American journal of mental retardation : AJMR最新文献

Convergences and divergences between four of the most commonly used checklists for psychiatric disorders (the Reiss Screen, The Mini PAS-ADD, the DASH-II, and the ADD) were examined. We screened 181 individuals with intellectual disability for psychiatric disorders with the four checklists and compared the results on the checklists. The concordance of the overall scores on the four checklists was high; but the agreement on specific psychiatric disorders was limited. The results indicate that the checklists are useful as general indicators of psychiatric disorders, but are of less value for specifying the nature of the disorders in individuals with intellectual disability.

Compulsive, self-injurious, and autistic behaviors were examined in 31 boys and 29 girls with fragile X syndrome aged 5 to 20 years. Self-injurious behavior occurred in 58% of boys and 17% of girls, whereas compulsive behavior occurred in 72% of boys and 55% of girls and did not appear to be associated with self-injurious behavior. Fifty percent of boys and 20% of girls met diagnostic criteria for autism on the ADOS-G. Girls who showed compulsive behavior had lower levels of FMRP than girls who did not show compulsive behavior, and boys with autistic symptoms had lowered levels of cortisol. Taken together, these data suggest that autistic and compulsive behaviors are highly prevalent in fragile X syndrome and that lowered levels of FMRP and cortisol may be biological markers for these behaviors.

The social communication and compliance patterns of 63 mothers interacting with their young children who had mild developmental delays in social play and instructional tasks were examined in a longitudinal study. Results were consistent with the hypothesis that mothers appropriately adjust their social communications in accordance with children's developmental characteristics and task demands. The extent of scaffolding specificity that mothers used in the instructional task also indicated a high level of sensitivity to children's developmental characteristics. Analyses conducted over a 2-year period revealed that adjustments were commensurate with children's emerging social communication abilities, suggesting that mothers of children with developmental delays continue to display social communication patterns that are supportive of their child's development.

Although often described as temperamentally "easy" and sociable, children with Down syndrome also exhibit behavior problems. Affective development is important for social and behavioral competence. We examined negative affective expressions and a range of emotion regulation/coping strategies during a frustrating task in a sample of children with Down syndrome, nonspecific mental retardation, and typical development. Results revealed that children with Down syndrome displayed significantly more frustration and more orienting to the experimenter without asking for help. Typical children used more goal-directed strategies, including assistance-seeking and cognitive self-soothing. Findings suggest that children with Down syndrome may use a limited repertoire of strategies for coping with frustration. Suggestions for future intervention studies are provided.

Current prescribing preferences among relevant experts regarding the use of psychotropic medication for the management of behavior problems in adults with intellectual disabilities in the absence of a diagnosed psychiatric illness was defined. We used a questionnaire design to synthesize the preferences of a large group, namely, clinical psychiatrists, thereby establishing a consensus. A total of 108 completed questionnaires were analyzed. A very strong preference for the use of nonmedication-based interventions was established. Of the medication options presented, atypical antipsychotics were most favored, with Risperidone the most preferred option from within this group. Citalopram was the most preferred antidepressant and Carbamazepine, the most preferred mood stabilizer/antiepileptic.

We investigated how change in the characteristics of 140 adolescents and young adults with an autism spectrum disorder (ASD) would predict subsequent change in maternal well-being and in the quality of the mother-child relationship. Overall patterns of improvement in maternal well-being and mother-child relationship quality were observed during the study. When the son or daughter had declining behavior problems, were prescribed more psychotropic medications, and exited from high school during the study period, mothers' well-being and perception of relationship quality improved to a greater extent. In addition, improvements in maternal well-being and relationship quality were observed in mothers of daughters, in mothers of individuals with mental retardation as well as ASD, and in mothers of those in better health.

Mothers of 110 children with autism spectrum disorders (ASD) were interviewed with the Child and Adolescent Impact Assessment when their children were approximately 9 years old. Regression analyses revealed that African American mothers reported lower levels of perceived negative impact of having a child with ASD than did Caucasian mothers. Higher repetitive behavior scores on the Autism Diagnostic Interview-Revised, lower adaptive behavior scores on the Vineland Adaptive Behavior Scales, and less perceived social support were also significant predictors of higher perceived negative impact. Identifying predictors of perceived negative impact is an important first step in designing interventions to support families and target parents who may be at risk for experiencing higher levels of stress.

An intervention group (n=23) of preschool children with autism was identified on the basis of parent preference for early intensive behavioral intervention and a comparison group (n=21) identified as receiving treatment as usual. Prospective assessment was undertaken before treatment, after 1 year of treatment, and again after 2 years. Groups did not differ on assessments at baseline but after 2 years, robust differences favoring intensive behavioral intervention were observed on measures of intelligence, language, daily living skills, positive social behavior, and a statistical measure of best outcome for individual children. Measures of parental well-being, obtained at the same three time points, produced no evidence that behavioral intervention created increased problems for either mothers or fathers of children receiving it.

Prevalence estimates often use U.S. Census Bureau estimates of the population as denominator data. Postcensal estimates are population estimates produced following a decennial census. Intercensal estimates are surrounded by 2 census years and supersede postcensal estimates. In this report we describe prevalence estimates in Atlanta for mental retardation, cerebral palsy, and hearing and vision loss for 8 year olds from 1991-1994 and 1996. We used calculations of postcensal and intercensal population estimates. Intercensal population data were consistently higher than postcensal data, and prevalence estimates for developmental disabilities were lower using intercensal population data. This discrepancy varied by race and ethnicity. Comparison of population estimates, particularly at state and local levels, should be considered to assess meaningful differences in published prevalence estimates using intercensal data.

To evaluate the clinical benefit of prokinetic therapy in aspiration pneumonia in patients with developmental disabilities, we conducted a retrospective study; records of 22 tube-fed patients were reviewed from December 1990 to October 1998 for a mean of 22.7 months before and 38.9 months during Cisapride therapy. Numbers of hospital admissions per patient-year before and during Cisapride administration were reduced from 2.75 to .61, with a relative risk reduction of 4.5. Days of hospitalization were reduced from 32.3 to 6.4. There were no adverse events noted from the therapy. Appropriately monitored prokinetic therapy may prove to be beneficial in preventing aspiration pneumonia in selected patients with developmental disabilities.