage, acceptable respondent burden, and moderate to good reliability, validity, and sensitivity. CONCLUSIONS: Social outcomes should be more routinely included in disability and rehabilitation research. Recommendations for selection and further development are made.

Persons with Disabilities↗

PubMed1993

An examination of phonemic processing abilities in children during their first-grade year.

The present study examined the development of reading and phonological processing abilities of 209 first graders (118 males, 91 females; mean age = 86.7 months) assessed during the first and last quarters of their first-grade year. The children were arranged into three different groups based on their Time 2 reading and intelligence data (children with and without reading disabilities, and "garden-variety" poor readers). Analyses indicated that the children with reading disabilities and the garden-variety poor readers did not differ significantly on many of the tasks, but both performed differently than the children without reading disabilities. Developmental analyses indicated that all three groups increased their reading and phonological skills; however, the gap between the performance of the children without reading disabilities and the other two groups widened from Time 1 to Time 2. The most important finding of the present study concerned the classification results of the discriminant analysis, which correctly identified the group membership of 207 of the 209 children (99.04% correct).

Awareness↗

PubMed2005

[Autism: educational models for a quality life].

AIMS: Our aim is to describe the change that is taking place in the field of education in developmental disabilities from models centred on the clinical symptoms and on the limitations in the adaptive skills to models that focus on valuable personal results in terms of quality of life. DEVELOPMENT: In order to understand these changes, we outline some of the key points that have given rise to a particular cultural construction of disability and we also discuss how the situation is changing towards models aimed at achieving important personal results. In autism, as in the other developmental disorders, special emphasis has traditionally been placed on an education focusing on symptoms and on skills, and, although things are now beginning to head in that direction, little attention has been given to education based on the person and his or her quality of life. These changes imply new roles for the professionals attending these people. These roles involve combining technique with empathy and ethics, and they are more firmly based on the active role of individuals with autism, together with their rights, interests and opinions. CONCLUSIONS: Models of intervention must pay special attention to the pursuit of valuable personal results, which are oriented towards living a quality life and must involve the active participation of the individuals themselves as well as their relatives.

Autistic Disorder↗

PubMed2001

Wolf-Hirschhorn (4p-) syndrome.

Wolf-Hirschhorn syndrome (WHS) is a well-known congenital malformation syndrome caused by deletion of the short arm of chromosome 4 (4p-). In spite of more than 100 reported cases, information on its natural history remained very limited until recently. It was generally thought that these children had severe developmental disabilities and tended to be mere survivors devoid of personality. However, it is now evident that individuals with WHS are capable of more acquisition of developmental milestones than previously suggested. It is therefore very important to have guidelines for health supervision and anticipatory guidance of such patients. Although thought to affect 1 per 50,000 births, we believe that the syndrome is more common because of the many syndromes with which it is still misdiagnosed, and because only 58% of cases can be recognized on regular G-banding. The following discussion outlines the historical evolution of our recognition of the several complex aspects of this syndrome, from the very early description to the latest knowledge on clinical and cytogenetic/molecular genetic aspects. Its purpose is to draw the attention of professionals (particularly pediatricians and family practitioners) to a clinical disorder that probably affects many more individuals than previously thought. Accurate identification of such patients can lead to the organization of the most appropriate laboratory testing, to the prediction of the prognosis with relative certainty, to the development of the most appropriate health maintenance and educational plans, and to referral of the patient and the family to support groups.

Abnormalities, Multiple↗

PubMed2005

Out-of-home placement of children with intellectual disability: Israeli-born parents vs. new immigrants from the ex-USSR.

Although the policy of deinstitutionalization encourages parents to raise a child with development disability at home, professionals are becoming increasingly aware of these parents' care-giving roles. Immigrant parents from the ex-USSR who have children with developmental disabilities are potential clients for placement, but to date, the tendency in Israel to out-of-home placement by immigrant parents, compared with Israeli-born parents, has not been studied. The placement variables were examined as a function of place of birth, emotional stress and social support. The sample was 100 parents who have children aged 6-21 years with mild to moderate mental retardation (according to the American Association on Mental Retardation definition) who live at home. Fifty parents were immigrants (arrived in Israel after 1990) and 50 were Israeli-born. They live in the region of Haifa and the north of Israel. The following measurements were carried out: (1) Demographic Questionnaire for data such as place of birth, age, socioeconomic status, etc., (2) Questionnaire of Resources and Stress, (3) Family Support Scale and (4) Out-of-Home Placement Questionnaire. The results showed that parents' readiness to apply for out-of-home placement proved to be related to their stress level and child's age, regardless of their origin (immigrants or Israeli-born) and regardless of social support resources. The older the children with mental retardation and the higher the stress levels felt by their parents, the higher was these parents' potential to apply for out-of-home placement. Immigrant parents tended to report a significantly higher level of stress than Israeli-born parents. No difference was found in the social support resources available to both research groups. Immigrant parents' stress level was higher as the child's mental retardation level was more moderate and their time in Israel was longer. Stress level among Israeli-born parents was higher among those who were religious, were of lower socioeconomic status and/or when, in addition to the mental retardation, the child suffered from other medical problems. In conclusion, families with children with mental retardation should be referred to services in an integrative way, regardless of the origin of the children's parents. Professionals must increase their own awareness of parents' level of stress and its impact on their readiness to apply for out-of-home placement. Recommendations for practical work and for future researches are made.

Adaptation, Psychological↗