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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The AIDS epidemic poses a serious threat to people with developmental disabilities, the magnitude of which has not yet been fully realized by many professionals working with this population. Models for effective AIDS prevention education have been developed, however, within other populations. Key principles utilized in existing models were discussed and recommendations presented on how to adapt these models when designing programs for people who have developmental disabilities, most specifically, those in the mild/moderate range of mental retardation.
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PMID:Developing an AIDS prevention education program for persons with developmental disabilities. 258 13

Ensuring effective service delivery by direct-care personnel in institutional living units for persons with developmental disabilities historically has been a difficult process, despite considerable attention from researchers, service providers, and governmental regulatory agencies. In this investigation, we conducted a normative evaluation of the extent and quality of treatment services currently provided in residential living units and evaluated a comprehensive management system designed to improve such services. Results of the first experiment, encompassing 22 living units in three states, indicated that on the average two thirds of observed resident behavior did not involve any therapeutic activity. The results also provided social validity for the criteria used to evaluate the quality of treatment provision based on opinions of mental retardation professionals. Results of the second experiment indicated that a behavioral management program implemented during 23 separate time periods across five living units was accompanied by consistent and durable decreases in resident nontherapeutic activity as well as increases in specifically designated habilitative activity. The results provide support for the successful incorporation of behavioral management technology into human service settings on a large-scale, long-term basis.
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PMID:Improving residential treatment services: implementation and norm-referenced evaluation of a comprehensive management system. 274 36

This paper attempts to assess public and professional attitudes toward drug treatment in mental retardation and concludes that considerable sentiment has developed in recent years against the use of pharmacotherapy. A number of factors contributing to this prevailing attitude were identified and discussed. In particular, a series of investigations carried out by researchers at the Coldwater Regional Center for Developmental Disabilities (Michigan), which have had negative implications for drug treatment, were summarized. These studies have suggested that psychotropic drugs, especially the antipsychotics, may adversely affect clinical management of mentally retarded persons, depress learning performance, and interfere with the efficacy of reinforcement contingencies. However, certain features of these studies, such as the procedures for selecting subjects, the doses utilized and overall guiding philosophy, appear to limit their relevance. Balanced against these are a number of other investigations showing circumscribed positive clinical effects, a lack of interference with learning and little or no disruption of reinforcement contingencies. It was concluded that all-encompassing judgments about the value of pharmacotherapy in mentally retarded people are premature at this time. We suggested that a major objective of clinical drug research should be to look for enhancement of adaptive functioning by discovering appropriate subject-treatment combinations, while remaining vigilant for adverse effects.
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PMID:A critical appraisal of recent drug research in mental retardation: the Coldwater studies. 287 82

In recent years, a number of articles have appeared in the literature concerning the fragile X syndrome; however, in few cases was the diagnosis of the syndrome in young children discussed. A review of 20 children younger than 7 1/2 years of age who had the fragile X syndrome seen at the Cincinnati Center of Developmental Disorders was undertaken in an attempt to establish guidelines that would aid the practicing physician in determining which children should have a chromosomal analysis. All children were developmentally delayed; 95% had speech delays. Short attention span with hyperactivity, temper tantrums, mouthing of objects persisting at an age beyond when it would be expected, autistic behaviors, and poor gross motor coordination were seen in 50% or more of the children. Mental retardation was present in the family history of 65%, and 90% had a family history of at least one of the following: mental retardation, learning disabilities, or hyperactivity. The most common physical findings were long and/or wide and/or protruding ears, prominent jaw and/or long face, high arched palate, and a flattened nasal bridge. The fragile X syndrome can be recognized by noting key aspects of the behavioral and family histories as well as the physical findings.
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PMID:Fragile X syndrome: recognition in young children. 292 95

The improved survival of extremely premature infants has generated intense interest in the quality of life of the survivors. This review focuses on the major long-term complications of prematurity (developmental disability, retinopathy of prematurity, chronic lung disease) and concludes with an overview of the broader spectrum of morbidity. Severe impairment (cerebral palsy, mental retardation, retrolental fibroplasia, severe chronic lung disease) fortunately occurs in a small proportion of survivors. However, the prevalence of the lesser morbidities (minimal cerebral dysfunction/learning disability, poor growth, postneonatal illnesses, rehospitalization) is less clearly defined. These problems all have an impact on families, and on medical and educational services.
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PMID:Medical complications of prematurity. 293 64

Results of a nationwide study of public mental retardation/developmental disabilities (MR/DD) spending in the states during Fiscal Years 1977 through 1986 were summarized. Trends identified included: (a) continuing growth in spending for community services, (b) contraction of total spending for institutional operations, and (c) predominance of ICF/MR support in large (16+ beds) congregate care settings. Periodic replication of the study was recommended as was additional research to identify the political and economic determinants of state MR/DD spending.
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PMID:National study of public spending for mental retardation and developmental disabilities. 312 16

This report is the third in a series on problem behavior and psychiatric impairment in a population of 35,000 individuals receiving developmental disabilities services. Young and middle-aged adults were found to receive psychotropic medication at higher rates than children, adolescents, or elderly persons. Psychotropic receipt rates were found to increase with increasing severity of mental retardation, but most evidently with increasing restrictiveness of residential setting, increasing rated severity of problem behaviors, and presence of a psychiatric impairment. Rates of medication receipt also varied as a function of psychiatric diagnostic category. Discussion remarks emphasize the need to include information relative to clinical and social aspects of program settings and the roles and decision-making performance of physicians and psychologists in research on settings serving persons with developmental disabilities.
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PMID:Problem behavior and psychiatric impairment within a developmentally disabled population. III: Psychotropic medication. 335 39

The purpose of this study was to develop and standardize an instrument designed to assess the extent to which people with mental retardation demonstrate knowledge about citizenship rights and responsibilities. The test development phase included: (a) generating 83 items related to six content areas (i.e., human, civil, and legal rights; and moral, civic, and legal responsibilities), and (b) pilot testing these items with 236 members of self-advocacy groups for people with developmental disabilities. The resulting 30-item instrument was standardized with a sample of 391 self-advocates from 13 states. The psychometric properties of the standardized instrument included: a mean performance level of 77% correct; a mean item-total correlation of r-ij = .33; and an internal consistency reliability coefficient of r alpha = .82. The instrument's potential usefulness as a device for screening, diagnosis, and program evaluation was supported by its psychometric properties. Future studies could address the use of the instrument with the secondary school age population that faces the transition from school to community.
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PMID:Measuring knowledge of citizenship rights and responsibilities. 335 44

A follow up of 14 cases of tuberous sclerosis is presented. Cutaneous signs, epileptic seizures and developmental disabilities were recorded over a period ranging between 2 and 25 years from the onset of symptoms. A correlation can be established between the time of appearance of epilepsy and the degree of mental retardation. Antiepileptic treatment does not seem to prevent developmental disability.
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PMID:[Bourneville's tuberous sclerosis: neurological manifestations and skin anomalies]. 360 8

Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) are preventable forms of mental retardation and developmental disability caused by heavy prenatal alcohol exposure. Our best evidence of the overall prevalence of FAS is around 1 in 750 live births, but this figure will vary according to the drinking habits of the community and the diagnostic skills and interests of local physicians. It is likely that many infants are born with FAS or FAE, are never recognized as such, and are never properly diagnosed or evaluated. Other diagnoses that are sometimes confused with FAS include Noonan syndrome and William syndrome. More often, children with milder FAS or FAE go unrecognized. Careful evaluation of possible maternal alcohol abuse during pregnancy can be an important factor in differential diagnosis and proper case management. Alcohol is a teratogenic drug that can produce a wide variety of deficits from prenatal exposure, depending on the dose, timing, and conditions of exposure, as well as on individual differences in sensitivity on the part of the mother and the child. Not all children who are exposed are affected. Perhaps 30-40% of the children of chronic alcoholic mothers who were drinking during pregnancy will have FAS. These children are at high risk for mental retardation or developmental disability. Even within this group, however, there can be large individual differences in eventual outcome. Prognosis involves an interaction between the extent of the damage and the stability and structure of the environment. Children whose mothers were abusing alcohol during pregnancy can be at risk for various learning and attentional problems even without FAS, but in the absence of morphologic effects, the diagnostic and prognostic picture is less clear. Systematic efforts toward both prevention and intervention can assure that each child develops to his or her own best potential.
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PMID:Fetal alcohol. Teratogenic causes of developmental disabilities. 361 65


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