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Query: UMLS:C0004352 (autism)
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Perceptions by staff of the classes of reinforcers and aberrant behaviors of a sample of 470 people with predominantly severe or profound mental retardation were explored. Principal components analysis of a 45-item survey suggested eight classes of reinforcers: consumable, verbal-speaker, visual-motor, social, physical-contact, passive-observer, play, and academic reinforcers. Stepwise multiple regression was used to predict five classes of maladaptive behaviors as measured by the Aberrant Behavior Checklist (irritability, lethargy, stereotypy, hyperactivity, and inappropriate speech) from the eight classes of reinforcers. Each class of psychopathology was related to a unique set of predictors. All classes of psychopathology could be predicted by staff perceptions of underresponsiveness to social reinforcers and overresponsiveness to consumable reinforcers. The findings of organized structures of reinforcers and their covariation with pathological behaviors have implications for research and intervention as well as theoretical value in defining aberrant behaviors in people with mental retardation.
J Autism Dev Disord 1992 Mar
PMID:Staff perceptions of reinforcer responsiveness and aberrant behaviors in people with mental retardation. 159 66

The 1985-86 data from 308 children and young adults under age 25 with autism and from 326 with severe or profound mental retardation can be compared to national data from the 1980 MNCUES and the 1987 NMES because the methods are similar. These data provide detailed answers to the questions, what health care services are used? what are the expenses? Who pays them? Until now, the absence of comprehensive national data had hindered the development of new approaches to financing the care of children with serious, lifelong conditions. These data permit policymakers to take into account the needs and expenditures for severely developmentally disabled children when reforming the health care financing system. None of the children or young adults had expenditures in excess of $50,000, and very few reached the upper $20,000s. For children with autism the average annual health care expenditure was about $1,000 and about $1,700 for young adults, compared to the $414 average for all American children. They received an average of four physician visits annually, slightly above the U.S. average for children. Their hospitalization rate was twice the average for children. Hospitalization accounted for one-third the health care expenditures among children with autism, but for two-thirds among young adults. For children and young adults with severe retardation the average expenditure on health care was about $4,000, due to the physical impairments in two thirds of the children. They averaged about 12 physician visits annually, falling to 8 among young adults. Children were hospitalized about eight times the national rate, and young adults about twice. Among severely retarded children and young adults living at home, hospitalization accounted for over half the health care expenses, but for only one third for those in residential placement. Unfortunately, preventive and habilitative services were but a tiny fraction of health care expenditures and were demonstrably underutilized. Only 60% of these children had routine dental examinations within the last 12 months, a worse record than the average child. For the individuals whose primary physicians judged that they would benefit from physical or speech therapy, less than one quarter were receiving them. Care for seriously, chronically disabled children places great burdens on immediate family members. Only 20% of the severely retarded youngsters from age 10 to 24 could be left alone at home, even for a few minutes, and only 30% of the autistic ones. These developmental disabilities create needs for personal care and family support that traditionally have not been considered health services.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Health care financing for severe developmental disabilities. 170 21

Examined the effects of two instructional methods on language generalization and long-term retention in 23 adults with autism and severe to profound mental retardation. Analog language teaching employed discrete trials in a controlled setting concentrating on discrimination and identification of materials. Natural language teaching emphasized instruction through interactions that occurred incidentally to training students in the use of materials to perform functional tasks. Assessments were conducted under conditions favoring analog teaching to assure against partiality toward natural language teaching. Under such disadvantageous conditions, the methods of natural language teaching would be supported by results showing either no difference or an advantage in their favor. Both techniques increased initial and long-term generalization though the results suggest no relative superiority for either method under these assessment conditions. A significant interaction was found between prior functioning level and sequence of instruction. Because natural language teaching has many strengths, few drawbacks, and produces equal generalization and retention under disadvantageous conditions, it is strongly supported as preferable for people with autism and mental retardation.
J Autism Dev Disord 1991 Dec
PMID:Analog language teaching versus natural language teaching: generalization and retention of language learning for adults with autism and mental retardation. 177 59

An extended family is reported in which Rett-Hagberg syndrome, autism with mild ataxia and autism with profound mental retardation occurred separately in three female second-cousins. The authors suggest alternative explanations for the possible association between autism and Rett-Hagberg syndrome: that they may be closely related genetic disorders, or that they may constitute relatively homogeneous phenotypes with several possible aetiologies.
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PMID:The syndromes described by Kanner and Rett-Hagberg: overlap in an extended family. 231 29

The diagnosis of behavioral and cognitive disorders in preschool children is difficult. Infantile austism is more likely to be diagnosed than is mental retardation. Yet most children with infantile autism are also mentally retarded, and many of those with severe and profound mental retardation show autistic behavior. Factors misleading professionals into overlooking mental retardation when assessing preschool children were discussed, and essential components in the management of preschool children with behavioral, developmental, or cognitive deviations were examined.
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PMID:Misleading cues in the diagnosis of mental retardation and infantile autism in the preschool child. 271 15

The relationships between frequency of rumination in a boy with profound mental retardation and a variety of environmental, interpersonal, and temporal variables were investigated by collecting and analyzing data during all waking hours over a 4-week period. Low levels of rumination were associated with periods of special education programming (versus nonschool hours), individual attention (versus group activities and independent play), and time spent with caretakers who like the child (versus those who like him less). The findings also revealed a mealtime effect (decreasing rumination as time elapsed following meals) and a time of day effect (increasing rumination as the day progressed). Directions for future research and possible implications for the environmental management of rumination are discussed.
J Autism Dev Disord 1989 Sep
PMID:Variables associated with frequency of rumination in a boy with profound mental retardation. 279 88

Three severely mentally retarded, multiply handicapped, adolescents were treated in a classroom setting for social skills deficits. Two of these children exhibited symptoms of autism including periods of echolalia, and fascination with tactile and visual stimulation. One of the pair was deaf. The third child was profoundly mentally retarded and had minimal expressive language skills. All had received sign language training to facilitate communication. Treatment focused on increasing the frequency of eye contact, in seat and response to verbal prompt behaviors, skills deemed necessary to facilitate use of sign language communication and to increase social interaction. Baseline and treatment were evaluated in a multiple baseline, alternating treatment design across children. Baseline was taken on responses to 10 standard questions, asked by the teacher, based on verbal presentation and sign language. This same procedure was then continued during the initial treatment phase following training sessions. During training, the children received social reinforcement, performance feedback and edible reinforcement, in the form of candy, for appropriate performance. Physical and verbal prompts as well as pictorial cues were employed to shape appropriate behavior. In the second treatment phase, training was implemented in the classroom in which baseline data had been collected. Improvement in target behaviors, via training sessions held four days a week, was noted. These data suggest that use of a combination of visual stimuli, operant and social learning methods can remediate social skills deficits in children with multiple psychological and physical deficits. The implications of these findings for current and future research are discussed.
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PMID:Training social skills to severely mentally retarded multiply handicapped adolescents. 297 Jan 2

This case study presents the history of a child diagnosed with severe tuberous sclerosis (TS) with an original prognosis of severe to profound mental retardation. Infantile spasms and seizures were eventually controlled, and with educational and therapeutic intervention, this child progressed until she was functioning within normal limits by age 4. This paper presents the position that early diagnosis, early seizure control, and early multidisciplinary intervention are crucial in reducing the poor prognosis in such cases.
J Autism Dev Disord 1984 Dec
PMID:Tuberous sclerosis: case study of early seizure control and subsequent normal development. 609 76

This paper discusses problems with current research on the use of nonvocal communication systems with special reference to the severely and profoundly mentally retarded. A strategy for research, designed to provide a method whereby critical practical and theoretical issues can be isolated, is described. The approach involves surveys of use, development of procedures for assessment and program monitoring, the development of teaching methods for use with neglected groups, and experimental investigations of the interaction of system variables and subject characteristics. The strategy is illustrated with examples from ongoing research.
J Autism Dev Disord 1981 Mar
PMID:A strategy for research on the use of nonvocal systems of communication. 692 94

Examined the effects of antecedent exercise conditions on maladaptive and stereotypic behaviors in 6 adults with both autism and moderate to profound mental retardation. The behaviors were observed in a controlled environment before and after 2 exercise and 1 non-exercise conditions. From the original group of 6 participants, 2 were selected subsequently to participate in aerobic exercise immediately before performing a community-integrated vocational task. Only antecedent aerobic exercise significantly reduced maladaptive and stereotypic behaviors in the controlled setting. Neither of the less vigorous antecedent conditions did. When aerobic exercise preceded the vocational task, similar reductions were observed. There were individual differences in response to antecedent exercise. Use of antecedent aerobic exercise to reduce maladaptive and stereotypic behaviors of adults with both autism and mental retardation is supported.
J Autism Dev Disord 1994 Oct
PMID:Vigorous, aerobic exercise versus general motor training activities: effects on maladaptive and stereotypic behaviors of adults with both autism and mental retardation. 781 6


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