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PubMed2006

Longitudinal relationships between sibling behavioral adjustment and behavior problems of children with developmental disabilities.

Siblings of children with developmental disabilities were assessed twice, 2 years apart (N = 75 at Time 1, N = 56 at Time 2). Behavioral adjustment of the siblings and their brother or sister with developmental disability was assessed. Comparisons of adjustment for siblings of children with autism, Down syndrome, and mixed etiology mental retardation failed to identify group differences. Regression analysis showed that the behavior problems of the child with developmental disability at Time 1, but not the change in their behavior over time, predicted sibling adjustment over 2 years. There was no evidence that this putative temporal relationship operated bidirectionally: sibling adjustment did not appear to be related to the behavior problems of the children with developmental disabilities over time.

Adaptation, Psychological↗
PubMed2003

Respect for the developmentally disabled and forgoing life-sustaining treatment.

A developmentally disabled person should be treated at all times as a unique individual and not as some anonymous "disabled person." The developmentally disabled should not be subjected to invasive medical treatment that is unduly burdensome or nonbeneficial, or be forced to endure a quality of life not meaningful to them as individuals. They have a right to refuse or accept treatment that a surrogate must exercise on behalf of each individual in a responsible and careful manner. Three cases and a preliminary approach to the ethical analysis of decisions to allow developmentally disabled persons to die by forgoing medical treatment are offered. The "best interests" of a developmentally disabled individual, properly understood, can serve as a useful and ethically defensible standard for determining the ethical propriety of surrogate decision making about forgoing life-sustaining medical treatment of the disabled.

Adolescent↗
PubMed1992

Computers in medicine: enhancing medical care for children with developmental disabilities.

Caring for children with developmental disabilities and their families requires the close monitoring and management of a multitude of complex medical and psychosocial issues. The need for an interdisciplinary team approach to address these concerns presents special logistical problems on how to organize and present the information obtained during a clinic visit, and how to expedite the dissemination of this information to the team members. I am currently utilizing a computerized medical record database in the Developmental Disabilities Clinic at Children's Hospital-Columbus, Ohio and at The Nisonger Center a university affiliated program (UAP). The hardware required for the operation of this system includes a Macintosh PowerBook 170 and FilemakerPro software by Claris. The flexibility of use and the potential future applications of this program provides a practical clinical approach to caring for children with developmental disabilities.

Child, Preschool↗
PubMed2004

Grief in the shadows: exploring loss and bereavement in people with developmental disabilities.

A greater understanding of how developmentally disabled people cope with loss and bereavement is needed to improve assessment and intervention for these individuals. Misconceptions exist about how effectively developmentally disabled persons can articulate their perceptions and feelings about traumatic experiences, death, and the subsequent impact of the events that follow. The lived experience and expression of grief may differ for the developmentally disabled population. As a result, their reactions may not be adequately recognized, interpreted, or managed therapeutically, compounding their distress. Three case reports of developmentally disabled individuals who experienced a loss are presented, along with helpful guidelines regarding assessment and intervention.

Adaptation, Psychological↗
PubMed1981

Reinforcer variation: implications for motivating developmentally disabled children.

Motivating developmentally disabled children to participate in educational activities can be very difficult. This is especially true for children diagnosed autistic. Because there is some evidence to suggest that stimulus variation may influence motivation, the present study investigated the effects of constant vs. varied reinforcer presentation on correct responding and on-task behavior. Results from a reversal design showed declining trends in both correct responding and on-task behavior when the same reinforcer was consistently presented, whereas, varying the reinforcers produced significantly improved and stable responding. the results are discussed in relation to the literature on stimulus variation and its effects on responsiveness.

Autistic Disorder↗
PubMed1977

Comparison of three training procedures for teaching social responses to developmentally disabled adults.

Three developmentally disabled adults were taught three peer interactive responses--verbailization, recreation, and cooperation--by three training procedures: (a) modeling, (b) instruction and feedback, and (c) modeling, instructions, and feedback. All three training procedures increased all three responses, but the most effective procedure was modeling, instructions, and feedback. In the two modeling conditions, videotapes of nonretarded adults were used, demonstrating the feasibility of this method for teaching retarded persons.

Adult↗
PubMed2002

Christine: a case study of literacy acquisition by an adult with developmental disabilities.

Christine, an adult with developmental disabilities, had no history of education. A nonreader, she began to receive literacy tutoring at age 35. In 7 years she was educated through an eclectic approach that primarily entailed echo reading of brief passages, such as sentences and stories. She moved from holistic recognition of print to an ability to respond to instruction about analysis of some features of print, thereby gaining insights into decoding and spelling. This approach contrasts with literacy instruction that teaches adults with developmental disabilities to memorize small units of decontextualized print (letter-sound correspondences or survival words) before reading full text. Implications for facilitating literacy in adults with developmental disabilities by using contextually supported reading instruction are explored.

Adult↗
PubMedDate not supplied

Length of stay for psychiatric inpatient services: a comparison of admissions of people with and without developmental disabilities.

This study investigated associations between the presence of developmental disabilities and length of inpatient stay for mental health care. All psychiatric admissions of people with developmental disabilities over a 5-year period were selected (n = 294), and were compared using survival analysis to a random sample of admissions from the general psychiatric population (n = 287). Overall, people with developmental disabilities stayed in hospital longer than those without developmental disabilities, and this extra stay was partially attributed to casemix differences between the cohorts. Subanalysis in both cohorts showed that those going back to their usual living arrangement stayed a shorter period than those who were discharged elsewhere, and that people with developmental disabilities were less likely to be discharged to their usual living arrangement than were people without the disability. This study highlighted the importance of specialized residential and personal supports for people with developmental disabilities and a coexisting mental disorder.

Adult↗
PubMed2006

Sexuality of children and adolescents with developmental disabilities.

Children and adolescents with developmental disabilities, like all children, are sexual persons. However, attention to their complex medical and functional issues often consumes time that might otherwise be invested in addressing the anatomic, physiologic, emotional, and social aspects of their developing sexuality. This report discusses issues of puberty, contraception, psychosexual development, sexual abuse, and sexuality education specific to children and adolescents with disabilities and their families. Pediatricians, in the context of the medical home, are encouraged to discuss issues of sexuality on a regular basis, ensure the privacy of each child and adolescent, promote self-care and social independence among persons with disabilities, advocate for appropriate sexuality education, and provide ongoing education for children and adolescents with developmental disabilities and their families.

Adolescent↗
PubMed1995

Nursing care of children with developmental disabilities having surgery.

Children with developmental disabilities (CWDD) who undergo surgery have special needs. The nurse is required to make accurate assessments of the intellectual, psychosocial, and physical state of the child as well as the emotional functioning of the family. The nurse must be aware of the legal implications and his/her own attitudes regarding CWDD. Parents must be accepted as partners with the health care team and open communication should be established. Special concerns for the health care team are latex allergy and malignant hyperthermia. Nursing Care Plans specific to the child with pain, epilepsy, hydrocephalus, myopathy, Down syndrome, myelomeningocele, and cerebral palsy are provided. The material presented here should serve as a basis for nurses to deliver family-centered compassionate care to children and their families who are living with the burdens and enduring the hardships brought about by developmental disabilities.

Child↗
PubMed1996

Postnatal causes of developmental disabilities in children aged 3-10 years--Atlanta, Georgia, 1991.

Primary prevention of developmental disabilities requires knowledge of the specific causes of these conditions. Postnatal causes account for 3%-15% of all developmental disabilities and often are preventable. To assess the prevalence and determine the specific etiology of postnatally acquired developmental disabilities, CDC analyzed data from its ongoing Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) for 1991 (the most recent year for which complete data were available). This report summarizes the findings of the analysis, which indicate that bacterial meningitis and child battering were the leading postnatal causes of developmental disabilities and that children with postnatally acquired developmental disabilities had a higher average number of disabilities than all other children with developmental disabilities.

Cerebral Palsy↗
PubMed2004

[Quantitative study of brain perfusion patterns of 99mTc-ECD SPECT in children with developmental disabilities].

The aim of this study was to investigate the relationship between developmental disabilities and brain perfusion patterns. We performed technetium-99 m-ethylcysteinate dimer (99m-Tc-ECD) single photon emission computed tomography (SPECT) in 30 children with neurological disorders using the Patlak plot method. In children without developmental disabilities, the distribution of regional cortical perfusion evolved in relation to brain maturation. At one month of age, there was a predominant uptake in the perirolandic cortex. Radionuclide uptake in both the parietal and occipital cortices became evident by three months. Uptake in the temporal and frontal cortex increased by 6 and 11 months, respectively. Brain perfusion showed a pattern similar to that of adults by two years of age at the latest. In children with developmental disabilities, developmental changes of brain perfusion were delayed compared to normally developing children. Brain SPECT is a useful tool to assess the brain maturation in children with developmental disabilities.

Adolescent↗
PubMed1997

A state-university collaboration to serve persons with developmental disabilities and mental health needs.

Persons with developmental disabilities and mental health needs present a complex and potentially rewarding challenge to workers in both developmental disabilities (DD) and mental health (MH) fields. These individuals may be shuttled between (DD) and (MH) systems. Effective care requires the person obtain services from both systems. This paper describes one possible mechanism of service delivery for persons with developmental disabilities and mental health needs.

Colorado↗
PubMed2005

Evaluating the establishment and maintenance of visual-visual and gustatory-visual equivalence relations in adults with developmental disabilities.

Four adults with developmental disabilities were taught to make conditional discriminations between either pictures and their corresponding printed English and Spanish words, or tastes and their corresponding printed English and Spanish words. Participants required more training trials to master the visual-visual conditional discriminations than the gustatory-visual conditional discriminations, and 3 of the 4 participants performed with higher accuracy on visual equivalence class test trials than gustatory-visual equivalence class test trials. A follow-up equivalence test conducted 30 to 40 days later showed substantially greater stability over time for the gustatory-visual classes than for the visual classes, for all participants. That participants acquired gustatory-visual conditional discriminations, as well as equivalence classes based on those conditional discriminations, may have relevance for incorporating gustatory stimuli into mand training sessions, as well as for teaching individuals with sensory impairments in other modalities.

Adult↗
PubMed2005

[Sleep disturbance in patients with developmental disability].

Many patients with developmental disabilities exhibit various types of sleep disturbance. However, we have no idea of a specific approach to relieve the symptoms on sleep disturbance, although recent basic neuroscience has provided many novel findings on the neuronal mechanisms of the sleep-wakefulness cycle. In this brief review, a flip-flop circuit was introduced to explain neuronal mechanisms of the abrupt change between sleep and wakefulness. The rate of atonia during non-REM sleep was also introduced, as this index may useful for assessing the cholinoaminergic balance of the central nervous system. Sleep hygiene was also based on basic sleep-wakefulness mechanisms. To maintain sleep hygiene is a fundamental approach caring for patients with sleep disturbance, and specific approaches such as medication and treatment of sleep disordered breathing should also be based on the basic mechanisms of the sleep-wakefulness cycle. It was emphasized that effective intervention should only occur after the careful assessment of neuronal background of each patient.

Child↗
PubMed2003

Validity of a performance assessment of activities of daily living for people with developmental disabilities.

BACKGROUND: Since clients with different types of developmental disabilities often experience difficulties in activities of daily living (ADL), it is critical that assessments of ADL are evaluated in order to ensure that one can make valid judgements based on the results of the appraisal. The purpose of the present study was to evaluate the validity of a specific performance assessment instrument, the Assessment of Motor and Process Skills (AMPS), when used by occupational therapists with clients with developmental disabilities. Unlike global ADL assessments, the AMPS is used not only to evaluate the level of ADL dependence, but also to estimate the quality of each specific action performed when a person is performing ADL tasks. METHODS: Data were gathered from 1724 participants with different developmental disabilities, including intellectual disability (ID), cerebral palsy and spina bifida. Many-Facet Rasch (MFR) analysis was used to examine person-response validity, and task and item scale validity. RESULTS: Goodness-of-fit statistics showed that the tasks and items had acceptable scale validity. The participants had acceptable person-response validity on the ADL motor scale, but had slightly lower than expected levels of person-response validity on the ADL process scale. The results indicate that clients with more severe forms of ID may have a higher proportion of different performance profiles in ADL than is expected by the MFR model of the AMPS. Since the proportion of participants who did not meet the criteria was only 3% lower than expected and in accordance with other studies, the difference may not be clinically meaningful. Otherwise, the results indicated that the AMPS is a valid tool when used with clients with developmental disabilities. CONCLUSIONS: Further research is needed to evaluate the use of the AMPS in clinical assessment and intervention planning for this group of clients.

Activities of Daily Living↗
PubMed1996

Issues in sexuality and gynecologic care of women with developmental disabilities.

The reproductive needs of women with developmental disabilities often are overlooked by family, caregivers, institutions, and even health care professionals because these women are regarded as somehow asexual. However, women with developmental disabilities are becoming more active in their communities, leading to greater opportunities for social-sexual interactions and an even greater need for reproductive services. Nurses are in a pivotal position to provide a variety of reproductive services encompassing not only the needs of women with developmental disabilities but also of their support systems. Special considerations during the gynecologic examination are discussed, as are available birth control options.

Adult↗
PubMed2002

The epidemiology of developmental disabilities in low-income countries.

Although most of the world's children live in developing countries and may be at high risk for disability, very little is known about the prevalence and causes of developmental disabilities in these countries. This paper discusses methodological difficulties contributing to this lack of knowledge, and provides an overview of what is known about the epidemiology of developmental disabilities in low-income countries. At least some forms of developmental disability appear to be more common in low-income countries than in wealthier countries, despite the probability of higher mortality among children with disabilities in low-income countries. For example, most studies of severe mental retardation in low-income countries report prevalences greater than 5 per 1,000 children, while prevalence estimates from industrialized countries are consistently below this. Major risk factors for developmental disabilities in some low-income countries include specific genetic diseases, a higher frequency of births to older mothers, consanguinity, and specific micronutrient deficiencies and infections. Trauma and toxic exposures are also important risk factors, but their contributions to the etiology of developmental disabilities in low-income countries are not well documented. Though many of the causes of developmental disabilities are understood and preventable, proven methods of prevention are not being fully implemented in developing countries. Epidemiologic studies are needed to raise awareness of the public health impacts of developmental disabilities in low-income countries and to provide a basis for setting priorities and designing efficient interventions.

Adolescent↗