Journal on Developmental Disabilities

Dr. Bruce McCreary whose entire career was devoted to working with individuals with developmental disabilities and their families passed away at Kingston General Hospital on November 15, 2017 at the age of 78.

Background This study examined health disparities between children with and without developmental disabilities (DD) living in child protective care. We conducted a population-based study of children in care in Manitoba, Canada; 11% were identified with DD. Method Using administrative health data, we compared the health status and health services utilization of children in care with (n = 1,212) and without (n = 2,424) DD, matched by age, sex, and region of residence, using Generalized Estimating Equation (GEE) regression modelling. Results Among children in care, those with DD were significantly more likely to have a history of mood and anxiety disorders, respiratory illnesses, diabetes, hospital-based dental care, and injury-related hospitalizations, and made more ambulatory physician visits compared to those without DD. Conclusions Compared to their counterparts in care, those with DD are more likely to have health problems and use health services. Recommendations are made for further research.

Children and youth with complex special needs (CSN) present with mental health issues and experience diverse developmental and physical health challenges, often requiring care from several service sectors throughout their lifespan. Despite the chronic service needs of children with CSN, little is known about the factors that contribute to the need for additional financial support to care for these children. To address this gap in the literature, the present study sought to identify risk factors present amongst children and youth seeking mental health services whose families were referred for complex special needs funding in the province of Ontario, Canada. Using data collected from 1,020 male children in Southwestern Ontario using the interRAI Child and Youth Mental Health assessments, the present study examined whether children referred for CSN funding differed from children in clinical care who were not referred for CSN funding. Binary logistic regression analyses revealed that impairments in family functioning (OR = 6.206, CI: 1.827‑20.551) were most strongly associated with CSN funding referral. Child challenges in completing activities of daily living were also associated with CSN referral, but this effect was small (OR = 1.063, CI: 1.020‑1.100). Implications for decisions around funding allocation with respect to CSN funding in Ontario are discussed.

This mixed-methods convergent study examined whether the Scribble Drawing, Bridge Drawing with Path (BDP), and Future Trip Drawing art-based assessments from the field of art therapy, could be utilized as creative methods in evaluating imagination and symbolic development of drawings in adults with autism spectrum disorder (ASD). Fourteen (N = 14) adults with medium- to high-functioning ASD (Mage = 27.7 years) participated in a single individual study session during which they completed the three aforementioned imaginative drawings. The results showed that the three art-based assessments with supporting written and verbal narrative associations can be considered as effective creative methods to measure imagination and symbolic development in adults with ASD. Most of the participants envisioned, developed, and described more non-social symbols representing real places and objects from their world than social (self and people) symbols in their Scribble Drawing (79%; n = 11) and Future Trip Drawing (86%; n = 12). One compelling Scribble Drawing finding was that half of the participants’ scribble lines directly embodied symbols not present to their senses; as a result, there was no need for them to add to their scribble lines to create their concrete symbols. This finding supports previous literature that certain individuals with ASD have detail-focused cognitive processing and drawing styles. A noteworthy BDP finding was that participants’ BDP end points led to things that made their life feel meaningful (i.e., art program, nature, theatre). This finding calls upon developmental service providers to implement recreation programs and organize excursions to local art galleries and museums for adults with ASD. The authors believe that the results of this study will inspire future art-based assessment research investigating imagination, symbolic development, and executive function abilities in adults with ASD.

Down syndrome is associated with a range of developmental strengths and challenges. The treatment use of individuals with Down syndrome along with associated factors have not yet been determined. In a pilot study to address this issue, we elected to conduct an online survey rather than a classical representative population survey to generate relevant information quickly. An online survey was completed by 162 primary caregivers of children and youth with Down syndrome. Caregivers reported the types of treatments children were currently receiving and had received in the past, along with the overall satisfaction with treatments. Associations with other child variables (e.g., age, gender, and race) and family characteristics were also examined. Findings indicate that children were currently receiving a mean of 6.1 (SD = 3.5) different types of therapy treatments; the most common treatments was speech–language therapy currently received by 73%. Only 2.4% of children were currently receiving applied behaviour analytic treatment, an empirically supported therapy. Caregivers reported using a number of treatments without empirical support including facilitated communication, holding therapy, and auditory/sensory integration. Caregivers tended to agree that each treatment was efficacious and contributed to their child’s growth. Treatments that were associated with strong agreement included medication (69.8%), care from family and friends (62.8%), assistive technology (58.3%), and floortime (55.6%). Future research should focus on understanding the process of treatment selection by caregivers of children with Down syndrome and develop accessible guidelines on empirically supported therapies.

Individuals with disabilities are less likely to partake in community-based recreation activities if they perceive negative attitudes from other community members. This study sought to evaluate the impact of an adapted physical exercise (APEX) program for adults with autism spectrum disorder and intellectual disability on members of a university fitness facility (i.e., bystanders). Seven bystanders (all university students) who had been present during APEX training sessions participated in a semi-structured interview. Emergent themes and sub-themes indicated that inclusion of individuals with disabilities within a university fitness facility also benefits program bystanders.

While functional analysis is widely viewed as the gold standard assessment technique to determine the function, or purpose, of a challenging behaviour, a number of barriers exist to conducting such assessments in natural settings such as classrooms. The trial-based functional analysis (TBFA) is a promising modification which embeds assessment trials throughout on-going daily activities in the natural environment. TBFAs may be more conducive to natural settings as they minimize risk by ending trial segments after a single occurrence of the target behavior, increase ecological validity, and minimize disruptions to the daily schedule. Researchers have systematically evaluated the utility of trial-based functional analyses (TBFA) on the development of effective, function-based interventions. The purpose of the current study was to contribute to this growing body of evidence by conducting two TBFAs for a student with autism spectrum disorder in a publicly funded school setting and evaluating the effects of a function-based intervention informed by the TBFA results. A demand fading protocol (the removal of all instructions, followed by their gradual reintroduction) was implemented to address the escape-maintained challenging behaviour (behaviours used to get out of an undesired activity). Data indicated increased engagement with academic stimuli and decreases in challenging behaviour as a result. The generalization of these results with novel staff and novel tasks was also demonstrated. These results support the utility and feasibility of TBFAs to assess behavioural function and the resulting ABA approaches to reduce challenging and disruptive behaviour in publicly funded school settings.