Research in developmental disabilities
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There is a growing and evolving research evidence base regarding sexuality issues and adults with intellectual disabilities. Individuals can face challenges, including the right to express their sexuality and to access necessary education and supports. ⋯ Adults with intellectual disabilities need education and support to express their sexuality and to meet individual needs.
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A Systematic Tool to Reduce Inappropriate Prescribing (STRIP), which includes the Screening Tool to Alert doctors to Right Treatment (START) and the Screening Tool of Older Peoples' Prescriptions (STOPP), has recently been developed in the Netherlands for older patients with polypharmacy in the general population. Active involvement of the patient is part of this systematic multidisciplinary medication review. Although annual review of pharmacotherapy is recommended for people with an intellectual disability (ID), a specific tool for this population is not yet available. ⋯ However, in this pilot study the implementation rate of suggested interventions was low. To improve the implementation rate, the treating physician should be involved in the review process. Besides, specific adaptations to STRIP to address drug-related problems specific for this population are required.
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MRI shows promise as a prognostic tool for clinical findings such as gross motor function in children with cerebral palsy(CP), however the relationship with communication skills requires exploration. ⋯ Structural MRI has potential prognostic value for communication impairment in children with CP. WHAT THIS PAPER ADDS?: This is the first paper to explore important aspects of communication in relation to the type and severity of brain lesion on MRI in a representative cohort of preschool-aged children with CP. We found a relationship between the type of brain lesion and communication skills, children who had cortical and deep grey matter lesions had overall communication skills>1 SD below children with periventricular white matter lesions. Children with more severe brain lesions on MRI had poorer overall communication skills. Children with CP born at term had poorer communication than those born prematurely and were more likely to have cortical and deep grey matter lesions. Gross motor function better accounted for overall communication skills than the type of brain lesion or brain lesion severity.
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The spinothalamic pathway mediates sensations of temperature, pain, and touch. These functions seem impaired in children with Down syndrome (DS), but have not been extensively examined in adults. The objective of the present study was to compare the spinothalamic-mediated sensory functions between adults with DS and adults from the general population and to examine in the DS group the relationship between the sensory functions and level of intellectual functioning. ⋯ Overall, the difference in spinothalamic-mediated sensory functions between the DS and control groups was not statistically significant. However, DS participants with a lower intelligence level had a statistically significant lower performance on the sharp-dull discrimination test than DS participants with higher intelligence level (adjusted p=.006) and control participants (adjusted p=.017). It was concluded that intellectual functioning level is an important factor to take into account for the assessment of spinothalamic-mediated sensory functioning in adults with DS: a lower level could coincide with impaired sensory functioning, but could also hamper QST assessment.
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Review Meta Analysis
Parent inclusion in early intensive behavior interventions for young children with ASD: a synthesis of meta-analyses from 2009 to 2011.
This paper presents a comprehensive synthesis of six meta-analyses of early intensive behavioral interventions (EIBI) for young children with autism spectrum disorders published from 2009 to 2011. Analysis was conducted in three steps to account for different formats of treatment delivery and the extent to which parents took part in treatment. The three components of the synthesis were (a) descriptive analysis, (b) effect size analysis, and (c) mediator analysis via partial correlation and linear regressions. ⋯ Although favorable effects were apparent across comparative studies, analysis by type of delivery format revealed that EIBI programs that include parents in treatment provision are more effective. Mediator analyses suggest that treatment variables and child characteristics impact program effectiveness when accounting for the extent of parent inclusion. Clinical implications toward individualized treatment tailoring are discussed.