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PubMedDate not supplied

Designing and implementing a school-based dental program for students with developmental disabilities.

Students with developmental disabilities in Atlantic County Special Services School District (ACSSSD) receive on-site dental care through a program created by UMDNJ-New Jersey Dental School (NJDS). The program's goal was to coordinate dental school resources with those of a school district, county agencies and the Delta Dental Foundation to provide quality dental services to the students, aged 3-21 years. The University developed a Needs Assessment Survey and distributed 450 surveys to the students' parent/guardian(s). Completed surveys were returned by 131 respondents. Of the 131 children represented, 75 had not been seen by a dentist within the past year. In response to guardian reported access problems, UMDNJ-NJDS and ACSSSD developed a school-based dental care delivery system and a program for health promotion and disease.

Adolescent↗
PubMed2007

Rapid assessment of severe cognitive impairment in individuals with developmental disabilities.

BACKGROUND: Most standardized intelligence tests require more than 1 hour for administration, which is problematic when evaluating individuals with intellectual disabilities and developmental disabilities (IDDD), because a significant proportion of these individuals can not tolerate lengthy evaluations. Furthermore, most standardized intelligence tests are of limited usefulness for individuals with severe cognitive deficits because of floor effects. METHODS: A number of low-difficulty items were selected from standardized tests. A total of 271 participants with profound, severe, moderate and mild levels of cognitive impairment took part in this study. In the formative phase, 68 participants were evaluated with the selected items, and those items that differentiated between levels of cognitive impairment were retained in the battery. The instrument was then modified and standardized with an additional 203 participants. RESULTS: The instrument, referred to as the Rapid Assessment for Developmental Disabilities (RADD), required 10-25 min for administration. Internal reliability estimates from the RADD total score and from individual subtests satisfied conventional and rigorous statistical criteria (median alpha r = 0.93). The RADD total score was strongly correlated with the level of cognitive impairment (rho = 0.86). The RADD total score and individual subtests differentiated between all levels of cognitive impairment ( Wilks Lambda = 0.135, F(42,525.832) = 12.075, P < 0.001). Receiver operating characteristic curves indicated the instrument was particularly sensitive to the cognitive abilities of the most seriously impaired participants. CONCLUSIONS: The RADD, composed of low-difficulty items from published tests, is rapidly administered, assesses a wide range of cognitive skills and differentiates among all levels of cognitive impairment. The battery has clinical utility with populations exhibiting short attention spans because of its ability to quickly assess a wide range of cognitive abilities. The RADD also has research potential for the documentation of cognitive function in studies of individuals with IDDD.

Adolescent↗
PubMed1990

Quality of the residential environment in board-and-care homes for mentally and developmentally disabled persons.

Data from a multistate survey of board-and-care homes were used to compare the quality of the residential environment in homes for mentally disabled and developmentally disabled persons. Staffing levels, services, quality of the physical structure, rapport between residents and staff, number of residents, staff training, and fire and safety precautions were analyzed. The global quality of the residential environment was found to be appreciably better in homes serving the developmentally disabled. Implications of the findings for public policy are discussed, with specific reference to advocacy strategies used in behalf of developmentally and mentally disabled persons.

Adult↗
PubMed2005

Prevention of developmental disabilities.

People with developmental disabilities have problems with major life activities such as language, mobility, learning, self-help, and independent living. Developmental disabilities begin anytime during development upto 22 years of age and usually last throughout a person's lifetime. It reflects the person's need for a combination and sequence of special interdisciplinary or generic care, treatment or other services that are of life-long or extended duration and that are individually planned and coordinated. They currently represent a large proportion of the childhood illnesses and disorders. The causes can be environmental, genetic or multifactorial. Prevention is important to reduce the neuromorbidity in the society. Strategies for prevention are discussed which take into account the possible causal associations.

Child↗
PubMed1999

Grant award to the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska. Center for Substance Abuse Treatment (CSAT), Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), HHS. Availability of grant funds for the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska.

This notice is to inform the public that CSAT and CMHS are making available approximately $5,000,000 for an award in FY 1999 to the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska to support development, implementation, and evaluation of a comprehensive, seamless system of care for persons with co-occurring substance abuse (including alcohol and other drugs) and mental health disorders in Anchorage, Alaska, and its environs. CSAT and CMHS will make this award if the application is recommended for approval by the Initial Review Group and the CSAT and CMHS National Advisory Councils. This is not a formal request for applications; assistance will be provided only to the Alaska Division of Mental Health and Developmental Disabilities. Eligibility for this program is limited to the State of Alaska, as specified in Congressional report language, in recognition of primacy of its responsibility for, and interest in, providing for the needs of its citizens, and because the success of the program will depend upon the authority and ability to broadly coordinate the variety of resources essential for full program success. The State has committed itself to moving certain mental health services from their extant institutional bases to community bases, and, simultaneously, changing from parallel systems of service delivery--for substance abuse and mental health problems--to an approach designed to deliver services seamlessly to persons with comorbidity. Alaska needs a high level of systemic competence in delivering these services due, in great part, to its climate (resulting in deaths of homeless comorbid persons), and to the requirements of its proposed systems changes. The proposed project presents a unique opportunity for SAMHSA and its Centers to learn, first hand, how the transition from parallel systems to a seamless system of care can be accomplished in a small city in a rural/frontier State, and at what costs. The project promises to yield learnings on the factors and circumstances that facilitate and/or retard systemic change in complex treatment systems. This "Anchorage Comorbidity Services" project is also part of SAMHSA's commitment to improving services, and relates directly to the resolution unanimously adopted by its National Advisory Council earlier this year. Funding from CSAT and CMHS will support some services to persons with co-occurring disorders; continuing planning, review, management, and infrastructure development for the effort; and a tripartite evaluation of the project, including process, outcome, and impact evaluations. This is a unique opportunity to evaluate significant change in a State system of care for persons with co-occurring disorders.

Alaska↗
PubMed1980

Recognizing the mental health needs of developmentally disabled people.

Many developmentally disabled persons and their families are being denied adequate mental health services. This problem exists because of the attitudes of mental health professionals and the structure of major agencies that serve the disabled. The author presents brief case histories that illustrate the types of stress experienced by the developmentally disabled and makes suggestions for therapeutic intervention.

Community Mental Health Services↗
PubMed2007

Setting the stage: early child and family characteristics as predictors of later loneliness in children with developmental disabilities.

Children with developmental disabilities often report having few friends. Researchers have tended to focus on social skill deficits, neglecting other potent predictors of children's feelings of loneliness. In a sample of 82 children with developmental disabilities, we examined characteristics of the child at age 3 (i.e., the conclusion of early intervention services) as well as family income and emotional climate as predictors of children's reported feelings of loneliness at school during middle childhood (age 10). Children with lower levels of externalizing behavior problems at age 3 and from families with a more positive family climate, as indicated by the Family Environment Scale, reported less loneliness at age 10. Implications for children, families, and early intervention services are discussed.

Child↗
PubMed1995

A collaborative approach to reduce hospitalization of developmentally disabled clients with mental illness.

Developmentally disabled clients with a concomitant mental illness are often underserved or inappropriately treated because of interorganizational barriers, leading to unnecessary hospitalization and lengthy delays in community placement. To overcome these barriers, agencies responsible for developmental disabilities and mental health services in Spokane County in Washington State developed a collaborative system of care in 1989. An interagency consortium was established to promote coordination of services between the community mental health center, the state hospital, the county human services agency, the state's regional developmental disability service agency, the state institution for the developmentally disabled, and several community agencies serving developmentally disabled persons. Between 1990 and 1992, admissions of developmentally disabled persons to the state hospital were more likely to be appropriate admissions of persons suffering from a mental illness, developmentally disabled clients were discharged more efficiently, and crisis respite services were used in place of hospitalization. In addition, anecdotal reports indicated a reduction of interagency tensions.

Community Mental Health Services↗
PubMedDate not supplied

Mentoring treatment teams to integrate behavioral and psychopharmacological treatments in developmental disabilities.

Individuals with developmental disabilities often have a concomitant psychiatric disorder severe enough to require treatment. The behavioral endpoint of psychiatric disorders may require integrated behavioral and psychopharmacological treatments to stabilize their condition and enhance their quality of life. We used a mindfulness-based mentoring model to facilitate the integration of behavioral and psychopharmacological treatments at the treatment team level. Using a multiple baseline design across treatment teams, we assessed the degree of integration of these two treatment modalities using a 23-item rating scale, and then introduced mentoring successively across the three treatment teams. Following mentoring, six follow-up assessments at monthly intervals were undertaken to assess functioning of the treatment teams in the absence of mentoring. The low levels of integration of behavioral and psychopharmacological treatments occurring during baseline improved significantly within each team commensurate with the mentoring. Further, the enhanced treatment team functioning was maintained during a 6-month follow-up period. Mentoring of treatment teams may be an effective first step in integrating behavioral and psychopharmacological treatments that are deemed essential in the care and treatment of individuals with developmental disabilities and mental illness.

Behavior Therapy↗
PubMed1998

Clinical findings among sexually abused children with and without developmental disabilities.

Although children with developmental disabilities have a heightened risk for sexual abuse compared to those without disabilities, little is known about effects of sexual abuse on this population. Some researchers suggest that the effects are similar, and victims appear to share the same range of variability as people without disabilities. Others suggest that the effects may be complicated by limited coping resources and disability-related issues. Documented effects of sexual abuse on individuals with developmental disabilities was discussed. Clinical findings among a group of 43 children with and 43 children without developmental disabilities referred for treatment of child sexual abuse were also presented.

Adaptation, Psychological↗
PubMed1994

Effect of adult continuing wh-questions on conversational participation in children with developmental disabilities.

Children with developmental disabilities often converse less frequently than their developmentally matched peers. This low conversational participation can cause problems for the children's future language and discourse development. The purpose of this experimental study was to test the hypothesis that adult topic-continuing wh-questions would elicit topic continuations in children with relatively low language ability, but not in children with relatively high language ability. Twenty-three children with developmental delays interacted with an adult who conducted two play sessions. In each session, the adult used a different interaction style. The two styles differed in the adult's use of topic-continuing wh-questions. Results indicate that adult use of topic-continuing wh-questions supported the use of child continuations in children at all language levels. The type of continuations (single word versus multiword) that were elicited depended on the language level of the children. Clinical implications are discussed.

Adult↗
PubMed1978

Developmental disabilities.

The concept of developmental disabilities as a group of problems with origins in the stages of human development has been broadened by recent legislation to include mental retardation, cerebral palsy, epilepsy, autism, dyslexia, and other neurological impairments. The debate continues on whether or not specific disability categories should be named, but the functional aspects of the problems seem to be generally accepted. Potential implications of this legislation for occupational therapy are discussed in this paper. Numerous programs supported by a variety of governmental units and private agencies will need qualified professionals. This paper concludes with a brief list of six developmental disability programs of the University of Michigan University Affiliated Facility and an outline of three models of field placement in developmental disabilities for occupational therapy students.

Developmental Disabilities↗
PubMed2001

Concurrent validity of the Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disabilities Inventory in children with developmental disabilities and acquired brain injuries.

The Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disability Inventory (PEDI) are the most commonly used measures of functional performance in children. The purpose of this study was to determine the concurrent validity of the instruments when used with children with developmental disabilities and acquired brain injury. The subjects were 41 children, age 1.3 to 9.5 years, who were receiving inpatient or outpatient services at a pediatric rehabilitation unit in Brisbane, Australia. Spearman correlation coefficients between the two tests were greater than 0.88 for self care, transportation/locomotion, and communication/social function. The high correlations indicate that the two tests measure similar constructs. Choosing between the tests depends on situational requirements and depth of information required.

Brain Injuries↗
PubMed2004

Longitudinal prescribing patterns for psychoactive medications in community-based individuals with developmental disabilities: utilization of pharmacy records.

BACKGROUND: Little is known about longitudinal prescribing practices for psychoactive medications for individuals with intellectual disabilities and developmental disabilities (IDDD) who are living in community settings. METHODS: Computerized pharmacy records were accessed for 2344 community-based individuals with IDDD for whom a total of 3421 prescriptions were written during a 17-month period of study. Forty-two psychoactive medications were rank ordered in terms of prescription frequency. RESULTS: Fifty-two per cent (52%) of all prescriptions written during the study period were for psychoactive medications. Anticonvulsant, antipsychotic and antidepressant medications were the most commonly filled prescriptions among psychoactive medications. Sixty per cent (62%) of the study population was given prescriptions for more than one psychoactive medication and 36% received three or more psychoactive medications. During the study period there was a statistically significant increase in prescriptions filled for olanzapine, risperidone, valproic acid, and clonazepam whereas prescriptions filled for thioridazine, haloperidol, and benzotropine showed a significant decline (P < 0.05-0.001). Distribution of psychoactive drug class by age showed that the majority of prescriptions were filled for individuals between 20 and 50 years with the exception of prescriptions for psychostimulants which peaked for individuals prior to 20 years. CONCLUSIONS: (1) Analysis of pharmacy billing records provides a method for assessing prescribing patterns of psychoactive medications in community-based individuals with IDDD. (2) Polypharmacy for psychoactive medications is prevalent in this setting. (3) The second-generation antipsychotic medications are prominently represented by an increasing number of filled prescriptions during the study period.

Adult↗
PubMedDate not supplied

Health disparities among adults with developmental disabilities, adults with other disabilities, and adults not reporting disability in North Carolina.

OBJECTIVES: The purposes of this study were (1) to identify disparities between adults with developmental disabilities and non-disabled adults in health and medical care, and (2) to compare this pattern of disparities to the pattern of disparities between adults with other disabilities and adults without disabilities. METHODS: The authors compared data on health status, health risk behaviors, chronic health conditions, and utilization of medical care across three groups of adults: No Disability, Disability, and Developmental Disability. Data sources were the 2001 North Carolina Behavioral Risk Factor Surveillance System and the North Carolina National Core Indicators survey. RESULTS: Adults with developmental disabilities were more likely to lead sedentary lifestyles and seven times as likely to report inadequate emotional support, compared with adults without disabilities. Adults with disabilities and developmental disabilities were significantly more likely to report being in fair or poor health than adults without disabilities. Similar rates of tobacco use and overweight/obesity were reported. Adults with developmental disabilities had a similar or greater risk of having four of five chronic health conditions compared with non-disabled adults. Significant medical care utilization disparities were found for breast and cervical cancer screening as well as for oral health care. Adults with developmental disabilities presented a unique risk for inadequate emotional support and low utilization of breast and cervical cancer screenings. CONCLUSIONS: Significant disparities in health and medical care utilization were found for adults with developmental disabilities relative to non-disabled adults. The National Core Indicators protocol offers a sound methodology to gather much-needed surveillance information on the health status, health risk behaviors, and medical care utilization of adults with developmental disabilities. Health promotion efforts must be specifically designed for this population.

Adolescent↗
PubMed2000

[Empowerment of people with developmental disabilities].

People with developmental disabilities have their own life cycles and social services for them, such as therapeutic training, education, vocational training, and community care, should respect their initiative in decision-making and controlling their own lives. However, social isolation of the disabled people and their families, lack of resources, and discrimination have resulted in their disempowerment. This paper discusses the professionals' role in empowerment, focuses on social and consumer models, and emphasizes the importance of the partnership between professionals and self-help groups.

Adolescent↗
PubMedDate not supplied

Social work in a dental program for the developmentally disabled.

This article discusses the role of a social worker in a dental school based program for the developmentally disabled. Developmentally disabled people constitute a heterogeneous population with problems that often prevent them from receiving appropriate dental services. A social worker in the dental care setting can help this population access dental services. Data gathered during a 2-year period support the hypothesis that patients living at home present more obstacles to dental care and require more social work intervention in obtaining dental care than patients living in residential settings.

Dental Care for Persons with Disabilities↗
PubMedDate not supplied

Analyzing Pennsylvania community residential facilities for individuals with intellectual and developmental disabilities.

Evolving residential requirements for individuals with mild and moderate intellectual disabilities and related developmental disabilities increasingly place these persons in community settings. The increasing numbers of these individuals are dependent upon local practitioners for needed health services. National and Pennsylvania data are reviewed in an effort to provide a general awareness of these community living arrangements, which in turn may assist in the delivery and the follow-up of oral health services.

Adolescent↗