Co-occurrence of developmental disorders: The case of Developmental Dyscalculia

Five to seven percent of children experience severe difficulties in learning mathematics and/or reading. Current trials that are focused on identifying biological markers suggest that these learning disabilities, known as Developmental Dyscalculia (DD) and Dyslexia (for reading), are due to underlying brain dysfunctions. One ongoing controversy concerns the extent to which arithmetic impairments are specific to DD or shared with other developmental disorders such as Dyslexia. This review explores and develops a hypothesis for cases of DD + Dyslexia. Three factors warrant consideration: (a) the behavioral factor, including definitions of the disabilities and assessment tools; (b) the cognitive factor, including whether co-occurrence of DD and other developmental disorders such as Dyslexia derive from similar or different cognitive risk factors; (c) the biological factor, including consideration of static vs. developmental neuropsychology. Better understanding of the causes of co-occurrence of DD and Dyslexia, or other developmental disorder such as Attention Deficit Hyperactivity Disorder (ADHD), can have an important influence on research that examine the two disorders, including research on therapy and etiology.     

发展性障碍儿童的脑发育特点及干预

随着发展认知神经科学的兴起, 研究者借助脑成像等技术探讨了发展性障碍儿童的脑结构发育特点, 发展缺陷与脑功能损伤的关系以及障碍干预和脑功能改善的机制等, 这为揭示发展性障碍儿童异常神经机制的共性和特异性, 进而为早期诊断和干预提供了重要的生物学标记。针对儿童期常见的发展性障碍, 从脑结构损伤、脑激活异常、脑网络连接和脑功能康复等方面对相关研究进行了总结, 指出未来研究应拓展角度, 注重揭示各发展性障碍之间异常脑发育特点的共性和特异性的具体表现、病理机制及基因基础等; 临床工作者应注重将脑发育的异常和功能改善用于辅助各类障碍的早期识别和干预效果评估。     

Federal family and disability policy: special relevance for developmental disabilities

The article reviews the federal statutes and relevant decisions of the U.S. Supreme Court that constitute the core concepts of disability policy and their application to persons with disabilities (especially developmental disabilities) and their families.     

儿童青少年内外化心理病理问题“共发”现象研究现状与展望

儿童青少年内外化心理病理问题存在共发现象,已受到发展心理学和心理病理学研究者的广泛关注。本文对当前关于儿童青少年内外化问题的描述性研究和解释性研究进行了梳理,对儿童青少年共发现象发生率、发展特点、预测因素和发展结果等方面的重要研究发现进行系统性介绍。最后,基于发展级联和个体与环境因素交互作用视角,对未来本领域的研究进行展望,以期系统、完整地揭示内外化问题共发的原因。     

The direct support workforce in community supports to individuals with developmental disabilities: issues, implications, and promising practices

Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to the sustainability, growth, and quality of community services for people with developmental disabilities (ANCOR [2001] State of the states report. Alexandria, VA: ANCOR; Colorado Department of Human Services, [2000] Response to Footnote 106 of the FY 2001 appropriations long bill: Capacity of the community services systems for persons with developmental disabilities in Colorado; Hewitt [2000] Dynamics of the workforce crisis. Presentation at the NASDDDS Fall meeting. Alexandria, VA). While long in existence, these challenges are ones of growing concern because the number of people demanding community services is increasing and the population of people from which to recruit workers is declining (Office of the Assistant Secretary for Planning and Evaluation [2006] The supply of direct support professionals serving individuals with intellectual disabilities and other developmental disabilities: Report to Congress. Washington, DC: Office of Disability, Aging and Long-Term Care Policy, ASPE, U.S. Department of Health and Human Services). As the service system moves towards consumer direction, managed care, and more noncategorical service delivery systems, the difficulties of providing for an adequate and well-prepared workforce to support people with developmental disabilities becomes more complex and multifaceted. The solutions to those challenges are also more complex. This article reviews the literature regarding the complexity of the direct support workforce crisis, the effects of this crisis on various stakeholder groups, promising practices designed to address the challenges, and the related practice and policy implications.     

Using indices of happiness to examine the influence of environmental enhancements for nursing home residents with Alzheimer's disease

The present study extends the growing behavioral literature on indices of happiness for persons with developmental disabilities to the geriatric population. Data on indices of emotional affect (i.e., happiness) were collected prior to, during, and after each resident was exposed to environmental enhancement activities of various durations. Results showed that every activity improved each resident's level of happiness when compared to pre- and postactivity levels. These outcomes suggest that indexing affect may be as useful for nursing home residents as it has been for individuals with developmental disabilities.     

Disability in the family: a life span perspective

This article provides an overview of disability in families. The goal of the article is to raise awareness of the status of people with disabilities and their families to develop culturally relevant psychological support. Families have widely varying perspectives on disability; those perspectives influence responses to disability from the preconception and prenatal developmental stages through old age. An international literature review is provided with consideration of cultural meanings of disability, preparation for dealing with disability, coping strategies, support, developmental dynamics, competing needs of family members, and ethics. Voices of people with disabilities and their families are included.     

The next exclusion debate: assessing technology, ethics, and intellectual disability after the Human Genome Project

Recent scientific discoveries have made it much easier to test prenatally for various genetic disabilities, such as Down syndrome. However, while many observers have heralded such "advances" for their effectiveness in detecting certain conditions, others have argued that they perpetuate discrimination by preventing the birth of children with disabilities. This article examines the ethical and social implications of the Human Genome Project for individuals with intellectual disabilities and their families. It details the critique of prenatal testing articulated by many disability rights activists as well as scholarly and professional responses to that critique. A review of the pertinent research literature includes perspectives of genetic professionals, ethicists, disability studies scholars, parents of children with disabilities, and disabled individuals themselves. Finally, the article explores how future research endeavors, policies, and practices may more effectively integrate and respect the positions of these various stakeholders.     

The roles of aggressive and affiliative behaviors in resource control: A behavioral ecological perspective

Extant literature in developmental psychology has documented the co-occurrence of aggressive and affiliative behaviors with various measures of social dominance. While these findings have been taken as evidence for the functional value of aggression, they have not been integrated into a more general theoretical frame accounting for contextual variation. In this paper the literature on aggression, agonism, affiliation, and social dominance is reviewed in light of behavioral ecological theory suggesting that different forms of competition (scramble and contest) determine, respectively, the use of affiliative and aggressive strategies. Results generally support the hypotheses advanced by this theory. In order to further integrate these findings suggestions for the study sequences of behavior, where reconciliations follow aggression, are made.     

A methodology for assessing the functions of emerging speech in children with developmental disabilities

An approach based on Skinner's (1957) theory of verbal behavior has been developed to understand and teach elementary communication skills to children with autism and developmental disabilities (Sundberg & Partington, 1998). However, few studies have directly examined the characteristics of emerging language in children with developmental disabilities. The purpose of this study was to develop and evaluate an assessment for identifying the elementary functions of vocal speech in children. Participants were 4 children with developmental disabilities, aged 6 years to 12 years, who exhibited at least one distinguishable vocal response (word or phrase) frequently in the natural environment. The assessment focused on three verbal operants delineated by Skinner (mand, tact, and intraverbal). One or more functions were identified for at least one vocal response of each child. Results suggested that this assessment would be useful for (a) evaluating Skinner's theory, (b) guiding decisions about language training for individual children, and (c) studying the nature of expressive language development in children with developmental disabilities.     

Conceptualizing Self-determination from a Behavioral Perspective: The Role of Choice,Self-control,and Self-management

The goal of education can be defined in many ways; but in searching the literature, we found that in most cases, people consider the goal of education to be developing a self-determined individual. Self-determination is an abstract term. Behavior analysts may find this term difficult to define. Therefore, it may be difficult to observe and measure whether “self-determined behaviors” have developed. Many other service providers use this term frequently; thus, behavior analysts working with these service providers must come to terms with this concept in order to better collaborate. We argue that self-determination can be operationally defined with the concepts of choice, self-control, and self-management. By using the measurable behaviors included in these concepts, we believe that services can be developed to teach self-determination skills. This paper explores these concepts and how they can contribute to an operational definition of self-determination, and ultimately, help behavior analysts work with other providers to effectively teach self-determination to individuals with developmental disabilities.

     

Maltreated Adolescents

Abstract

The authors review literature on the developmental tasks of adolescence and the unique problems faced by adolescent victims of maltreatment. The developmental domains addressed include cognition, identity, behavior and affect regulation, family and peer relationships, and sexuality. Research on the co-occurrence of multiple types of victimization is discussed. The relationship between multiple victimization and violent crime, with a focus on parricide, is examined. The authors call for greater attention to the assessment and study of multiple forms of maltreatment and its outcomes in adolescence, since adolescence is one of the least researched developmental periods in terms of single or multiple victimization.     

Comprehensive employment preparation for adolescents with developmental disabilities: an empirical paradigm

This paper presents a comprehensive employment preparation intervention for adolescents with developmental disabilities. Vocational preparation is viewed in terms of the development of job and related psychosocial skills. The Comprehensive Employment Preparation program is designed to help youth and young adults with developmental disabilities acquire the skills necessary to prepare them for effective functioning as self-sustaining, working members of society. Substantial research indicates that social, problem-solving and employment-seeking skills are significant factors in attaining and maintaining employment. At this time, relevant literature clearly reveals that progress is being made in assessing individual deficiencies and programs for development of improved social competency. Future policy and research issues are reviewed.     

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.     

Counselors With Disabilities: A Comment on the Special Feature

The aim of this comment is to focus more attention on the topic of counseling and disabilities. A literature review is presented on the question of whether clients perceive counselors with disabilities more positively or more negatively than they perceive counselors with no obvious physical disabilities. The results of the review provide tentative implications for counselors.     

An evaluation of delay to reinforcement and mand variability during functional communication training

Children with autism spectrum disorder and other developmental disabilities often exhibit invariant responding (i.e., restricted behavioral repertoires), deficits in communication, and challenging behavior. Approaches demonstrated in the basic and applied literature to increase response variability include extinction, lag schedules of reinforcement, and percentile schedules of reinforcement. Results of basic studies have also indicated that delays to reinforcement often produce increases in response variability. The purpose of the current study was to evaluate the effects of a delay to reinforcement on the variability of communication responses during functional communication training with individuals with developmental disabilities and histories of engaging in challenging behavior. Results indicated that delays to reinforcement increased mand variability with all four participants with variable effects on challenging behavior across participants.     

Occupational therapy using a sensory integrative approach for children with developmental disabilities

This article provides an introduction and overview of sensory integration theory as it is used in occupational therapy practice for children with developmental disabilities. This review of the theoretical tenets of the theory, its historical foundations, and early research provides the reader with a basis for exploring current uses and applications. The key principles of the sensory integrative approach, including concepts such as "the just right challenge" and "the adaptive response" as conceptualized by A. Jean Ayres, the theory's founder, are presented to familiarize the reader with the approach. The state of research in this area is presented, including studies underway to further delineate the subtypes of sensory integrative dysfunction, the neurobiological mechanisms of poor sensory processing, advances in theory development, and the development of a fidelity measure for use in intervention studies. Finally, this article reviews the current state of the evidence to support this approach and suggests that consensual knowledge and empirical research are needed to further elucidate the theory and its utility for a variety of children with developmental disabilities. This is especially critical given the public pressure by parents of children with autism and other developmental disabilities to obtain services and who have anecdotally noted the utility of sensory integration therapy for helping their children function more independently. Key limiting factors to research include lack of funding, paucity of doctorate trained clinicians and researchers in occupational therapy, and the inherent heterogeneity of the population of children affected by sensory integrative dysfunction. A call to action for occupational therapy researchers, funding agencies, and other professions is made to support ongoing efforts and to develop initiatives that will lead to better diagnoses and effective intervention for sensory integrative dysfunction, which will improve the lives of children and their families.     

Aging family caregivers: policies and practices

This review examines later life family support for adults with developmental disabilities from a life course perspective that takes into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: (1) trends affecting family caregiving, (2) health and social outcomes of life-long caregiving, (3) support needs of families, (4) family support policies and practices, and (5) recommendations for a research and policy agenda. Research examining outcomes of life-long caregiving has shown that most families adapt well to having a family member with disabilities. However, some families are at risk for poorer physical and mental health outcomes. These include cultural minorities and families of adults with behavioral challenges. Caregiving does seem to have a negative impact on maternal employment and family income as mothers often give up or cut back on employment to care for a child with developmental disabilities, who is more likely to continue living in the family home throughout adulthood than other adult children. Federal and state initiatives are addressing issues of family support through both the developmental disabilities and aging service systems.     

Developmental dyspraxia and developmental coordination disorder

This article discusses the role developmental dyspraxia plays in developmental coordination disorder (DCD), based upon a review of literature on apraxia, developmental dyspraxia, and DCD. Apraxia and dyspraxia have often been equated with DCD. However, it is argued that apraxia and dyspraxia primarily refer to the problems of motor sequencing and selection, which not all children with DCD exhibit. The author proposes to distinguish developmental dyspraxia from DCD. Other issues discussed include the assessment, etiology, and treatment of developmental dyspraxia and DCD, and the relationship between DCD and learning disabilities. A research agenda is offered regarding future directions to overcome current limitation.     

Prevalence of Children's Exposure to Domestic Violence and Child Maltreatment: Implications for Prevention and Intervention

The purpose of this paper is to review research on the prevalence of children's exposure to domestic violence, to consider the available literature on the co-occurrence of domestic violence and child maltreatment, and to gain more understanding about the impact of exposure on children. There is clear evidence indicating that both severe and moderate violence occurs frequently in homes among family members and that children are exposed to this violence. However, because of differing definitions of what constitutes domestic violence and variability in research methodologies for collecting the data, there are significant discrepancies in prevalence reports across studies. Of great concern is the immediate impact on the children and the long-term consequences for their later relationships. Fewer studies have been done on the co-occurrence of domestic violence and child maltreatment. However, it is likely that children who live in homes where domestic violence occurs are more likely to be abused and neglected. On the basis of available research, there is little doubt that vast numbers of children are exposed to domestic violence and that children's responses vary widely depending on their risk and vulnerability, as well as the structure of their environments. A developmental risk and protective factors framework will be used to integrate the information on children's exposure to violence.