SIDDS: Simulations in developmental disabilities

SIDDS, or simulations in developmental disabilities, is a computer system that provides students with the opportunity to acquire and practice skills in behavioral psychology. During the simulation, the student assumes the role of a psychologist whose professional duties involve the assessment and treatment of the severe problem behavior displayed by a child with a developmental handicap. Following an introduction to the use of the program, SIDDS guides the student/clinician through a series of steps involved in reducing a behavior problem. With the goal of eliminating the client’s behavior problem, the student/clinician proceeds through referral, problem identification, assessment, functional hypothesis, and treatment stages. This article describes the content and structure of SIDDS and provides a glimpse of what future developments of this system will entail.     

The epidemiology of developmental disabilities in low-income countries

Although most of the world's children live in developing countries and may be at high risk for disability, very little is known about the prevalence and causes of developmental disabilities in these countries. This paper discusses methodological difficulties contributing to this lack of knowledge, and provides an overview of what is known about the epidemiology of developmental disabilities in low-income countries. At least some forms of developmental disability appear to be more common in low-income countries than in wealthier countries, despite the probability of higher mortality among children with disabilities in low-income countries. For example, most studies of severe mental retardation in low-income countries report prevalences greater than 5 per 1,000 children, while prevalence estimates from industrialized countries are consistently below this. Major risk factors for developmental disabilities in some low-income countries include specific genetic diseases, a higher frequency of births to older mothers, consanguinity, and specific micronutrient deficiencies and infections. Trauma and toxic exposures are also important risk factors, but their contributions to the etiology of developmental disabilities in low-income countries are not well documented. Though many of the causes of developmental disabilities are understood and preventable, proven methods of prevention are not being fully implemented in developing countries. Epidemiologic studies are needed to raise awareness of the public health impacts of developmental disabilities in low-income countries and to provide a basis for setting priorities and designing efficient interventions.     

Supporting communication in young children with developmental disabilities

The behavior of parents, adult caregivers, and peers comprises the critical features of community support for the development of communication in young children with developmental disabilities. In a bio-ecological model of development, communication development is the result of the interactions of individuals with specific characteristics, in particular contexts over time. From the perspective of this model, foundational findings of intervention research to current views of communication development in children with developmental disabilities are summarized. The contributions of individual child characteristics to child-caregiver interactions that support language development are illustrated based on research with children who have autism, Williams syndrome, Down syndrome, and children who use augmentative communication systems. Parent-child interaction and the quality and quantity of parent talk are discussed as factors in children's language development. The effects of young children's delayed language on their interactions with peers, the contributions of peers to children's language learning and use, and the critical features of classroom settings that support child language development are reviewed. MRDD Research Reviews 7:143-150, 2001.     

A developmental study of learning disabilities and memory

Seven-, ten-, and thirteen-year-old learning-disabled (LD) and non-learning-disabled (NORM) children were presented specially structured lists of 38 words each and tested for free recall. Each list contained only four semantically related words. Two of the four related words were presented contiguously (serial positions 9 and 10) and the other two words were spaced (serial positions 20 and 30). All children recalled disproportionately more adjacent words (item 9 or 10) than any other words. Spaced words (items 20 and 30) were less likely to be recalled by the younger children than by the older children and by the LDs than by the NORMS. These findings provided support for the distinction between automatic and purposive semantic processing. NORMs' recall was governed by purposive semantic processing to a greater extent than was LDs' recall. However, no group or age differences were observed in automatic semantic processing.     

Brain plasticity,learning, and developmental disabilities

This is a time of significant gains in methodological development for examining the developing human brain. New efforts are underway to unify the understanding of the development of brain anatomy with physiological, cellular and molecular processes that influence behavioral development. This special issue provides animal models of behavior and brain development, applications of noninvasive imaging and genetic methods to human brain development and behavior, and select reviews of how these models and methods have been applied to the examination of developmental disabilities. This issue reflects a sampling of current approaches to the study of brain plasticity, development and learning in typically and atypically developing humans and animals.     

Role structure and burnout in the field of human services.

This article discusses a study that investigated burnout as a function of aspects of role structure for people working in the field of human services. The subjects, the staff of a residential rehabilitation and mental health center, completed a six-team questionnaire, the Maslach Burnout Inventory, and the Least Preferred Coworker Scale. The relationships of accuracy, concentration of social support network, mutual references, and motivational hierarchy were analyzed in three multiple regressions with emotional exhaustion, personal accomplishment, and depersonalization. Emotional exhaustion was found to have occurred less often when a person's social support network within the setting was not concentrated solely within the formal work subgroup, personal accomplishment was enhanced by an ambiguous role structure, and depersonalization was found to be related primarily to a person's values toward personal relationships and work and to be more prevalent among those with concentrated networks and ambiguously structured roles.     

Co-occurrence of developmental disabilities with birth defects

This article begins with a discussion of the concepts of comorbidity and co-occurrence of diseases and health conditions. These concepts are then applied to the literature on the population-based prevalence of developmental disabilities and birth defects. Most of the existing literature focuses on co-occurrence and obtains data from both clinical and administrative sources. Developmental disabilities occur more frequently in children with multiple, rather than with isolated, birth defects. More research, with more sophisticated study designs, will be necessary to further elucidate the contributions of birth defects to the etiology of developmental disabilities, control for other risk factors, and to identify strategies for prevention and intervention services.     

Assessment of anger and aggression in male offenders with developmental disabilities

Systematic assessment of anger among people with developmental disabilities has been lacking, especially for hospital inpatients. Reliability and validity of anger self-report psychometric scales were investigated with 129 male patients, mostly forensic. Anger prevalence and its relationship to demographic, cognitive, and personality variables and to hospital assaultive behavior were examined. High internal and intermeasure consistency, and some concurrent validity with staff ratings, were found. Retrospective validity regarding physically assaultive behavior in the hospital was obtained. Hierarchical regressions revealed that patient-reported anger was a significant predictor of assaults postadmission, controlling for age, length of stay, IQ, violence offense history, and personality variables.     

Placebo effects in developmental disabilities: implications for research and practice

Recent clinical trials of secretin in children with autism showed robust placebo effects and no benefit of secretin over placebo. This article explores the reasons for the observed placebo effects, focusing on the heightening of positive expectancy by media attention and by the sensory experiences associated with intravenous injections. Comparisons are drawn with research involving other novel treatments and other clinical populations of children with developmental disabilities and neurobehavioral disorders. Research regarding mechanisms of placebo effects is reviewed, including patient and clinician attributes, expectancy effects, participation effects, changes in caregiver behavior, and conditioning. New evidence regarding the biological basis of placebo effects is briefly presented. Since placebo effects are ubiquitous and may operate by a variety of mechanisms, research design is critical in designing clinical trials and in evaluating other outcomes research. Measurement issues important for research in developmental disabilities are emphasized. Ethical concerns have been raised regarding the use of placebo in clinical research, but current analysis suggests that placebo controls are necessary and defensible on ethical grounds, if certain conditions are met. The study of placebo effects ("placebology") holds great promise as a new area of research in therapeutics. The author's research in the potential augmentation of stimulant effects in children with attention deficit/hyperactivity disorder (ADHD) by adding placebo in open label is briefly presented. The placebo has always been integral to the practice of medicine, but advances in scientific medicine and medical ethics have diminished the role and use of placebo in practice. An innovative approach to the ethical use of placebo is proposed.     

Mechanism for testing operant conditioning and body rocking in developmental disabilities

A mechanism is described for testing operant conditioning and body rocking in developmentally disabled persons. The system is made up of a reinforcement dispenser, a lever-pulling mechanism, and flexible chair back for testing body rocking. Experience with the system has shown it to be sturdy and reliable, and the reinforcement dispenser to be adaptable to a wide range of food preferences.     

Life skills instruction for children with developmental disabilities

The Preschool Life Skills program is an intervention package designed to teach functional skills to prevent problem behavior in typically developing children. The purpose of the current study was to evaluate the effects of the instructional package (renamed “Life Skills”) with children with developmental disabilities. The program involved teaching 12 life skills to nine participants across four instructional units. The units were instruction following, functional communication, tolerance of denial and delay, and friendship skills. Teachers provided instruction through a three-tiered instructional approach, starting with class-wide instruction followed by small group and one-to-one instruction as necessary. We extended previous research by using visual prompts during all three tiers and progressively increasing intertrial intervals during one-to-one instruction. Results indicated that the intervention led to skill acquisition with all nine participants. The skills maintained 4 weeks after instruction ended.     

Enhancing frequency recording by developmental disabilities treatment staff

We evaluated a staff training and management package for increasing accuracy of recording frequency of problem behavior in a residential care facility. A multiple baseline design across the first and second work shifts showed that 2 of 8 participants increased their accuracy following in-service training, and all 8 improved during a condition with supervisor presence and feedback. Improvements were maintained when feedback was removed and generalized to activity periods when neither supervisor presence nor feedback was provided. Other staff behavior was not adversely affected by the intervention package.     

A multidisciplinary treatment for encopresis in children with developmental disabilities

Achieving continence of one's bowel movements is a key step in development and failure to do so leads to many negative consequences. Treatments for encopresis appearing in the literature have employed behavioral strategies; medications such as suppositories, laxatives, or enemas; and in some studies a combination of these approaches. To date, attempts to extend successful treatments for encopresis in typically developing children to those with developmental disabilities have been limited. The current study included three participants diagnosed with developmental disabilities who had a history of encopresis. None of the participants had a continent bowel movement under baseline conditions. Continent bowel movements increased during treatment that included the addition of suppositories to elicit continent bowel movements. Two participants began having independent continent bowel movements (i.e., without requiring suppositories) and medication was successfully faded out for the remaining participant. Treatment took between 13 and 21 days.     

Establishing derived requesting skills in adults with severe developmental disabilities

This project examined whether a history of reinforced relational responding would result in derived requesting skills in 3 adults with disabilities. Participants were first taught to request preferred items using pictures; they were then taught conditional discriminations between pictures and their dictated names and between dictated names and their corresponding text. Finally, requests for preferred items using corresponding text were evaluated. All 3 participants demonstrated derived requesting skills.     

Environmental toxicants and developmental disabilities: a challenge for psychologists

Developmental, learning, and behavioral disabilities are a significant public health problem. Environmental chemicals can interfere with brain development during critical periods, thereby impacting sensory, motor, and cognitive function. Because regulation in the United States is based on limited testing protocols and essentially requires proof of harm rather than proof of lack of harm, some undefined fraction of these disabilities may reflect adverse impacts of this "vast toxicological experiment" (H. L. Needleman, as quoted in B. Weiss & P. J. Landrigan, 2000, p. 373). Yet the hazards of environmental pollutants are inherently preventable. Psychologists can help prevent developmental disabilities by mobilizing and affecting public policy, educating and informing consumers, contributing to interdisciplinary research efforts, and taking action within their own homes and communities to reduce the toxic threat to children.     

Improving accepting and giving compliments with individuals with developmental disabilities

Individuals with developmental disabilities, such as autism spectrum disorder, typically exhibit conversation skill deficits, with two prevailing deficits including giving and accepting compliments. The current study used an individualized approach to assess and teach accepting and giving compliments specific to performance, possession, and appearance with three adolescents and young adults with developmental disabilities. We taught these skills using behavioral skills training and prompting during conversations utilizing a multiple-baseline design across participants. We also observed generalization and treatment extension of the participants' skills in conversations with adults not associated with teaching and in the absence of any teaching procedures. The results support the efficacy of the procedures used toward improving giving and accepting compliments within the context of a conversation. We discuss considerations to improve the social acceptability of and refinements to the teaching procedures and acquired skills.     

Recognizing the role of parents in developmental outcomes: a systems approach to evaluating the child with developmental disabilities

When developmental concerns arise in children, a clinical assessment focuses on the child's developmental profile to achieve three goals (1) determine diagnosis, (2) develop interventions, and (3) evaluate progress. Parents often have needs during this time that are not addressed by professionals because of the exclusive focus on the child during the evaluation. In this article, we suggest that clinicians take a "systems" approach to the assessment process by recognizing how the well being of family members can impact a child with a developmental disability. We review systems theory and its conceptualization of individual functioning and discuss how parental well-being differs according to child diagnosis. Finally we suggest a systems-based model to use during the assessment process.     

Quality care in residential placement for children and youth with developmental disabilities

There is a growing concern for quality care in residential placements outside of the natural family for children and youth with developmental disabilities. Ideally, children with developmental disabilities should remain with their natural parent or parents of parents with appropriate supports until the age when children typically leave home. In reality, parents of children and youth with development disabilities are not always able or willing to care for their children at home, and alternate residential placements must be found. This paper will discuss some of the issues surrounding the provision of quality care in out-of-home residential placements for children and youth with developmental disabilities.