Word-attack skills in individuals with mental retardation

This article assesses the state of the literature on word-attack skills and phonological awareness (PA) in individuals with mental retardation, in light of progress towards the development of effective teaching procedures. The literature contains promising findings. Studies have shown PA to be correlated with word-attack skills in individuals with mental retardation, as has been shown conclusively in typically developing children. This suggests that instruction in PA would facilitate the acquisition of word-attack skills in individuals with mental retardation, as it does with typically developing children. As of yet, however, very few experimental studies designed to demonstrate effective teaching procedures for PA and word-attack skills have been published. This research field might evolve most effectively and efficiently by following a two-step research program. First, test new teaching procedures in a series of small-N studies, each study incorporating modifications of teaching procedures based on the results of the previous study. Once procedures prove effective at this level, the resources necessary to pursue large-scale studies can be used to their best advantage.     

A survey of habit behaviors exhibited by individuals with mental retardation

The purpose of this study was to investigate the prevalence and characteristics of habit behaviors exhibited by individuals with mental retardation living in the community. Two hundred and fifty-nine direct care staff and parents from the upper mid-west and northeast regions of the country completed a survey measuring the prevalence of major habit disorders (bruxism, trichotillomania, motor/vocal tics, and stuttering) and habit behaviors exhibited by individuals with mental retardation being served by community residential agencies. Habit disorders were also subjectively evaluated according to the respondents' perception of the severity and noticeability of the behavior, and naturalness of appearance of the individual. In addition, respondents indicated their usual reaction to the habit disorder. Overall, stuttering was found to be the most prevalent habit disorder (32%), followed by tics (16·6%), bruxism (13·1%), and trichotillomania (5%) for the sample surveyed. Furthermore, differences were found in the prevalence of habit disorders and other habit behaviors by level of mental retardation and age (adults versus children/adolescents). The implications and limitations of the data, as well as suggestions for future investigations of habit disorders and habit behaviors exhibited by individuals with mental retardation, are discussed. © 1998 John Wiley & Sons, Ltd.     

Pupillary responses in recognizing awareness in persons with profound mental retardation

Pupil-size changes have been shown to indicate positive or negative reactions to several sensory and psychologic stimuli in normal persons. Whether this could be extended to mentally retarded patients who lack ability for verbal or motor behavior was tested by pupillary responses to several visual, tactile, and auditory stimuli. 24 institutionalized severely and profoundly retarded patients were examined by video camera in their usual environments rather than in a controlled laboratory setting. The videotapes were later projected onto a screen for pupil-size measurements. Pupils dilated with pleasant stimuli, including visualizing a familiar person, soft touch to the arm, music, and soft compliments. There was constriction with presenting an unfamiliar person, rough grasp of the arm, and abrasive noise and harsh commands. The findings demonstrate the existence of pupil reactivity in profoundly retarded persons and suggest such testing as a means of determining which elements of their environment are pleasing or aversive to them.     

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.     

Making choice a routine part of mealtimes for persons with profound mental retardation

Despite increased recognition of the importance of providing routine choice opportunities for persons with severe handicaps, this population continues to experience a typical lack of such opportunities. We evaluated a program for increasing the amount of choices made during routine mealtimes by persons with profound mental retardation and minimal communication skills. The choice provision program, involving systematic presentation of alternative food and drink items in a step-wise fashion during the course of the meal, was implemented with three persons in a residential facility. Results indicated that after implementation of the choice program, all three participants made consistently more choices concerning the foods and beverages they consumed relative to baseline. The choice provision program was conducted without extending the amount of time typically allotted to mealtime within the residential setting. Results are discussed in regard to additional research needed to continue developing means of assisting persons with profound mental retardation to exert control over meaningful events in their lives.     

Equivalence relations in individuals with language limitations and mental retardation

The study of equivalence relations exhibited by individuals with mental retardation and language limitations holds the promise of providing information of both theoretical and practical significance. We reviewed the equivalence literature with this population, defined in terms of subjects having moderate, severe, or profound mental retardation. The literature includes 55 such individuals, most of whom showed positive outcomes on equivalence tests. The results to date suggest that naming skills are not necessary for positive equivalence test outcomes. Thus far, however, relatively few subjects with minimal language have been studied. Moreover, we suggest that the scientific contributions of studies in this area would be enhanced with better documentation of language skills and other subject characteristics. With recent advances in laboratory procedures for establishing the baseline performances necessary for equivalence tests, this research area is poised for rapid growth.     

Behavioral momentum in computer-presented discriminations in individuals with severe mental retardation

Behavioral momentum was examined in 2 individuals with severe mental retardation via within-subject manipulations of obtained reinforcer rates. Subjects performed self-paced discrimination problems presented on a touch screen computer monitor. Two different problems, Tasks A and B, alternated in blocks of 15 trials on a multiple schedule. Reinforcers were snack foods. The reinforcement schedule for Task A was continuous (fixed-ratio 1) and the schedule for Task B was continuous in some conditions and variable ratio in other conditions. Behavioral momentum was assessed in test sessions by prefeeding, presenting response-independent food, and making available alternatives to the tasks. When the obtained reinforcer rate for Task A was at least twice that for Task B, resistance to change was greater for Task A. When both reinforcer rates and response rates were a pproximately equal for the two tasks, resistance to change was approximately equal. These results are consistent with behavioral momentum effects. They extend previous findings with humans by examining momentum in self-initiated discrete-trial discrimination tasks with ratio schedules, and by isolating relative reinforcer rates as a controlling variable via within-subject manipulations.     

Written lists as mediating stimuli in the matching-to-sample performances of individuals with mental retardation.

Students with mental retardation learned to write lists in order to perform a matching task that they could not do otherwise. After an initial assessment phase, reinforcement was arranged in the computerized tasks to follow selection of the six pictures that were identical to those in the six-picture samples presented. In Study 1, even though the participants wrote a list of the names of the six sample pictures on each trial, read a list, or did both, they often made errors when a brief delay preceded picture selection. In contrast, performance was nearly perfect when a list was written, read, and remained available at the time of picture selection, suggesting that the list served to mediate the delays. Study 2 examined the stimulus control by two- and six-picture samples over the list writing. Early during testing, 1 participant refrained from writing lists on two-picture trials but wrote lists on six-picture trials, thereby maximizing reinforcement and minimizing its delay; the other participant showed this pattern of list writing after supplemental training. The studies suggest methods for establishing a rudimentary repertoire of mediating behavior that has relevance for teaching instruction-following skills in natural settings.     

Helmet restraint and visual screening as treatment for self-injurious behavior in persons who have profound mental retardation

Enhancement of sensory, cutaneous stimulation may be one reason for self-injurious behavior among persons with mental retardation. For self-injury involving head or face, a contingently applied helmet prevents access to the sensitized skin area. Such a restraint procedure, with visual occlusion superimposed on the helmet, was tested with two women who are profoundly retarded. Helmet and transparent shield reduced target responses by both women to approximately 7% of baseline rates. When the helmet's face shield was made opaque, a small, further response reduction was obtained. Stable, low rates were maintained over a 6-month maintenance period.     

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.     

Improving methodological and technological analyses of adaptive switch use of individuals with profound multiple impairments

Basic response–event relations can be difficult to demonstrate with individuals with profound multiple impairments who participate in adaptive switch programs. Numerous variables that impede learning and contribute to performance variability present challenges to assessment methods. As switch use may be the only operant under stimulus control with some individuals, however, improvement in assessment methods and measurement technology is important. In three case studies, response–event relations were examined in individuals who were provided with an adaptive switch that could activate an electronic leisure device. With two individuals, evidence of learning was assessed in a novel alternating‐treatments design. Switch use was compared under conditions in which switch closures produced activation and conditions in which closures deactivated the device. With the remaining individual, the effects of momentary activation by switch closure were compared to timed activation. Data were collected with a combination of data collection technologies. Whole‐session rate and response‐duration data provided some evidence of learning in all participants. Data also were converted into within‐session cumulative graphs, which aided data interpretation. The results demonstrate advances in assessment of learning in people with profound multiple impairments. Copyright © 2003 John Wiley & Sons, Ltd.     

Developmental psychology and mental retardation. Integrating scientific principles with treatment practices

The current debates about "best practices" within mental retardation reflect key unresolved issues about the nature of mental retardation and the goals of treatment programs. The central axiom proposed is that better integration of basic principles about human development with treatment practices for children will yield substantial benefits to individuals and society. To illustrate the format for this proposed integration, three principles have been abstracted from scientific inquiry in human development: (a) targeted environmental prevention, (b) metacognitive conveyance, and (c) ecological dominion. A contextual analysis, using special education as an example of a major treatment setting, indicates that application of these developmental principles is likely to reduce the prevalence of mild retardation (as currently defined), to minimize social and behavioral problems, and to foster improved levels of environmental mastery (adaptive success) for many children with low IQs and cognitive deficiencies. Consistent with these developmental principles, the current construct of mental retardation is judged inadequate, and an alternative diagnostic strategy is proposed. This strategy is based on repeated developmental profiling of a child and his or her biosocial environmental history.     

Automatic prompting to reduce persistent tongue protrusion in a woman with severe to profound mental retardation

This study assessed whether an intervention approach relying on auditory prompting delivered automatically through a portable device was effective to reduce tongue protrusion in a woman with severe to profound mental retardation. The device involved (a) an optic sensor, i.e., a miniphotocell kept under the lower lip with medical tape, (b) a small signal transmission box, and (c) a Walkman for presenting the prompts. Initially, the automatic prompting condition was combined with occasional praise from a research assistant for having the tongue in the mouth. Analysis showed that the occurrence of tongue protrusion dropped from about 65% of the observation time during the initial baseline to less than 5% through the intervention. The study lasted 4.5 mo.     

Types of social interactions among individuals with mental retardation who present problems of conduct

This study compared the types of social interactions among groups of adults with mental retardation who also were characterized as demonstrating or not demonstrating difficulties of conduct. Using an Interaction Assessment Protocal, participants were observed during their daily activities at randomly selected periods throughout the day. The specific roles of an interaction (initiate or receive), the type of communication (Mand or Non-Mand), relevant affective behaviors, and the outcome of communications (comply, ignore, resist) were noted. No significant differences were obtained between groups of persons with and without conduct disorders on any of the interaction dimensions evaluated. Limitations of these findings and implications for further investigations are offered.     

Measurement of range of motion in individuals with mental retardation and with or without Down syndrome

The purpose of this study was to assess differences in variability of three joints' range of motion in the lower extremity among individuals with Down syndrome, mentally retarded individuals without Down syndrome, and sedentary subjects without mental retardation (ns = 13, 25, and 30, respectively). Range of motion for hip and knee flexion was obtained using a Myrin goniometer. For hip abduction the range of motion was obtained using a double protractor goniometer (Brodin type). Three test repetitions were carried out, and the greatest value was recorded. As no significant differences were found between left and right sides for each motion, the average was used to represent the range of motion. The Down syndrome group had significantly higher mean range of motion in hip flexion than the mentally retarded group. No significant differences in mean range of motion were found between Down syndrome and sedentary groups, but a significant difference was observed between the control and mentally retarded groups. In hip abduction, the Down syndrome group showed significantly higher mean range of motion than the control and mentally retarded groups. The control group had significantly a higher mean range of motion than the mentally retarded group. No significant differences were found in knee flexion between the two mentally disabled groups, but significant differences in mean range of motion were found between each of the two groups of mentally retarded individuals and the control group. Because differences exist in mean range of motion between the two mentally disabled groups, individualized and differentiated training programs to improve flexibility must be designed based on the type of handicap.     

Theoretical influences on research on language development and intervention in individuals with mental retardation

In this article, we consider the theoretical debates and frameworks that have shaped research on language development and intervention in persons with mental retardation over the past four decades. Our starting point is the nativist theory, which has been espoused most forcefully by Chomsky. We also consider more recent alternatives to the nativist approach, including the social-interactionist and emergentist approaches, which have been developed largely within the field of child language research. We also consider the implications for language development and intervention of the genetic syndrome-based approach to behavioral research advocated by Dykens and others. We briefly review the impact and status of the debates spurred by the nativist approach in research on the course of language development in individuals with mental retardation. In addition, we characterize some of the achievements in language intervention that have been made possible by the debates spurred by nativism and the various alternatives to it. The evidence we consider provides support for all three alternatives to the nativist approach. Moreover, successful interventions appear to embody elements of several of these approaches as well as other theoretical approaches (e.g., behaviorism). We conclude that language intervention must be theoretically eclectic in its approach, with different strategies appropriate for teaching different features of language, at different points in development, and for children displaying different characteristics or learning histories.     

Simple mental addition in children with and without mild mental retardation.

The speeded performance on simple mental addition problems of 6- and 7-year-old children with and without mild mental retardation is modeled from a person perspective and an item perspective. On the person side, it was found that a single cognitive dimension spanned the performance differences between the two ability groups. However, a discontinuity, or "jump," was observed in the performance of the normal ability group on the easier items. On the item side, the addition problems were almost perfectly ordered in difficulty according to their problem size. Differences in difficulty were explained by factors related to the difficulty of executing nonretrieval strategies. All findings were interpreted within the framework of Siegler's (e.g., R. S. Siegler & C. Shipley, 1995) model of children's strategy choices in arithmetic. Models from item response theory were used to test the hypotheses.