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

In Part 1 of this two-part series, studies concerned with the effects of vestibular stimulation on human development and function were reviewed and some implications for therapy were suggested. In Part 2, three categories of dysfunction with possible links to the vestibular system are discussed. Studies in the category of mental retardation evaluate motor development and sensory preference. Possible vestibular associations with emotional disturbance are examined by review of studies concerned with etiology, motor activity, speech, and clinical observations. A brief review of studies concerned with early identification and speech and language factors of learning-disabled children constitutes the third category. Interpretations are drawn and some implications for therapy are made.
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PMID:Effects of the vestibular system on human development, part 2: Effects of vestibular stimulation on mentally retarded, emotionally disturbed, and learning-disabled individuals. 22 86

In a study of special education programs in five urban school systems, parent interview data for 1726 children revealed how early the children's problems were identified and how the medical system was involved in the diagnosis. Problems included speech impairment, learning disabilities, emotional disturbance, mental retardation, sensory disorders, and physical and health disabilities. Overall, 4.5% of the children's problems were identified at birth, and only 28.7% before the age of 5 years. Variation in age at identification depended on the condition: 1 year for Down syndrome and cerebral palsy versus a 6-year range for mental retardation. Although physicians were most likely to identify the less common, more severe handicaps, they also identified from 15% to 25% of learning disabilities, speech impairments, emotional disorders, hyperactivity, and "other" development problems. The type, severity, and complexity of the condition were significant predictors of physician identification. No racial, socioeconomic, or site biases were associated with whether a physician was first to identify. Age at identification was predicted by the complexity of the problem, the association with other health and developmental concerns, socioeconomic indicators, and whether a physician was involved in the diagnosis. In the absence of clear assumption of responsibility for early identification, much terrain remains uncharted by medical practitioners and the schools. A better systematic sharing of responsibility for the early identification of developmentally disabling conditions is needed.
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PMID:Early identification of children's special needs: a study in five metropolitan communities. 244 88

Tested diagnostic classifications of child psychopathology produced by a computerized technique known as multidimensional actuarial classification (MAC) against the criterion of expert psychological opinion. The MAC program applies series of statistical decision rules to assess the importance of and relationships among several dimensions of classification, i.e., intellectual functioning, academic achievement, adaptive behavior, and social and behavioral adjustment, to perform differential diagnosis of children's mental retardation, specific learning disabilities, behavioral and emotional disturbance, possible communication or perceptual-motor impairment, and academic under- and overachievement in reading and mathematics. Classifications rendered by MAC are compared to those offered by two expert child psychologists for cases of 73 children referred for psychological services. Experts' agreement with MAC was significant for all classification areas, as was MAC's agreement with the experts held as a conjoint reference standard. Whereas the experts' agreement with MAC averaged 86.0% above chance, their agreement with one another averaged 76.5% above chance. Implications of the findings are explored and potential advantages of the systems-actuarial approach are discussed.
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PMID:Validation of a systems-actuarial computer process for multidimensional classification of child psychopathology. 705 Jan 77

Two experiments evaluated the effects of the condition of mental retardation on psychologists' impressions of emotional problems of a retarded subject. In Experiment 1 we found that the same debilitating phobia was less likely to be considered an example of a neurosis or an emotional disturbance when the subject also was suggested to be mentally retarded as compared to intellectually average. Experiment 2 provided a conceptual replication of the results of Experiment 1 and extended findings of diagnostic overshadowing to cases involving schizophrenia and personality disorder. The magnitude of these effects did not differ significantly as a function of whether the case description suggested schizophrenia or personality disorder. The results validate the existence of a diagnostic overshadowing phenomenon.
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PMID:Emotional disturbance and mental retardation: diagnostic overshadowing. 710 29

Describes the development and validation of the Developmental Behavior Checklist (DBC), a standardized instrument completed by lay informants to assess behavioral and emotional disturbance in children and adolescents with mental retardation (MR). Items describing common behavioral and emotional problems in this population were generated by extracting descriptions from 664 case files of children and adolescents with behavior disorders seen at a specialist developmental assessment service over 12 years. These items were reduced to a set of 96 items administered to a sample of 1,093 children and adolescents with mental retardation and then submitted to a principal components analysis. Six interpretable and partly validated subscales were obtained which explained 36% of the total variance and had satisfactory internal consistency. Interrater and test-retest agreement were satisfactory for both total scale score and for scores on each of the subscales. Good evidence of concurrent validity was provided by substantial positive correlations between total scores on the DBC completed by lay informants and the ratings of experienced psychiatrists based upon interviews and scores on two standardized instruments that must be completed by health professionals. The discriminative validity of the total score as assessed by area under the ROC curve was excellent (92%). Standardized norms for the DBC are derived from an epidemiological study of behavior problems in children and adolescents with mental retardation undertaken in two Australian States. Norms are available for the mild, moderate, severe, and profound MR groups and for the MR population as a whole.
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PMID:The Developmental Behavior Checklist: the development and validation of an instrument to assess behavioral and emotional disturbance in children and adolescents with mental retardation. 755 89

A range of behaviours has been postulated as specific manifestations of the Fragile X (fra(X)) syndrome. This study examines a broad range of behaviours in subjects with fra(X) syndrome and in control individuals. It was designed to take account of methodological factors which may account for differing findings in previous studies. Subjects were 48 children, adolescents, and young adults with fra(X) syndrome. They were compared with a large community epidemiological sample (N = 454) of persons with mental retardation (M.R.), matched for age, sex, and IQ. Behavioural problems were studied using the Developmental Behaviour Checklist, an instrument of established reliability and validity in the evaluation of behavioural and emotional disturbance in children and adolescents with mental retardation. Fragile X subjects had more shyness and avoidance of eye contact and less antisocial behaviour. Further methodological issues pertaining to studies of behaviour phenotype in general are discussed.
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PMID:Behavioural and emotional disturbance in fragile X syndrome. 794 4

Approximately 5% of all public school students are identified as having a learning disability (LD). LD is not a single disorder, but includes disabilities in any of seven areas related to reading, language, and mathematics. These separate types of learning disabilities frequently co-occur with one another and with social skill deficits and emotional or behavioral disorders. Most of the available information concerning learning disabilities relates to reading disabilities, and the majority of children with learning disabilities have their primary deficits in basic reading skills. An important part of the definition of LD is its exclusions: learning disabilities cannot be attributed primarily to mental retardation, emotional disturbance, cultural difference, or disadvantage. Thus, the concept of LD focuses on the notion of a discrepancy between a child's academic achievement and his or her apparent capacity to learn. Recent research indicates, however, that disability in basic reading skills is primarily caused by deficits in phonological awareness, which is independent of any achievement-capacity discrepancy. Deficits in phonological awareness can be identified in late kindergarten and first grade using inexpensive, straightforward testing protocol. Interventions have varying effectiveness, depending largely on the severity of the individual child's disability. The prevalence of learning disability identification has increased dramatically in the past 20 years. The "real" prevalence of LD is subject to much dispute because of the lack of an agreed-upon definition of LD with objective identification criteria. Some researchers have argued that the currently recognized 5% prevalence rate is inflated; others argue that LD is still underidentified. In fact, it appears that there are both sound and unsound reasons for the increase in identification rates. Sound reasons for the increase include better research, a broader definition of disability in reading, focusing on phonological awareness, and greater identification of girls with learning disabilities. Unsound reasons for the increase include broad and vague definitions of learning disability, financial incentives to identify students for special education, and inadequate preparation of teachers by colleges of education, leading to overreferral of students with any type of special need. There is no clear demarcation between students with normal reading abilities and those with mild reading disability. The majority of children with reading disabilities have relatively mild reading disabilities, with a smaller number having extreme reading disabilities. The longer children with disability in basic reading skills, at any level of severity, go without identification and intervention, the more difficult the task of remediation and the lower the rate of success. Children with extreme deficits in basic reading skills are much more difficult to remediate than children with mild or moderate deficits. It is unclear whether children in the most severe range can achieve age- and grade-approximate reading skills, even with normal intelligence and with intense, informed intervention provided over a protracted period of time. Children with severe learning disabilities are likely to manifest an increased number of and increased severity of social and behavioral deficits. When children with disabilities in reading also manifest attention deficit disorder, their reading deficits are typically exacerbated, more severe, and more resistant to intervention. While severe reading disorders are clearly a major concern, even mild deficits in reading skills are likely to portend significant difficulties in academic learning. These deficits, too, are worthy of early identification and intervention. Even children with relatively subtle linguistic and reading deficits require the expertise of a teacher who is well trained and informed about the relationships between language development and reading development.
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PMID:Learning disabilities. 868 62

As a widely used, easy-to-administer, and nonthreatening task, the Draw-a-Person (DAP) holds particular promise as a nonverbal index of intelligence in persons with mental retardation. The DAPs of 108 adolescents and adults with mental retardation were reliably scored using Naglieri's cognitive and emotional disturbance scoring systems. Contrary to expectations, visual-motor skills emerged as the best predictor of DAP cognitive scores. Intelligence was correlated with DAP scores, but had considerably less predictive value than visual-motor skills. DAP emotional indicator scores were only modestly associated with social adaptation; even less support was found linking DAP emotional indicators to psychopathology. Findings point to considerable caution in using the DAP as an index of intelligence or as a screen for adjustment problems or specific psychopathology. Although related to intelligence, this popular task seems predominantly to measure visual-motor development in adults with mental retardation.
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PMID:The Draw-a-Person task in persons with mental retardation: what does it measure? 875 72

Transition services for students with learning disabilities have not always been a priority in public schools. Although school personnel have long acknowledged the transition needs of students considered to have more severe disabilities, such as mental retardation, physical problems, and emotional disturbance, they do not always consider that students with learning disabilities also need transition programming. The result has been a neglect of these students' transition needs, which has likely contributed to some of the problems experienced by young adults with learning disabilities. This article focuses on the effect of educational reform on transition services for students with learning disabilities. General education reform--fueled by some of the critical reports of the 1980s--inclusion, and some of the more recent efforts to reform public education (namely, Goals 2000) are all discussed as they relate to the transition needs of students with learning disabilities.
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PMID:Transition in an era of reform. 882 Feb

Behavioral and emotional disturbance was assessed in 70 children and adolescents with Williams syndrome. They were compared with an epidemiological control population, which was statistically controlled for age, gender, and level of mental retardation. Those with Williams syndrome were more likely to be diagnosed as suffering psychiatric disorder. The disorder was characterized by anxiety, hyperactivity, preoccupations, and inappropriate interpersonal relating. Significantly increased rates of other individual symptoms were also found, including sleep disturbance and hyperacusis. These results, considered with earlier findings, suggest that there is a valid behavior phenotype of Williams syndrome. This is frequently associated with sufficient impairment to consider inclusion of the behavior phenotype in future official taxonomies of mental disorders.
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PMID:Behavioral and emotional disturbance in individuals with Williams syndrome. 924 7


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