Vision and oral health needs of individuals with intellectual disability

Over the past 20 years, there has been an increased emphasis on health promotion, including prevention activities related to vision and oral health, for the general population, but not for individuals with intellectual disability (ID). This review explores what is known about the prevalence of vision problems and oral health conditions among individuals with ID, presents a rationale for the increased prevalence of these conditions in the context of service utilization, and examines the limitations of the available research. Available data reveal a wide range of prevalence estimates for vision problems and oral health conditions, but all suggest that these conditions are more prevalent among individuals with ID compared with the general population, and disparities exist in the receipt of preventive and early treatment for these conditions for individuals with ID. Recommendations for health improvement in these areas include better health planning and monitoring through standardized population-based data collection and reporting and increased emphasis on health promotion activities and early treatment in the healthcare system.     

Cognitive development following early brain injury: evidence for neural adaptation

Over the past few decades a large body of work from developmental neurobiology has shown that mammalian brain development is the product of dynamic and adaptive processes operating within highly constrained, but continually changing, biological and environmental contexts. The recent study of children with prenatal focal brain injury supports this dynamic view of development for humans. Children's injuries often affect substantial portions of one cerebral hemisphere, resulting in damage that would compromise cognitive ability in adults. However, longitudinal behavioral studies of this population have revealed only mild deficits. It is suggested here that children's capacity for adaptation reflects normal developmental processes operating against a backdrop of serious neural perturbation. Data from three behavioral domains--linguistics, spatial cognition and affective development--illustrate this complex profile of change.     

Belief-desire reasoning as a process of selection

Human learning may depend upon domain specialized mechanisms. A plausible example is rapid, early learning about the thoughts and feelings of other people. A major achievement in this domain, at about age four in the typically developing child, is the ability to solve problems in which the child attributes false beliefs to other people and predicts their actions. The main focus of theorizing has been why 3-year-olds fail, and only recently have there been any models of how success is achieved in false-belief tasks. Leslie and Polizzi (Inhibitory processing in the false-belief task: Two conjectures. Developmental Science, 1, 247-254, 1998) proposed two competing models of success, which are the focus of the current paper. The models assume that belief-desire reasoning is a process which selects a content for an agent's belief and an action for the agent's desire. In false belief tasks, the theory of mind mechanism (ToMM) provides plausible candidate belief contents, among which will be a 'true-belief.' A second process reviews these candidates and by default will select the true-belief content for attribution. To succeed in a false-belief task, the default content must be inhibited so that attention shifts to another candidate belief. In traditional false-belief tasks, the protagonist's desire is to approach an object. Here we make use of tasks in which the protagonist has a desire to avoid an object, about which she has a false-belief. Children find such tasks much more difficult than traditional tasks. Our models explain the additional difficulty by assuming that predicting action from an avoidance desire also requires an inhibition. The two processing models differ in the way that belief and desire inhibitory processes combine to achieve successful action prediction. In six experiments we obtain evidence favoring one model, in which parallel inhibitory processes cancel out, over the other model, in which serial inhibitions force attention to a previously inhibited location. These results are discussed in terms of a set of simple proposals for the modus operandi of a domain specific learning mechanism. The learning mechanism is in part modular--the ToMM--and in part penetrable--the Selection Processor (SP). We show how ToMM-SP can account both for competence and for successful and unsuccessful performance on a wide range of belief-desire tasks across the preschool period. Together, ToMM and SP attend to and learn about mental states.     

Child well-being in an era of welfare reform: the sensitivity of transitions in development to policy change

This study examined the age-specific pattern of effects of welfare policies on child achievement. Drawing from 7 random-assignment welfare and antipoverty evaluations that provided more than 30,000 observations of children's achievement, this study found that times of developmental transition are the only periods sensitive to the changes in families brought about by these policies. More specifically, small positive effects of welfare and antipoverty policies were found for children making the transition into middle childhood, and small negative effects of these same policies were found for children making the transition out of middle childhood and into early adolescence. Effects were robust across various program groupings and could not be attributed to family characteristics that differ for children of different ages. This research informs the understanding of how changes in employment and income for low-income parents affect development across childhood.     

A genetically informed study of marital instability and its association with offspring psychopathology

Parental divorce is associated with a number of emotional and behavioral problems in young-adult offspring, but theoretical and empirical considerations suggest that the relation may be partially or fully accounted for by passive gene-environment correlation or environmental selection characteristics. The current study used the Children of Twins Design to explore whether shared environmental or genetic factors confound the relationship between parental marital instability and measures of psychopathology. Comparisons of the offspring of adult twins in Australia on 3 factors of abnormal behavior, including drug and alcohol, behavioral, and internalizing problems, suggest that environmental influences associated with divorce account for the higher rates of psychopathology. The results are consistent with a causal connection between marital instability and psychopathology in young-adult offspring.     

Neurodevelopmental care in the NICU

Neurodevelopmental care, which is any NICU intervention undertaken to improve neurodevelopmental outcome, includes NICU design, nursing routines, nursing care plans, management of pain, feeding methods and, most importantly, encouraging parental involvement with their NICU infant. Recognition that sensory stimulation can overwhelm preterm infants and increase physiologic signs of stress led to attempts to reduce sensory input. More recent approaches judiciously add back soothing sensory input (e.g., therapeutic touch, soft music). Circadian light/dark cycles and physical activity improve preterm growth. Attention to infant positioning and handling affects physiologic variables and joint mobility, if not functional motor abilities. A highly organized system of care for NICU infants is Als' NIDCAP (i.e., Neonatal Individualized Developmental Care and Assessment Program). Although NIDCAP may reduce need for respiratory support and hospital length of stay, it does not significantly influence neurodevelopmental outcome at 2-3 years. Pain management includes benign interventions (e.g., nonnutritive sucking, oral glucose), but the prolonged use of narcotics must be balanced against the consequences of sedation and dependency. The foremost challenge for NICUs remains parent disenfranchisement. Kangaroo care, which involves parent/infant skin-to-skin contact, improves preterm growth, decreases nosocomial infections and may shorten hospital length of stay. A great deal of work needs to be done to identify and demonstrate efficacy of specific interventions and changes that humanize the NICU, encourage parental involvement, support infant development and optimize preterm neurodevelopmental outcomes.     

Reporting Race and Ethnicity in Genetics Research: Do Journal Recommendations or Resources Matter?

Appeals to scrutinize the use of race and ethnicity as variables in genetics research notwithstanding, these variables continue to be inadequately explained and inconsistently used in research publications. In previous research, we found that published genetic research fails to follow suggestions offered for addressing this problem, such as explaining the basis on which these labels are assigned to populations. This study, an analysis of genetic research articles using race or ethnicity terms, explores possible features of journals that are associated with improved reporting of race and ethnicity in genetic research. A journal’s expressed commitment to improving how race and ethnicity are used in genetic research, demonstrated by an editorial or in its instructions to authors, was the strongest predictor of following recommendations about reporting race and ethnicity. Journal impact factor had only a limited positive effect on attention to these issues, suggesting that editorial resources associated with higher impact factor journals are not sufficient to improve practices. Our findings reiterate that race and ethnicity variables are used inconsistently in genetic research, but also shed light on how journals might improve practices by highlighting the need for scientists to carefully scrutinize the use of these variables in their work.