Showing papers in "American journal of mental deficiency in 1981"

Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior.

Abstract: A set of criteria based upon biostatistical considerations for determining the interrater reliability of specific adaptive behavior items in a given setting was presented. The advantages and limitations of extant statistical assessment procedures were discussed. Also, a set of guidelines for differentiating type of adaptive behavior that are statistically reliable from those that are reliable in a clinical or practical sense was delineated. Data sets were presented throughout in order to illustrate the advantages of recommended statistical procedures over other available ones.

Psychosocial assets of parents of handicapped and nonhandicapped children.

Abstract: Parents of 34 handicapped children were compared to a control sample of parents of nonhandicapped children on a variety of measures, including marital satisfaction, social support, religiosity, psychological well being, and a measure of resources and stress. Significant differences were found between groups along a number of these dimensions.

Living in the community.

Abstract: The movement to deinstitutionalize and normalize the lives of mentally retarded individuals has led to significant changes in where people live and how programs are administered. In this literature review findings about the relationship between "successful" programs and size, staff to resident ratio, cost, client characteristics, program type, community support, family involvement, and peer relationships were selectively highlighted. Specific recommendations, originally presented to the President's Committee on Mental Retardation, were made for future program development and evaluation.

Contribution of infant characteristics to child abuse.

Abstract: This review suggested that atypical infants/children (with mental, physical, or behavioral abnormalities) are at risk for child abuse. An explanatory model of abuse was outlined and several studies described whose findings provide support for the model. Some infants or infant attributes are especially likely to be perceived as aversive and as such may serve as aggression-facilitating stimuli. Other factors that contribute to the probability of abuse are dispositions of the parent, such as hyperreactivity to noxious stimulation. Such dispositions may be constitutional or may have developed during negative transactions with the child. Characteristics of the child and of the caretaker as well as their social ecology all affect the likelihood of abuse.

Mainstreaming: fulfilling the promise?

Abstract: Four assumptions that propelled the movement away from self-contained classes for EMR children and towards mainstreaming were presented. Available data were provided for each assumption that indicated the extent to which the initial assumption has been realized. Overall, the data did not indicate major improvement in the caliber of education provided to EMR children as a consequence of the mainstreaming movement. The limitations of present conceptions of mainstreaming were cited as was the possibility of a need to redefine the concept of least restrictive environment.

Quality of life of mentally retarded adults transferred from large institutions to new small units.

Abstract: Quality of life of mentally retarded adults was assessed in large institutions and after transfer to new small units. Environmental changes in management practices and staff-resident interaction for both types of living units indicated significant improvement after transfer. Total adaptive behavior of transferred residents increased in the new units, but only the increase 9 months after transfer was significant when compared with behavior of matched control subjects. Total maladaptive behavior and antipsychotic drug prescription increased initially, with the former declining at subsequent assessments. Higher ability residents from "free" wards decreased participation in culturally normative activities and did not significantly change their adaptive behavior. Both higher and lower ability residents from "restricted" wards increased their participation in culturally normative activities and improved with regard to adaptive behavior. Significant increases and decreases in adaptive behavior over time paralleled the lack and subsequent initiation of off-unit occupations for residents with IQs over 50.

Changes in family support networks over the life cycle of mentally retarded persons.

Abstract: Utilization of personal and professional support networks by parents varies over the life cycle of their mentally retarded children. Data from a mail survey questionnaire, completed by 330 parents, were analyzed according to four stages in the life cycle: preschool (birth to 5 years old), elementary (6 to 12 years old), teenage (13 to 18 years old), and young adult (19 to 21 years old). In general, parents of younger children utilized more services and support networks and were more supportive of mainstreaming; parents of older children were less supported, more isolated, and more in need of expanded services.

Community integration of mentally retarded adults: community placement and program success.

Abstract: The extent of community and program success of 166 mentally retarded clients placed into a community-based program was evaluated over a 9-year period. Twenty predictor variables measuring institutional factors, client characteristics, training variables, and community characteristics were related to community or program success. Successful community placement was associated with sensorimotor and work skills, appropriate social-emotional behavior, gender, and family acceptance of community placement and involvement with the interdisciplinary team process. Program success was associated with language and psychomotor skills, education received prior to community placement, community and institution size, and family involvement. Sixteen percent of the clients were reinstitutionalized into either the state mental retardation facility or a mental health facility. Factors associated with successful placement and program progression were discussed as was a model for future deinstitutionalization research.

Independent living placement: five years later.

Abstract: The placement success and quality of life of 69 mentally retarded persons placed into independent housing 5 years previously was evaluated. Eighty percent (n = 55) were still in their original independent housing placement. On the basis of multiple regression analysis, the most significant predictor variables were the behavioral skill areas of personal maintenance, communication, community integration, clothing care and use, and food preparation. Unsuccessful placements were related to bizarre behavior, nutritional problems, and inadequate home maintenance. Quality of life variables analyzed included employment, finances, community utilization, leisure-time usage, and friendship patterns. Analysis of the quality of life variables presented a mixed picture: Part of the data reflected low income and possible loneliness; on the other hand, community utilization occurred frequently and involved normal activities. Clients reported that they were proud of their apartments and felt good about "doing their own thing." In light of the results, an extended assistance-training model was presented.

Hearing loss of Down syndrome adults.

Abstract: Audiological hearing-test data were obtained for 51 Down syndrome adults. Depending upon hearing-loss criteria, from 51 to 74 percent of the subjects had some degree of hearing impairment. Correlation coefficients between these hearing-acuity measurements and receptive hearing vocabulary scores suggest a moderate relationship. These data indicate that Down syndrome adults are prone to a wide variety of hearing difficulties that may reflect a variety of ear pathologies. These data and other studies have shown that both Down syndrome adults and children need frequent hearing screening and, when indicated, otological and/or audiological management. When otological treatment will be of long duration, aural rehabilitation, including prescription amplification, may be indicated as an adjunctive therapeutic procedure.

Effects of thioridazine dosage on the behavior of severely mentally retarded persons.

Abstract: A double-blind, placebo-controlled trial of thioridazine (Mellaril) was conducted with severely retarded patients. Subjects were assessed on a relatively low standardized dose as well as on the individual dosage that had previously been determined clinically as most effective. Both active drug conditions caused a reduction in hyperactivity, bizarre behavior, and self-stimulation. The standardized dose, which was less than half the mean titrated level, resulted in an equivalent therapeutic response. The need for more attention to dosage levels in future investigations was emphasized.

Trends in maladaptive behavior of mentally retarded persons placed in community and institutional settings.

Abstract: Changes in maladaptive behavior of retarded individuals referred and placed in institutional vs. community settings were examined. The results demonstrated that no significant time trend was present for either the institutional or community groups, regardless of clients' age and level of retardation. Placement, level of retardation, and age, however, were related to overall prevalence of maladaptive behavior among the individuals.

Physical restraint as positive reinforcement.

Abstract: The reinforcing function of physical restraint was analyzed for three retarded individuals who had a history of restraint and appeared to enjoy it. Using a preference paradigm with one participant and a reversal design with two others, we found that an arbitrary response systematically increased for each participant when followed by brief periods of restraint. No comparable increases occurred in conditions in which responses were not reinforced or were followed by stimuli designed to control for the nonrestraint components of the restraint consequence. Results were discussed in terms of three clinical issues: determining the possible role of restraint in maintaining behavior problems such as self-injury in natural settings, preventing or eliminating the reinforcing function of restraint, and using restraint reinforcement in treating behavior problems when this consequence is the only identifiable reinforcer for an individual.

Relationship between language and sensorimotor development of Down syndrome and nonretarded children.

Abstract: The relationship between sensorimotor and language development of Down syndrome and nonretarded children was investigated. The Ordinal Scales of Psychological Development (Uzgiris & Hunt, 1975) and the Receptive and Expressive Emergent Language (REEL) scale (Bzoch & League, 1970) were administered to 18 Down syndrome and 18 nonretarded children who had matched developmental ages of approximately 17 months. Comparison of the resulting scores indicated that although there were no differences between the groups on four subscales of the Uzgiris-Hunt, there were significant differences in favor of the nonretarded children on the Vocal Imitation subscale of the Uzgiris-Hunt and on Receptive and Expressive measures of the REEL. These results indicate that Down's syndrome children are delayed in their language development compared to nonretarded children of the same developmental age. This language delay appears to be related to deficiencies in vocal imitation skills but is not related to general sensorimotor functioning.

Employee withdrawal and job satisfaction in community residential facilities for mentally retarded persons.

Abstract: This study was conducted to provide information concerning employee stability in community residential facilities serving mentally retarded persons. Information was collected on turnover, length of service, absenteeism, job satisfaction, and increased overhead costs as a consequence of the turnover rate for 21 randomly selected small and large community residential facility organizations that operated a total of 47 living units in Tennessee. Subjects included all house managers (full-time and relief) and administrator/supervisors in the 21 organizations for fiscal year 1978-1979. The results revealed a significant problem of controllable turnover of direct-service employees. The major factors contributing to this problem appeared to be (a) a lack of effective methods to orient, integrate, and maintain new staff members, (b) low pay and wide variations for amount and kind of work to be accomplished, and (c) a lack of training and support systems to deal with behavior problems presented by some residents.

Extrapolated developmental indices for the Bayley Scales of infant development.

Abstract: Regression equations from the normative sample data of the Bayley Scales of Infant Development were derived and raw scores corresponding to Mental and Psychomotor Developmental Indices below 50 were computed. Extrapolated values are useful for estimating a child's present level of functioning, but because they are not based on empirical data, they should be considered estimates and used cautiously.

Prevalence and pattern of drug treatment for behavior and seizure disorders of TMR students.

Abstract: The prevalence and pattern of psychotropic and antiepileptic drug treatment for TMR children and adolescents in public schools were determined from teacher questionnaires and parent interviews. The relationship between drug use and age, race, and sex was also examined. The findings, indicated that during the school year, 10 percent of the students received medication for seizure disorders and 4.9 percent were treated for behavior disorders. An additional 1.8 percent were treated concurrently for both a seizure and a behavior disorder. The data also suggested that dosages of methylphenidate (Ritalin), the most frequently prescribed drug for persons with behavior disorders, were conservative. The results were interpreted with regard to drug use among nonretarded and severely and profoundly mentally retarded populations.

Social-environmental factors as predictors of adjustment of deinstitutionalized mentally retarded adults.

Abstract: Mentally retarded adults (N = 338) placed from five state institutions were studied 2 to 4 years, after they were placed in either foster family care or community residences Factors of the social environment that were most predictive of individual adjustment were determined Adjustment was defined as behavior in five areas of functioning: self-care, behavior control, community-living skills, use of community resources, and social support Multiple regression analysis revealed that social environmental factors and other characteristics of community settings played an important role in individuals' adjustment Important features of the social environment were similar across both settings

Performance of Down syndrome and other retarded children on the Cratty Gross-Motor Test.

Abstract: The Cratty Test of Gross-Motor Performance was administered to 18 Down syndrome and 18 other mentally retarded children between the ages of 7 and 14 years. Subjects were individually matched on both MA and CA. Examination of their test profiles showed that the Down syndrome children had consistently lower scores that did the matched control children, but only two of the differences were significant. The findings, therefore, provide tentative support for the notion that Down syndrome children suffer a specific deficit in some areas of motor coordination. A number of criticisms of the internal consistency of the test were discussed in terms of their theoretical and practical implications.

Use of independence training to teach shopping skills to mildly mentally retarded adults.

Abstract: Independence training, which consists of in-vivo modeling, self-evaluation, feedback, social reinforcement, and instructions, was used to train shopping behavior to mildly mentally retarded adults living in the community. Ten subjects were trained and 10 subjects served as no-treatment controls. Treatment was provided in therapy sessions at an outpatient clinic and in the grocery store. Subjects who received independence training improved significantly more than did the no-treatment control subjects during the 4 weeks of training. Clients in the treatment condition maintained gains at a 2-month follow-up. In addition, grocery shopping skills generalized to another store where training had not been provided.

Community residential adjustment: the relationship among environment, performance, and satisfaction.

Abstract: A cohort of 153 persons released from a state school for mentally retarded persons was studied with regard to two outcome measures of community residential adjustment: (a) adaptive behavior as measured by the percentage of mastered skills that a subject performed regularly and independently and (b) subjects' satisfaction with aspects of their residential environments. Five environmental dimensions of six residential program types were examined, and significant differences among the program types on these environmental dimensions were reported. A multiple regression analysis was performed to explain the relationship between the measures of adaptive behavior and individual and environmental characteristics. Benefits of this study's measurement of community adjustment were discussed in terms of their potential use for future research and for use by planners and providers of services.

Children's ratings of peers presented as mentally retarded and physically handicapped.

Abstract: Third- and sixth-grade children were shown slides and tapes presenting target children as either (a) physically nonhandicapped and nonretarded, (b) physically handicapped only, (c) mentally retarded only, or (d) physically handicapped and mentally retarded. All children were rated more favorably by third graders than sixth graders and more favorably by boys than girls. Physically handicapped target children were rated more favorably than were nonhandicapped children on behavioral intentions measures but were not rated differently on an attitude scale; retarded children were also rated more favorably than were nonretarded children on the former measures but less favorably on the attitude scale. Significant interactions were noted and implications of the results discussed.

Effects of motoric requirements on the acquisition of manual sign responses by severely handicapped students.

Abstract: Eight severely handicapped school-aged students were given training on communicative signs that varied according to iconic or abstract, touch or nontouch, and symmetrical or asymmetrical sign dimensions to determine the effects of motoric requirements on sign acquisition. A 2 X 2 Latin square design repeated between and within students was used. Symmetrical signs were acquired significantly faster than were asymmetrical signs, and touch signs were acquired significantly faster than were nontouch signs. Results of the acquisition of iconic vs. abstract signs were inconclusive.

Mental illness and mental retardation: cause or coincidence?

Abstract: 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.

Computer-assisted teaching of sight-word recognition for mentally retarded school children.

Abstract: A computer-assisted training program used to teach a sight vocabulary to mildly mentally retarded school children was described and evaluated The training program was designed to supplement conventional methods of teaching by using aspects of computer technology to implement various learning principles that would otherwise be difficult to employ Eight children were taught associations between the written and spoken versions of words by a "talking" computer These children increased their sight vocabularies by an average of 128 percent; a comparison group had a 34 percent increase Furthermore, this increase remained constant for over 23 weeks following the completion of the nonintensive 4-week training program

Social development and feeding milestones of young Down syndrome children.

Abstract: During an interdisciplinary longitudinal study, the social development and mastery of feeding skills of 89 young Down syndrome children were investigated. Sex, cardiac status, and muscle tone of subjects and parental follow-through data were examined for potential influence on Vineland Social Maturity Scale scores and on a selected subset of feeding milestones. The revealed that young Down syndrome children attained significantly higher scores on the Vineland and achieved most feeding milestones much earlier if they had no or only mild congenital heart disease, if their parents followed-through appropriately with furnished guidance, and if they had "good" muscle tone.

Mental retardation policy and research: the unfulfilled promise.

Abstract: Although research on problems relating to mental retardation has received considerable public support over the past two decades, the impact on policy has not been particularly marked Some of the reasons for this failure of research to influence the course of policy formulation were discussed The nature of the process itself is such that research is secondary to economic, political, and social considerations Furthermore, the research enterprise is fragmented and uncoordinated and is not oriented toward the needs of policy makers Some suggestions were offered to improve the link between research and public policy in the field of mental retardation

Effects of thioridazine (Mellaril) on titrating delayed matching-to-sample performance of mentally retarded adults.

Abstract: The effects of thioridazine on the performance of a titrating delayed matching-to-sample discrimination by four retarded adults was investigated. Trials began with the center of three response panels illuminated by one of three colors. The delay between depression of the center response panel and presentation of the two comparison stimuli on the side response panels varied according to the accuracy of the subjects' performance. The primary dependent variable was the limit of delay, defined as the longest delay at which the subject emitted four consecutive correct responses in a 30-minute session. The subjects' chronic doses of thioridazine were reduced systematically in a multiple baseline across-subjects design. For all of the subjects, the limit of delay increased after, and only after, reductions in the daily thioridazine dose had been implemented. Results indicated that the withdrawal of chronically administered thioridazine resulted in increased accuracy in a delayed matching-to-sample task, suggesting strongly that the drug impairs performance of this discrimination.

Ultradian rhythms in stereotyped and self-injurious behavior.

Abstract: Institutionalized profoundly mentally retarded persons who exhibited stereotyped motor movements, including self-injurious behavior, were observed continuously in their typical environments for periods of 8 to 14 hours on each of several days. In addition to targeting stereotyped responses, we collected data pertaining to activities, settings, other behavioral states, and social interactions. Spectral and cross-spectral analyses were conducted on data from each daily session. Power spectra indicated a marked ultradian or less than 24-hour rhythm for each subject on each day. Spectral density estimates were thought to reflect the influence of rhythmic changes in the institutional environment and, to a less degree, the influence of an endogenous rest--activity rhythm.

A functional classification of seizures and its distribution in a mentally retarded population.

Abstract: A functional classification of seizure impairment was described and its distribution examined in a population classified as mentally retarded in childhood and followed to age 22. Twenty-five percent of the sample had some history of seizures up to age 22. Seizure histories were found for 19 percent of these retarded persons in the preschool years and 13 percent in each period of early, late, and postschool years. A drop in minor seizure impairment occurred after age 5. A slightly higher frequency of seizure histories among males was found, largely due to subjects whose IQs were 50 to 59, where 44 percent of the males and 5 percent of the females had seizure histories. No significant association was found between degree of seizure impairment and severity of mental retardation.