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As people with learning disabilities live longer, their risk of getting cancer increases. Like the rest of the population, they may also have relatives who are affected. Now there is a source of help and information.
The child-rearing expectations of 101 Australian parents of intellectually handicapped children were assessed, using the Parent As A Teacher Inventory. The overall PAAT index for subjects scoring at either the upper or lower extremes proved to be valuable in identifying those parents who would be the most and least successful teachers in a home-based language training program.
The comprehensive, successful treatment of patients with cleft lip, alveolus and palate requires numerous surgical interventions and very close cooperation between various medical and dental specialists. The willingness and ability of the patient to undergo treatment are undoubtedly important factors in achieving optimal treatment outcomes. The presented case report shows that limited compliance makes it much more difficult for speech pathologists and orthodontists to treat mentally retarded patients. Only with combined orthodontic therapy and orthognathic surgery could the dental and skeletal abnormalities be corrected in adulthood.
Porphyromonas gingivalis fimbriae are critical for the promotion of bacterial infection. The fimA gene encoding fimbrillin, a subunit of fimbriae, has been classified into five genotypes (types I to V) based on their nucleotide sequences. Using a fimA type-specific PCR assay, our previous study demonstrated a close relationship between P. gingivalis possessing type II and type IV fimA genes and adult periodontitis. In that study, some clinical specimens were found to be positive for both types I- and II- fimA specific primers, likely due to the coexistence of two clonal types or a single clone of an unknown genotype in the samples. In the present study, we cloned a new variant of the fimA gene, designated as type Ib fimA, from P. gingivalis HG1691. The nucleotide sequence of the cloned fimA gene showed a 97.1% homology with that of type I fimA, indicating it as a clonal variant of type I fimA. Organisms with type Ib fimA were detected in 13.5% of periodontitis patients and in 2.9% of periodontal healthy adults. Statistical analysis revealed a strong relationship between periodontitis and specific fimA types such as type Ib [odds ratio (OR) 6.51], type II (OR 77.8), and type IV (OR 7.54). Moreover, type Ib fimA-organisms were also found to be related to periodontitis in Down's syndrome (OR 1.91) and mentally disabled populations (OR 4.00). These findings suggest that P. gingivalis with type Ib fimA is closely associated with the progression of periodontitis, similar to organisms with type II and IV fimA.
16 children with spastic cerebral palsy and 25 mentally retarded children were assessed via the scales "Self-Care" and "Mobility" of the Pediatric Evaluation of Disability Inventory (PEDI). Age-adjusted PEDI scores were compared with the classification according to the three levels of the German statutory nursing insurance. Good correlations and highly significant dependence were found in children with spastic cerebral palsy but no dependence was seen in mentally retarded children. Apparently, assessment guidelines of the German statutory nursing insurance do not guarantee a valid assessment in all disabled children. In conclusion, future assessments of nursing needs in children should employ standardised assessment methods.
OBJECTIVES: Low bone mineral density (BMD) is a major risk factor for osteoporotic fracture. The gold standard measurement of BMD, central dual-energy x-ray absorptiometry (DXA), requires transportation to a radiologic facility, patient agility and cooperation. For those with severe cognitive impairment, this is not realistic; hence, central BMD is seldom measured. The objectives were to evaluate the use of calcaneal BMD measurement (by qualitative ultrasound), the prevalence of osteoporosis diagnosis (based on calcaneal BMD), and treatment in individuals with severe cognitive impairment. DESIGN: This is a point prevalence descriptive study. Calcaneal BMD was measured using a Sahara sonometer (Hologic). Cognition (Mini Mental Status Examination), mobility (Berg balance scale, timed up-and-go), and chart audit were also undertaken. SETTING: This study was conducted at four dementia long-term care facilities (122 beds) in Edmonton, Alberta, Canada. PARTICIPANTS: Forty long-term care residents participated in this study with an average MMSE of 10 (range, 0-25). MEASUREMENTS: One hundred percent of study subjects cooperated with calcaneal ultrasound measurement. RESULTS: Based on calcaneal BMD measurement using recommended cutoffs, 92.5% were at high risk for osteoporosis or osteopenia and 5% were at moderate risk. One participant (2.5%) had a normal calcaneal BMD measurement. Calcium supplementation occurred in 32% of the high-risk group, 50% of the moderate-risk group, and 100% of the normal group. One (2.5%) participant was on hormone replacement therapy, and 12% were taking etidronate. CONCLUSIONS: Calcaneal ultrasound measurement could be a useful tool to assess BMD in cognitively impaired nursing home residents.
BACKGROUND: People with intellectual disabilities (IDs) experience significant health inequalities compared with the general population. The barriers people with IDs experience in accessing services contribute to these health inequalities. Professionals' significant unmet training needs are an important barrier to people with IDs accessing appropriate services to meet their health needs. METHOD: A three group, pre- and post-intervention design was used to test the hypothesis that a training intervention for primary health care professionals would increase the knowledge and self-efficacy of participants. The intervention had two components - a written training pack and a 3-hour face-to-face training event. One group received the training pack and attended the training event, a second group received the training pack only, and a third group did not participate in the training intervention. Research measures were taken prior to the intervention and 3 months after the intervention. Statistical comparisons were made between the three groups. RESULTS: The participants in the training intervention reported that it had a positive impact upon their knowledge, skills and clinical practice. As a result of the intervention, 35 (81.4%) respondents agreed that they were more able to meet the needs of their clients with IDs, and 33 (66.6%) reported that they had made changes to their clinical practice. The research demonstrated that the intervention produced a statistically significant increase in the knowledge of participants (F = 5.6, P = 0.005), compared with the group that did not participate in the intervention. The self-efficacy of the participants that received both components of the intervention was significantly greater than the group that did not participate in the training (t = 2.079, P = 0.04). Participation in the two components of the training intervention was associated with significantly greater change in knowledge and self-efficacy than those receiving the training pack alone. CONCLUSION: This intervention was effective in addressing the measured training needs of primary health care professionals. Future research should directly evaluate the positive benefits of interventions on the lives of people with IDs.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This study examined fears in children with and without developmental disabilities. Children assigned to classes designed as developmentally handicapped (D), integrated (or mainstreamed) (I), and regular (R) were assessed. In all, 82 children were tested and retested over a 2-week interval. Self ratings and parent ratings were obtained. Three instruments were used to assess specific fears, social anxiety, social competence, and behavior problems: the Fear Survey Schedule for Children--Revised, the Social Anxiety Scale for Children, and the Child Behavior Rating Form. Correlations between parent and child ratings were fair to good. Child-parent agreement was nonsignificantly higher for children without disabilities and for children with mild handicaps integrated into regular education programs than for children in classes designated as Developmentally Handicapped. Children's test-retest reliabilities were generally higher than those of parents. Children without disabilities showed significantly higher consistency over time than children with disabilities.
OBJECTIVES: The uptake of mammography for breast cancer screening is considerably lower among women with intellectual disability than for women in the general population. The purpose of the present study was to investigate carer perceptions of barriers and enablers to mammography use by these women. METHODS: To determine the reasons why women with intellectual disability are not utilising screening services, a series of focus groups were held with social trainers working in accommodation provided for people with intellectual disability. RESULTS: The major themes identified included the need for a medical referral or invitation from the mammography service to motivate people to attend; the belief that many women with intellectual disability would not understand the procedure or why it needs to be done and therefore would experience fear and anxiety to a greater extent than women in the general population; and that physical disabilities comorbid in many of the women would limit their ability to be adequately accommodated by the machines used to take a mammogram. CONCLUSIONS: The social trainers agreed that many of the barriers to screening would be difficult to overcome and supported alternative strategies to mammography, such as clinical breast examination.
This paper describes an evaluation study of a home-based, family-focussed counselling scheme providing support for English-speaking and Bangladeshi families of children with intellectual or multiple disabilities. Mothers and children in the intervention groups showed significant and positive changes compared to randomly allocated controls. The greatest benefits were derived by the more deprived and initially less well-supported Bangladeshi families. Mothers changed positively in ratings of perceived support and family functioning, and in their constructions of their child, themselves, husbands and family relationships. Although systematic teaching was not included, their children also showed improvements in developmental progress and behaviour problems.
A comparison between parent and teacher ratings of 109 school children on the French version of the Nisonger Child Behavior Rating Form, which measures social competence and problem behaviors of children with developmental disabilities, was conducted. Results indicated no significant differences between parent and teacher ratings on the two social competence subscales and two problem behavior subscales. Ratings differed significantly on three problem behavior subscales: (a) Conduct Problem, (b) Insecure/Anxious, and (c) Hyperactive. These results may be indicative of complementary information according to the context (home vs. school). Also, results support the premise that it is important to collect information from multiple sources in order to obtain a complete and global assessment of the child's problem behavior/psychopathology.
Although bullying has been shown to reduce quality of life in many spheres, anti-bullying strategies have yet to be incorporated into services for adults with severe intellectual disability (ID). The present study employed a survey of staff and parent concerns about 54 previously surveyed students who had left a school for pupils with severe ID. A content analysis of follow-up interviews was performed in 10 cases. Staff identified 19% of the survey sample as bullying others and 11% as being picked on. Neither gender nor communication ability had an impact. There was no significant change in bully or victim status over time, although some people did change. Parents or staff raised bully/victim problems in more than half of the interviews. There is sufficient evidence of bullying behaviour to warrant the adoption of anti-bullying strategies.
BACKGROUND: There has been limited research on differences in temperament between typically developing children and children with an intellectual disability (ID). Individual differences have generally been neglected in previous investigations of children with an ID. The present research investigated differences in temperament and social behaviour between typically developing children and children with an ID, in both home and school settings. METHODS: Participants were 100 children (M = 10.7 years, SD = 0.88) from both regular and special education schools. Temperament was measured using the Emotionality, Activity, Sociability (EAS) Temperament Survey for Children (parental and teacher ratings), while social behaviour was measured using the School Social Behaviour Scales, Second Edition (SSBS-2) and the Home and Community Social Behaviour Scales (HCSBS). RESULTS: There were minimal significant differences in temperament between the regular and special education groups. Children who attended regular schools had a significantly higher level of social competence and significantly lower level of antisocial behaviour both at home and school, when compared with children who attended special schools. CONCLUSIONS: The difference in social behaviour between children attending regular and special schools was attributed to the difference in intellectual ability of the two groups, as well as contextual influences of regular or special school environments.