Developmental Disabilities Clinic Research Articles

Primary Care of Adults with Intellectual and Developmental Disabilities Clinic: Coordination of Care Challenges

Primary Care of Adults with Intellectual and Developmental Disabilities Clinic: Coordination of Care Challenges

Correlates of DSM-5 Autism Spectrum Disorder Levels of Support Ratings in a Clinical Sample.

The DSM-5 features level of support ratings for social communication (SC) and restrictive and repetitive behaviors (RRB) for individuals with autism spectrum disorder (ASD). We contrasted cognitive, adaptive, and autism severity scores across SC and RRB groups for 158 individuals with ASD diagnosed in a developmental disabilities clinic. Roughly 46% of individuals were identified by licensed psychologists' clinical judgement as needing Level 2 SC support and 49% were identified as needing Level 2 RRB support. No individuals were rated as needing a combination of Level 1/Level 3 supports across domains. MANOVA and direct discriminant analysis revealed that both SC and RRB groups showed a graded pattern of higher adaptation/lower autism severity to lower adaptation/higher autism severity from Level 1 to Level 3.

An Interview with Emily Rubin

An Interview with Emily Rubin

Children with Autism Spectrum Disorders: Three Case Studies

Children with Autism Spectrum Disorders: Three Case Studies

The Presentation of Anxiety in Children with Pervasive Developmental Disorders

Although the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) diagnostic criteria generally discourage the diagnosis of other Axis I disorders in children with pervasive developmental disorder (PDD), anxiety symptoms are often observed in this clinical population. Moreover, there are some albeit limited data that suggest an association between anxiety and psychotic symptoms in children. Because co-occurring psychiatric symptoms have important clinical implications, this study examined anxiety and psychotic symptoms in children with and without PDD. Parents and teachers completed the Early Childhood Inventory-4 (ECI-4) or the Child Symptom Inventory (CSI-4) for children evaluated in a developmental disabilities clinic (PDD) or a child psychiatry outpatient clinic (non-PDD). Children were divided into four groups: 3-5- year-olds with (n = 182) and without (n = 135) PDD, and 6-12-year-olds with (n = 301) and without (n = 191) PDD. The 6-12-year-olds were further divided into high-anxious and low-anxious subgroups based on CSI-4 ratings and compared with regard to severity of psychotic symptoms. Teachers rated preschoolers with PDD as exhibiting more severe anxiety symptoms than the non-PDD group; however, the converse was true for parent ratings. For 6-12- year-olds, both parents and teachers rated children with PDD as significantly more anxious than non-PDD clinic referrals. In general, the severity of anxiety symptoms varied by PDD subtype (Asperger's disorder > PDDNOS > Autistic disorder) and IQ (high > low). Furthermore, highly anxious 6-12-year-olds with PDD received significantly higher parent and teacher ratings of psychotic symptom severity (strange behaviors, hearing voices, illogical thinking, inappropriate affect, and odd thoughts) than our low-anxious group, even when controlling for PDD symptom severity. Moreover, the relation between anxiety level and psychotic symptom severity was similar for both PDD and non-PDD children. Parent and teachers differed in their perceptions of the severity of specific anxiety symptoms. In addition, parent- versus teacher-defined anxiety level groups varied with regard to the differential severity of psychotic symptoms. This finding highlights the importance of continued investigation of source-specific syndromes in children with PDD. Two case vignettes are presented. Anxiety appears to be a clinically important concern in many children with PDD. Similarities in anxiety symptom presentation and their association with psychotic symptoms in both children with and without PDD support the possibility of: (1) psychiatric comorbidity in the former; (2) at least some overlap in causal mechanisms for anxiety and psychotic symptoms in both PDD and non-PDD children; and (3) a unique diagnostic entity comprised of PDD, anxiety, and psychotic symptoms. Lastly, clinicians should seriously consider dual diagnoses in children with PDD.

Neurobehavioral Assessment of Children and Adolescents Attending a Developmental Disabilities Clinic

Although the risk of the eventual development of tardive dyskinesia and other persistent adverse effects of neuroleptics is high, among adults with mental retardation and other developmental disabilities, neuroleptics may ameliorate dyskinesias, aggression, and inattention. The effects of traditional neuroleptics on a comparable population of children and adolescents with mental retardation and other developmental disabilities are unknown. The objective of this study was to develop an assessment battery to describe the effects of traditional neuroleptics on the behavior and movements of a small sample of children and adolescents with mental retardation and other developmental disabilities. 13 children and adolescents aged 6 to 16 years attending a developmental disabilities clinic were evaluated utilizing a Movement Assessment Battery to measure behavior and motions. Five subjects took traditional neuroleptic medications. Trained raters can reliably assess the movements and behaviors of children and adolescents with multiple handicaps. Children and adolescents with developmental disabilities may be vulnerable to experience functional impairment and akathisia, tics, and other dyskinesias when administered traditional neuroleptic medications.

Do Families Comply with Child and Adolescent Psychopharmacology?

Free AccessDo Families Comply with Child and Adolescent Psychopharmacology?James Robert Brasic, Robert H. Nadrich and Susan KleinrockJames Robert Brasic1. Clinical Assistant in Psychiatry at Bellevue Hospital Center and Research Assistant Professor of Psychiatry at the New York University School of MedicineSearch for more papers by this author, Robert H. Nadrich2. Bellevue Hospital Center, New York.Search for more papers by this author and Susan Kleinrock3. Bellevue Hospital Center, New York, NY.Search for more papers by this authorPublished Online:June 2005https://doi.org/10.1521/capn.6.2.6.22968PDFPDF PLUS ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutSuggested ReadingsBeutler , L. E., Brown, M. T., Crothers, L., Booker, K., & Seabrook, M. K. (1996). The dilemma of factitious demographic distinctions in psychological research. Journal of Consulting and Clinical Psychology, 64, 892–902. Crossref, Google ScholarBrasic , J. R., Will, M. V., Ahn, S. C., Nadrich, R. H., & McNally, G. (1998). A review of the literature and a preliminary study of family compliance in a developmental disabilities clinic. Psychological Reports, 82, 275–286. Crossref, Google ScholarCavanaugh , R. M., Jr. (1990). Utilizing the phone appointment for adolescent follow-up. Clinical Pediatrics, 29, 302–304. Crossref, Google ScholarKaplan, H. I., & Sadock, B. J. (Eds.). (1995). Comprehensive textbook of psychiatry/VI. (6th ed.). Baltimore, Maryland: Williams & Wilkins. Google ScholarKourany , R. F. C., Garber, J., & Tornusciolo, G. (1990). Improving first appointment attendance rates in child psychiatry outpatient clinics. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 657–660. Crossref, Google ScholarKutcher , S. P. (1997). Child and Adolescent Psychopharmacology. Philadelphia: W.B. Saunders Company. Google ScholarLai , K. Y. C., Pang, A. H. T., Wong, C. K., Lum, F., & Lo, M. K. (1998). Characteristics of dropouts from a child and adolescent psychiatry clinic in Hong Kong. Social Psychiatry and Psychiatric Epidemiology, 33, 45–48. Crossref, Google Scholar Previous article Next article FiguresReferencesRelatedDetails Cited byCited by1. Treatment adherence in a child and adolescent mental health service (CAMHS), Sri LankaOnline publication date: Go to citation Crossref Google Scholar2. Treatment of Movement Disorders in Autism Spectrum DisordersOnline publication date: 25 June 2013. Go to citation Crossref Google Scholar Volume 6Issue 2Apr 2001 Information© Guilford Publications Inc.PDF download

Season of birth in autism: a fiction revisited.

Variations of season of birth among autistic individuals were studied. The replicability of previously reported increases in birth rates in the months of March and August were examined in groups of individuals with autism or mental retardation (the comparison group). The sample was obtained from the Yale Child Study Center Developmental Disabilities Clinic and from the DSM-IV Autism/PDD field trial. Data were analyzed by applying the Jonckheere test of ordinal trend and the chi-square test, with Yates correction factor. With respect to March and August births, and with calculations based on the beginning and middle of the month, no significant seasonal effect was observed. Samples were subcategorized into verbal and mute groups, and again results failed to support the seasonality hypothesis.

A review of the literature and a preliminary study of family compliance in a developmental disabilities clinic.

To investigate the compliance of family members with the treatment recommended for patients, three child and adolescent psychiatrists assessed the charts of all active outpatients in a developmental disabilities clinic in the psychiatric department of a tertiary care municipal hospital utilizing a Family Compliance Checklist, a survey form for chart review, in October, 1993 (n = 40), and in April, 1994 (n = 41). Almost no clients missed appointments over a 6-mo. period. Only one family refused to permit the use of medication. Three families refused to make appointments. The majority of the patients were Hispanic and almost half were Roman Catholic. We conclude that most families of patients in a developmental disabilities clinic comply with recommended treatment plans including scheduled appointments and prescribed medications.

Children with both developmental and behavioral needs: profile of two clinic populations.

Little has been written about evaluation and intervention services for children with a combination of behavioral and developmental needs. Two multidisciplinary clinic populations were compared, a traditional Developmental Disabilities (DD) clinic and a Behavioral-Developmental Problems (BDP) Clinic that had the additional services of a child psychiatrist. The BDP clinic children had lower IQ's and more severe overall behavioral problems than children in the traditional DD clinic, but differences were not statistically significant. Children with Attention Deficit Hyperactivity Disorder (ADHD) and other psychiatric diagnoses were referred to both clinics at comparable rates. The effort to involve qualified mental health professionals in all aspects of professional training and clinical service for the DD population should be accelerated.

Cigarette smoking among patients with mental retardation and mental illness.

Among 136 adults with mental illness and mental retardation who were consecutively treated at a developmental disabilities clinic, 25 reported that they currently smoked cigarettes. Among those with mild and borderline retardation, smoking rates were 30 and 37 percent, respectively. Smokers were significantly more likely than nonsmokers to drink alcohol, use other drugs, and be sexually active. Multiple regression analysis found that a mild or borderline level of retardation and a diagnosis of schizophrenia were significant predictors of smoking. Mentally retarded persons with mental illness are at risk of tobacco-related disease and may benefit from prevention and smoking cessation interventions.

Asperger Syndrome and Autism Compared

The validity and neuropsychological characterization of Asperger syndrome (AS) was investigated by comparison with Higher-Functioning Autism (HFA) (ie autism associated with overall normal intelligence) in 73 potential subjects recruited from a consecutive case series seen at the Developmental Disabilities Clinic, Child Study Center, Yale University School of Medicine, New Haven, CT.

Use of commercial 'authoring systems' for medical education.

A recent development in computer-assisted medical instruction has been the introduction of 'authoring systems'. Authoring systems are computer programs which can allow an instructor to prepare computer-based medical instructional materials without the need to know programming languages or have more than minimal familiarity with the computer hardware. This report documents the use of a commercially available authoring system that was used to prepare a tutorial for medical student instruction. This lesson presented information about paediatric developmental disabilities in both a text and question-and-answer format. Significant improvement in knowledge was demonstrated by the pre- and post-test results of the study group compared to the control group. The control group consisted of students who did not view the tutorial but had been assigned to a paediatric developmental disabilities clinic. The medical students who viewed the tutorial generally had very favourable comments about the use of such a system for the presentation of new information.

An epidemiologic study of association between birth weight and mental outcome of children assessed in a developmental disabilities clinic

The purpose of this study is to determine the association between mental retardation and birth weight. Particular attention was given to very low birth weight children (less than 1500 g). Children between the ages of 2 and 7 years, evaluated at a Developmental Pediatrics Clinic, provided a sample of 107 mentally retarded children of which 40 were severely retarded (IQ

Patterns of behavioral disturbance in developmentally disabled children: a replicated cluster analysis.

Missouri Children’s Behavior Checklist ratings were obtained on two samples of children referred to a developmental disabilities clinic. One sample consisted of 131 children (89 males, 42 females), the other of 126 children (85 males, 41 females). The samples were equated on average age, socioeconomic status, and proportion of males to females. Hierarchal cluster analysis was performed on the checklist scale scores of the children in each sample, yielding four replicated behavior clusters. Analysis of mean scale scores of each cluster indicated the presence of three behavior problem subgroups (Aggressive-Active, Inhibited, and Mixed), and one Normal subgroup. Rules derived from the replicated clusters were applied to both samples from the developmental disabilities clinic, and to samples of non-referred and psychiatrically referred children. In each developmentally disabled sample, the largest proportion of children were in the Normal subgroup. The distribution of cluster membership frequencies differed significantly between nonreferred and developmentally disabled children, and between the latter and psychiatrically referred children. Results are discussed in relation to previous findings of mean problem scale elevations in these populations, in relation to broad band patterns of behavior disorders, and in terms of the utility of replicated cluster patterns for future classification.

The Utility of Behavior Checklist Ratings in Differentiating Developmentally Disabled from Psychiatrically Referred Children

The Missouri Children's Behavior Checklist ratings were obtained on 50 children referred to a child psychiatry clinic, 50 children referred to a developmental disabilities clinic, and 50 nonreferred controls. Samples were individually matched on age, sex, and socioeconomic status, with each sample consisting of 30 males and 20 females. As predicted, the psychiatric sample was rated significantly higher in problems related to aggression, activity level, and sleep disturbance than the developmental disabilities sample. Both referred groups were rated significantly higher than non-referred controls on these scales. On other behavioral dimensions, the developmentally disabled were similar to either the psychiatric or the control sample, but in sociability they were rated lower than either of the other groups. These findings, and separate analyses for each sex, are discussed in terms of the utility of the checklist method in discriminating between subgroups of referred children.