Community-based instruction for independent meal preparation by adults with profound mental retardation

Three adults with profound mental retardation and very limited reading skills were transitioned to community living after spending more than 20 years in a residential facility. Community-based instruction was used to teach them to independently prepare meals. Directed rehearsal and prompting procedures were used to teach them those meal preparation skills that they were unable to perform independently. We present assessment, training and followup data on the preparation of a dessert by the three participants. Following an assessment on the steps needed to prepare the dessert, training was introduced in a multiple baseline across subjects design. Results showed that the participants were able to independently prepare the dessert in up to 21 pre-training and training sessions. Monthly followup for six months showed that they were able to independently prepare the dessert in various community settings of their choice.     

Evaluation of a sexual abuse prevention program for adults with mental retardation.

Programs to teach sexual abuse prevention skills to persons with mental retardation have rarely been evaluated empirically, and typical evaluations are limited to assessment of the participants' knowledge rather than their performance of specific skills. In the present study, 6 adult women with mental retardation were trained in sexual abuse prevention, and performance was assessed using four separate measures: pretests and posttests of knowledge, verbal report, role play, and naturalistic probes. All women learned the skills but failed to exhibit them to criterion during the probes. We discuss the implications for further training and assessment of sexual abuse prevention skills.     

Acquisition and generalization of manual signs by hearing-impaired adults with mental retardation

Behavioral procedures have been used to teach manual communication skills to individuals with mental retardation, although few studies have examined the assessment of generalization of such skills beyond the teaching environment. In this study, we investigated the effectiveness of directed rehearsal for teaching and facilitating the generalization of manual signs by six hearing-impaired adults with mental retardation. The effects of directed rehearsal, alone and combined with positive reinforcement for correct responses, were compared to a no-training control condition in an alternating treatments design. Although directed rehearsal was superior to the no-training control condition in teaching manual signs, the procedure was more effective when combined with positive reinforcement. The combined procedure was used to facilitate the generalization of learned signs across a number of variables. The results showed that there were high levels of generalization by all participants across novel phrases, settings, and trainers but variable levels of generalization to another response mode by some subjects. Further, increased levels in overall vocal communication were found for most participants.     

Abuse and neglect of adults with mental retardation in different residential settings

Eighty-two per cent of all cases of abuse or neglect of an adult with mental retardation substantiated by the Abuse Investigation Division of the Connecticut Office of Protection and Advocacy for Persons with Disabilities over a five-year period occurred in the victim's residence. Chi square analyses revealed that there was significantly more abuse in institutions and group homes and significantly less in the individual's own home. Furthermore, analyses revealed that there was significantly more personal neglect in group homes and community training homes and significantly less in own homes. The results were discussed and recommendations made regarding ways of reducing abuse and neglect.     

An exploratory examination of intellectual disability and mental illness associated with alleged false confessions

The National Registry of Exonerations tracks cases of individuals who have been wrongly convicted and exonerated since 1989. Their most recent report revealed that 12% of those exonerated gave false confessions. The current study used data from the National Registry of Exonerations and focused on a sample of 2,378 individuals convicted of felonies with a focus on sexual offenses, as such crimes tend to be viewed as particularly heinous with increased consequences for those convicted. After examining various legal and extralegal factors, the results showed that those accused of sexual offenses, particularly sexual murders, had a greater likelihood of giving a false confession than those accused of non-sexual offenses. The likelihood of falsely confessing was higher among juveniles, those with mental illness and intellectual disabilities, and cases with multiple suspects. Females had a greater odds of falsely confessing to murder than males. Implications and recommendations are discussed.     

Goodness-of-fit ethic for informed consent to research involving adults with mental retardation and developmental disabilities

This article reviews current theory and research on informed consent policies for adults with mental retardation within a relational ethics framework that re-conceptualizes consent vulnerability in terms of the goodness-of-fit between participant decisional capacities and the specific consent context. Conceptualizing informed consent competence as a product of the relationship between person and consent context shifts assessment of decisional capacity away from an exclusive focus on a research participant's cognitive deficiencies to (a) an examination of those aspects of the consent setting that are creating or exacerbating consent vulnerability and (b) consideration of how the setting can be modified to produce a consent process that best reflects and protects the hopes, values, concerns, and welfare of adults with developmental disabilities.     

The abilities of children with mental retardation to remember personal experiences: implications for testimony

Investigated the abilities of children with mental retardation to remember the details of a personally experienced event. A simulated health check was administered to 20 children with mental retardation and 40 normally developing children, half matched on mental age (MA) and half matched on chronological age (CA) with the children with mental retardation. The children's memory was assessed immediately after the health check and 6 weeks later. Overall, the children with mental retardation accurately recalled the health check features, provided detail, and resisted misleading questions about features that did not occur. The group with mental retardation performed similarly to the MA matches on virtually all of the memory variables. The children with mental retardation performed worse than the CA matches on most of the memory variables, although they were able to recall a similar number of features. The findings are discussed in terms of the ability of children with mental retardation to provide accurate testimony.     

Intellectual functioning in adults with ADHD: a meta-analytic examination of full scale IQ differences between adults with and without ADHD

Although attention has been given to the intellectual functioning of children with attention-deficit/hyperactivity disorder (ADHD) relative to their non-ADHD peers, few studies have examined intellectual functioning in adults with ADHD. The purpose of the current investigation was to examine differences in intellectual ability between adults with and without ADHD via a meta-analytic review. Of the 33 studies meeting inclusion criteria, primary analyses focused on 18 studies representing 1,031 adults with ADHD and 928 non-ADHD, nonclinical comparison adults and containing Wechsler Adult Intelligence Scale (WAIS; D. Wechsler, 1955, 1981, 1994) Full Scale IQ scores or estimates. A significant effect was found such that adults with ADHD scored lower than non-ADHD adults on WAIS intelligence tests. However, this difference was small and not clinically meaningful. The presence of several moderators reflecting characteristics of the ADHD samples and study methodology suggested that only a subset of adults with ADHD (e.g., those with comorbid disorders) may experience lower general intellectual ability relative to non-ADHD comparison adults. Implications of the findings for clinical and research settings are presented as well as suggestions for improving methodology and reporting in future research.     

Assessing choice-making and preference in adults with profound mental retardation across community and center-based settings

We examined choice and preference in four adults with profound mental retardation within the context of a community-based and center-based location. Prior to the preference analysis, an independent selecting response was empirically assessed and validated for each adult. Results of the preference analysis showed that in the community site there was a higher cumulative frequency of choice-making responses towards beverages for all participants, and an indication of beverage preference for two of the four participants. Conversely, in the center-based setting, there were fewer responses made towards the beverages, and no indication of preference for any of the four adults. These results remained consistent during maintenance checks at 2, 4, 6, and 8 weeks post-intervention.     

Form E of the 16PF and adults with mental retardation: internal consistency and validity.

Form E of the Sixteen Personality Factors Questionnaire (16PF-E) was administered to 70 adults (45 men and 25 women) who resided in a public facility for mentally retarded persons. Alpha coefficients were computed for each of 16 primary trait scales. The Intelligence (B), Ego Strength (C), Dominance (E), Superego Strength (G), Parmia (H), Protension (L), Autia (M), Shrewdness (N), Guilt Proneness (O), and Self-Sentiment (Q3) scales exhibited low internal consistency, whereas Premsia (I) and Self-Sufficiency (Q2) evidence relatively higher levels. Personality traits of subjects were also assessed by staff ratings. Ratings were compared to 16PF-E primary and secondary trait scores via correlation coefficients. Results provided virtually no support for the validity of the 16PF-E primary scales and the Exvia, Anxiety, and Cortertia secondary factors as applied to the subject population. Limited support for the validity of the Independence secondary factor was found.     

Interaction of reinforcement schedules, a behavioral prosthesis, and work-related behavior in adults with mental retardation

The effects of variable-interval (VI) and fixed-ratio (FR) schedules of reinforcement for work-related behavior and an organizer for the work materials (behavioral prosthesis) were evaluated with 3 adults with severe or profound mental retardation. The participants had been recommended for study because of high rates of off-task and aberrant behavior in their daily vocational training programs. For 2 participants, VI and FR schedules resulted in the same outcome: more aberrant behavior than on-task and off-task behavior combined. The FR schedule nearly eliminated emission of aberrant and off-task behavior by the 3rd participant. Combining the behavioral prosthesis with FR reinforcement (FR+O) increased the proportion of time spent in on-task behavior by all participants under certain FR schedule parameters. Second-by-second analyses of the observation records revealed that FR schedules reduced off-task and aberrant behavior during work sequences (i.e., ratio runs), and FR+O led to a further reduction of these behaviors during postreinforcement pauses. Overall, the results show how organizer and schedule parameters can be adjusted to produce an optimized balance between productivity and reinforcement while undesirable behavior is minimized.     

Teaching a simple meal preparation skill to adults with moderate and severe mental retardation using video modeling

We evaluated whether adults with mental retardation in the moderate or severe range would acquire simple meal preparation skills via video modeling. Training was conducted in the kitchen of the participants' day treatment setting. The intervention consisted of (i) watching a video of an adult with a developmental disability making a peanut butter and jelly sandwich and (ii) receiving verbal praise for each step of the task that was performed correctly. All three participants mastered the task and demonstrated generalization across settings. All three participants also demonstrated maintenance of the skill one month following mastery. Copyright © 2003 John Wiley & Sons, Ltd.     

A National Survey of State Legislation defining mental retardation: implications for policy and practice after Atkins

In Atkins v. Virginia 2002, the U.S. Supreme Court held that the Eighth Amendment prohibits executing offenders who are mentally retarded. Rather than adopting a uniform definition of mental retardation, the court charged each state with defining mental retardation in a manner that enforces the constitutional restriction. An unanswered question is how states define mental retardation after Atkins, which has implications for capital defendants and forensic evaluators who conduct capital mitigation evaluations. This project identified the statutory definitions of mental retardation in each state, and grouped the definitions based on consistency with accepted clinical criteria for mental retardation. Results show that definitions of mental retardation vary considerably by state. The large majority of states, both overall and specifically among death penalty states, use criteria for mental retardation that are not entirely consistent with accepted clinical standards. As such, it is not clear whether the majority of states are effectuating the intent of Atkins. The implications of these findings for both policy and practice are discussed.     

Response allocation to concurrent fixed-ratio reinforcement schedules with work requirements by adults with mental retardation and typical preschool children.

The present experiments examined the effect of work requirements in combination with reinforcement schedule on the choice behavior of adults with mental retardation and preschool children. The work requirements of age-appropriate tasks (i.e., sorting silverware, jumping hurdles, tossing beanbags) were manipulated. Participants were presented with their choice of two response options for each trial that varied simultaneously on both work requirement and reinforcement schedule. Results showed that when responding to both choices occurred on the same reinforcement schedule, participants allocated most of their responses to the option with the easier work requirement. When the response option requiring less work was on a leaner reinforcement schedule, most participants shifted their choice to exert more work. There were individual differences across participants regarding their pattern of responding and when they switched from the lesser to the greater work requirement. Data showed that participants' responding was largely controlled by the reinforcement received for responding to each level of work. Various conceptualizations regarding the effects of work requirements on choice behavior are discussed.     

Cultural differences in the dialectical and non-dialectical emotional styles and their implications for health

Previous cross-cultural studies have repeatedly demonstrated that East Asians are more likely to show a dialectical emotional style than Americans, but do not distinguish between specific types of dialectical emotional styles. Using an age diverse sample, we found that compared to Americans, Japanese are more likely to experience both positive and negative emotions moderately frequently (i.e., moderate dialectical), but are no more likely to experience them frequently (i.e., high dialectical). Thus, dialectical emotions prevalent in East Asia may be characterised by a "middle way" rather than by emotional extremes. Furthermore, we explored whether dialectical emotion types are associated with better health profiles depending on cultural background. Our results show that the moderate dialectical type is associated with fewer physical symptoms in Japan than in the USA. Together, these findings show the cultural differences in the experience of balanced positive and negative emotions and their health correlates.     

Lifestyle differences between smokers,ex-smokers and non-smokers,and implications for their health

Abstract

Much evidence has been published in order to demonstrate that smoking cessation leads to a decrease in morbidity and mortality. Using data from the Health and Lifestyle Survey respondents were divided into three groups: smokers, ex-smokers and non-smokers and lifestyle characteristics such as diet and exercise were compared. Smokers were more likely to eat chips (French fries), fried food, butter and less likely to eat fresh fruit in winter, green vegetables and margarine high in polyunsaturated fats. Non-smokers were more likely than smokers and ex-smokers to take part in keepfit, jogging and swimming. Non-smokers in smoking households were more likely than non-smokers in non-smoking households to eat fried food, chips and butter and less likely to eat fruit in winter or margarine high in polyunsaturated fats. Results suggest that part of the assumed health benefits of smoking cessation are due to ex-smokers having a healthier diet than that of smokers.     

Establishing motion control in children with autism and intellectual disability: Applications for anatomical and functional MRI

Excessive motion makes magnetic resonance imaging (MRI) extremely challenging among children with autism spectrum disorder (ASD). The medical risks of sedation establish the need for behavioral interventions to promote motion control among children with ASD undergoing MRI scans. We present a series of experiments aimed at establishing both tolerance of the MRI environment and a level of motion control that would be compatible with a successful MRI. During Study 1, we evaluated the effects of prompting and contingent reinforcement on compliance with a sequence of successive approximations to an MRI using a mock MRI. During Study 2, we used prompting and progressive differential reinforcement of other behaviors (DRO) to promote motion control in a mock MRI for increasing periods of time. Finally, during Study 3, some of the participants underwent a real MRI scan while a detailed in‐session motion analysis informed the quality of the images captured.