Journal on Developmental Disabilities

The Assessment of Basic Learning Abilities (ABLA) test assesses the ease or difficulty with which persons with developmental disabilities are able to learn 2-choice visual and auditory discriminations. We examined the ABLA's ability to predict 3-choice discrimination performance with 12 adults with developmental disabilities. Participants performed significantly better on 3-choice tasks that require discriminations that they passed on the 2-choice tasks than on 3-choice tasks that require discriminations that they failed on the 2-choice tasks, strengthening the ABLA's predictive validity. Theoretical and applied implications of these results are

Family quality of life, a major issue for families of adults with developmental disabilities, has been under-examined by researchers. Utilizing interview data previously collected in one geographical region as part of a larger project, this secondary analysis explores service delivery as an important aspect of quality of life for families with adults who have developmental disabilities and are living at home. Employing a modified grounded theory approach, a finer-grained analysis of data from 10 interviews with family members revealed the following themes: (a) obstacles that families encounter when accessing services, (b) concerns about the future, (c) accepting additional responsibility, and (d) unmet service needs. Recommendations for service practice and future research based on the findings from the secondary analysis are discussed.

The current study evaluates the effectiveness of a community anger management group for individuals with dual diagnosis, a developmental disability and psychiatric disorder. Ten individuals who demonstrated difficulties in inappropriate anger expression and anger management participated. Caregivers were also encouraged to attend the group. Sessions were held over the course of 12 weeks and employed a modified cognitive-behavioural approach. Following treatment, assessments of anger disposition and control were available for nine clients and five carers. Both participants and caregivers reported a marginally significant decrease in client's anger behaviours, and a substantial improvement in client's anger regulation. Although results should be interpreted cautiously, the findings suggest that an anger management group may be an effective intervention for individuals with dual diagnosis.

Adult protective service workers (APSWs)(N=170) were asked across Ontario to estimate the prevalence of tobacco use, alcohol/drug problems among their clients with a developmental disability (DD) and to describe one person with the most severe alcohol/drug problem. Survey results (46.5% return) showed that overall 24% of males and 15% of females smoked tobacco. Ten percent of the males and 5% of the females were identified as having alcohol/drug problems. Among those with the most severe alcohol/drug problem, 50% of the males and 43% of the females had a psychiatric diagnosis in addition to DD. About thirty-five percent of the males and 27% of the females were known to use cannabis. The majority of APSWs believe that the currently available addiction treatment options in Ontario are inadequate to meet the needs of people with DD.

The issue of sexuality is a major concern for parents of children with learning disability and causes them great anxiety. Due to the lack of large-scale studies examining parental attitudes towards the sexuality of people with learning disability in Greece, it was decided to develop and evaluate a culturally appropriate instrument to use with Greek parents. Thus, the Parents' Own Child scale was developed to assess parents' attitudes towards the sexuality of their own offspring with learning disability, as a part of the GSAQ-LD-PARENTS. The evaluation process of the measure indicated that the 11-item, Likert-type scale presents satisfactory item characteristics, adequate reliability and homogeneity and preliminary support for criterion-related validity.

The present study examines sexual attitudes of parents who have adolescents or young adults with learning disability in Greece. Data from 100 Greek parents were collected during approximately six months in three Greek towns (Athens, Patra, Ioannina) using the GSAQ-LD-PARENTS. Analyses based on responses from 95 parents showed that most of the variables, with the exception of level of education, had no impact on parents' attitudes towards the sexuality of the individual with learning disability. There were differences in parents' attitudes measured by the five different scales of the GSAQ-LD-PARENTS. The findings can be used in the design of an educational program addressed to parents in order to help them to come to terms with their child's developing

Closure of institutions designed for adults with intellectual disability (ID) has meant that those with more complex psychiatric and/or medical conditions have been admitted to health care settings designed for the general population of non-disabled adults. This paper describes the characteristics and service utilization of persons with ID receiving inpatient psychiatric care in Ontario, and compares them to patients without ID in the same setting. Results reveal that significant discrepancy exists between the identified needs and services offered to patients with ID, with most interventions focused on behaviour management, including use of psychotropic medication, seclusion rooms, and confinement to unit.

Closure of institutions designed for adults with intellectual disability (ID) has meant that those with more complex psychiatric and/or medical conditions have been admitted to health care settings designed for the general population of non-disabled adults. This paper describes the characteristics and service utilization of all persons with ID receiving care in Ontario's complex continuing care hospitals, and compares them to patients without ID in the same setting. Overall, patients with ID appeared to be more clinically complex given their higher rates of functional impairment and aggressive behaviour, despite exhibiting less medical complexity. However, interventions mostly focused on behaviour management.

Background. Medical problems of individuals with intellectual disabilities (ID) have been increasingly recognized in recent years. However, less attention has been give to the needs of individuals in different diagnostic groups. The purpose of this study was to explore the healthcare experiences of parents of children with fragile X syndrome in Ontario. The main objectives of the study were (1) to identify the challenges and successes parents face when accessing healthcare services for their children with ID; and (2) to identify suggestions and strategies to enhance access and quality of healthcare services for children with ID. Methods. Qualitative data were obtained from parents during a focus group conducted with five mothers, two fathers and one foster mother of children with fragile X syndrome. Results. Four main themes emerged which described parents' experiences when accessing healthcare services for their child and/or children with fragile X syndrome. They include: (1) sensing something is not right; (2) negotiating the healthcare system; (3) dealing with healthcare professionals; and (4) parents as active agents. Conclusions. Parents made a number of suggestions of ways that healthcare professionals could deal more effectively with parents. They recommended that (a) doctors need to receive more education about intellectual disabilities; (b) doctors need to take extra time to provide appropriate information and care for children with fragile X syndrome; and (c) patience is a necessary trait for all healthcare professionals who provide care for children with special needs.

A telephone survey was conducted to determine attitudes towards individuals with intellectual disabilities. This article explores the perceptions of the public regarding the best living arrangements for adults with intellectual disabilities. A majority of the 680 respondents believed that some form of community living would work best, either in a supervised apartment or in a group home. Less than 20% of respondents felt a group home would negatively impact their neighbourhood. Respondents also indicated that they believed that a lack of community services was a major obstacle to inclusion within communities of people with intellectual disabilities.

Professional consensus panels have strongly recommended Intensive Behavioural Intervention (IBI) as the treatment of choice for young children with autism. Researchers have linked treatment quantity to better results; however, few attempts have been made to link other treatment factors (i.e., quality) to outcome. This study presents information about the reliability and validity of a pilot version of a measure to evaluate the quality of IBI (the York Measure of Quality of Intensive Behavioural Intervention or YMQI). Inter-rater reliability and internal consistency were generally adequate, although some items and categories were weak. Similarly, criterion related validity and construct validity were adequate for total scores and most categories when a subjective approach to coding was used. Although results were promising, future research is needed before the YMQI can be used as a reliable and valid measure or treatment quality. Research implications and directions for future research are discussed

Within the last ten years, deep brain stimulation has transformed the treatment of a variety of neurological disorders. The principle of deep brain stimulation relies on the continuous electrical stimulation of neural brain structures through implanted electrodes. The therapeutic effects of this technology are most evident in the field of movement disorders where this treatment has become routine for advanced Parkinson's disease patients. More recently, preliminary studies on the use of this technique in epileptic patients suggest that this therapy may be effective in decreasing seizure activity in these subjects. The use of deep brain stimulation is particularly valuable because of its success in treating the proportion of patients whose conditions are otherwise medically refractive. The present success achieved with the application of deep brain stimulation in the treatment of movement disorders warrants the consideration of its future application to related disorders. These disorders include the group of heterogeneous autism spectrum disorders. Individuals diagnosed with autism spectrum disorders present with unique movement disturbances that are similar to the disturbances that have been defined in most movement disorders. In addition, approximately one third of autistic individuals develop epilepsy and a considerable minority of autistic individuals who do not present with seizures, show epileptiform discharges. This abnormal brain activity has been suggested to be involved in the cognitive, language and behavioral deficits characteristic of these disorders. Despite its success in treating various movement disorders in the clinical setting, the exact mechanism of how deep brain stimulation works is still unclear. Complete understanding of the mechanisms of deep brain stimulation will allow for the optimization of present and future applications of this technology. The first goal of this essay is to discuss the recent findings on the therapeutic effects of deep brain stimulation within the central nervous system, particularly in the treatment of Parkinson's disease. The second is, specifically, through assessment of the benefits of using this technology in epileptic patients, to propose future experimental studies aimed at investigating the potential therapeutic properties of deep brain stimulation technology in treating autism spectrum disorders.

Recent advances in the understanding of the causes of epilepsy have resulted in an increased interest in treatment of this disorder in the past 30 years. With the introduction of more effective anti-epileptic drugs (AED), and genetic, molecular and imaging innovations, epilepsy can be treated effectively in the majority of cases. Although dietary therapy as a means to treat epilepsy has become less popular nowadays with the advent of new AEDs, it is still widely used for children with refractory seizures who are not responding to other treatment or who have serious adverse reactions to AEDs. The most popular diet in the treatment of epilepsy is the ketogenic diet, which has been used for more than 80 years. Even though there are not clearly defined guidelines as to how the diet is to be administered and sustained, there is no doubt as to the efficacy of this treatment. Despite the fact that there has been a long history of its use, much remains to be learned about the diet, including mechanisms of action and the biochemical basis of its therapeutic affects. Understanding why the diet is effective may allow for the development of new therapies.

Medical issues can be misunderstood and mistreated as psychiatric disorders in individuals with developmental disabilities (DD). Inappropriate use of psychotropic medication may exacerbate unrecognized medical problems leading to additional medical and behavioural concerns. Individuals who may be most vulnerable to this are those with major communication impairments such as individuals with severe DD and/or autism. This paper describes a case of a 42-year-old man with a diagnosis of schizophrenia and severe DD who presented with severe aggression necessitating admission to a specialized dual diagnosis inpatient unit. Comprehensive inpatient assessment included medical assessment and behaviour monitoring and indicated a longstanding risk for bowel obstruction, clinical presentation consistent with autism, lack of clear evidence for the original diagnosis of schizophrenia, and sensitivity to psychotropic medications. Treatment involving simple nursing and behavioural interventions as well as discontinuation of all psychotropic medication proved very effective with NO incidence of aggression at seven-month follow up. Importance of nursing assessment/treatment combined with behaviour monitoring is emphasized.