摘要:

ABSTRACT.The All‐Wales Mental Handicap Strategy (AWS) pledged government leadership and additional resources for the task of developing community based residential, domiciliary, respite, daycare and professional services for people with mental handicaps and their families throughout Wales. Ultimately, the authors of the AWS sought to affect for the better the extent to which people with mental handicaps experience typical community life. A large random sample of people with mental handicaps in four diverse districts was used to track changes in services received, professional input, involvement in individual planning, the number of community activities pursued, and the size and range of individuals' social networks across the middle 4 years of the AWS. The balance between private housing and service residence remained unchanged although, with the ageing of the cohort, there was a decrease in the proportion living with parents and an increase in those living independently or in another family situation. There was an increase in the availability of residential services in the form of ordinary housing and an associated contraction in large congregate care facilities. However, not all moves were towards more ordinary living. Some people moved from large statutory sector specialist facilities to other atypical forms of residence, as did some people from family homes. Family support services in the form of family aides and short‐term care increased significantly, but indicators still suggest that an expansion of these services is merited. Day services diversified slightly, but without affecting the major role of the traditional center. There was a decrease in the numbers receiving a fulltime service. Only a third of the sample received regular individual plan reviews of the services they received and the developmental goals set in their name. In general, individuals were involved in a greater number of community activities that brought them into contact with other citizens. However, such an increase has not led to significant changes in the size or composition of people's friendship networks. Overall, the changes in service provision and family and user experience have been in line with the direction set by the AWS. However, the degree of change still required before the new pattern of services envisaged by the AWS is substantially in existence, or the experience of people with mental handicaps conforms with the guiding principles which underpin it, is considerably greater than that achieved after 7 of its initial 10 ye

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00368.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT.Restraint fading and differential reinforcement were used to reduce the self‐injurious behaviour (SIB) and self‐restraint of a profoundly retarded man. The variables maintaining both behaviours could not be identified via pre‐treatment functional analysis; however, self‐restraint exerted at least some stimulus control over SIB. In Phase 1, the subject's topography of self‐restraint (wrapping arms in shirt) was replaced with another topography (wrapping wrists in towel) that could be more easily faded to a headband. However, the subject's restraints could not be completely faded, and any movement was accompanied by SIB; thus, in Phase 2, a compliance training procedure was implemented to reduce his SIB while increasing time out of restraint. In Phase 3, the subject was taught to mand for edibles during training sessions. Results indicated that restraint fading combined with the development of alternative behaviour could be an effective treatment procedure for those who engage in both self‐restra

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00369.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT.The effect of 4 months of oral zinc supplementation on immune functions in non‐institutionalized young female and male Down's syndrome (DS) subjects was studied. Along with plasma levels of zinc, the immune parameters, measured before and after zinc treatment, were plasma levels of thymulin, the percentage and the absolute number of circulating white blood cells, total lymphocytes, lymphocyte subpopulations, the mitogen‐induced lymphocyte proliferation, the production of interleukin‐2, and the activity of stimulated granulocytes. Some immune parameters were significantly influenced by zinc treatment. In particular, a normalization of thymulin and zinc plasma levels were found in these subjects after zinc supplementation. At the end of the clinical trial, invitrolymphocyte proliferation and polymorphonuclear activity also increased and reached normal values. Zinc administration exerted a positive clinical effect in these children, since a reduced incidence of infections was

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00370.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT.The subjects of this study were 22‐year‐old adults who had attended a special school for children with mental handicap. Since leaving school, they had dropped out of the mental handicap services. The subjects' leisure activities were compared with peers who had always attended regular classes as children. The subjects engaged in fewer types of activities than the comparisons and had fewer activities that involved interpersonal relations, especially with non‐family peers. The size of these differences was influenced by marital s

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00371.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT.Various procedures have been used to establish and increase manual signed and spoken requesting with individuals who are intellectually disabled. A few studies have used the so‐called blockable response conditioned establishing operation CBR‐CEO) as a stimulus control procedure to increase requesting. A variation on the BR‐CEO is the interrupted chain procedure, in which requesting for the activity that had been interrupted is reinforced by continuation of the activity. Rather than interrupting an ongoing activity, six individuals who are severely/profoundly intellectually disabled were studied with respect to the differential effectiveness of presenting them incomplete versus complete referents (i.e. activity and objects) as a consequence of their requesting on their rate of requesting. Data were collected within a reversal design. The results show that five out of six individuals more than doubled their rate of requesting. Incomplete presentation of referents may be a practical procedure to increase reque

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00372.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT.Twenty‐five people with a learning disability who were receiving lithium were assessed with regard to their knowledge of lithium and itsadverse effects, and their attitude to treatment. Questionnaires developed for use by people with mental illness were employed, and information was gathered both from people receiving lithium and their carers. Knowledge of the effects of lithium amongst this group was similar to that found in studies of mentally ill people. There was no significant difference in knowledge according to place of residence (with family, in a community residential facility or in hospital). Most people had a positive altitude to lithium treatment; those with more knowledge had more positive attitudes. People with learning disabilities who are prescribed lithium (and their carers) should receive written information about the effect of the drug. The prescriber should check that sufficient knowledge has been acquired to ensure safe

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00373.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT.This study was designed to investigate the family environment and the temperament of children with Down's syndrome (DS). Parents of 40 children with DS completed the Family Environmental Scale (FES). They also were asked to fill out the Temperament Assessment Battery for Children (TABC) for both the child with DS and the nearest same‐sex sibling. A similar questionnaire of the TABC (teacher form) was sent to the children's teachers. The results of these investigations revealed that there were high scores in categoriescohesion, expressiveness, achievement, moral/religious emphasis, organizationandcontrolon the FES, indicating that family members in the study cohort are relationship oriented, provide support for one another, emphasize ethical values and are able to express their feelings. Comparing TABC results between children with DS with their siblings, significant differences were observed in such categories asadaptability, approach/withdrawalandpersistence. Control children were scoring higher in theadaptabilityandpersistencecategories, whereas children with DS achieved significantly higher scores than the control children in theapproachiwithdrataalcategor

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00374.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT.In spite of a burgeoning literature on the association of Down's syndrome with Alzheimer's disease, the occurrence of multi‐infarct dementia has largely been overlooked. A 55‐year‐old woman with Down's syndrome in whom a dementing process was associated with evidence of significant cerebrovascular disease is reported here. It is considered that she sustained both multi‐infarct dementia and probable Alzheimer's disease. It is suggested that such cases are under

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00375.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00376.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Book reviewed in this articles:The Criminal Justice System and Mental Retardation; Defendants and Victims. Edited by RW. Conley, R Luckasson&G.N. BouthiletAugmentative and Alternative Communication: Management of Severe Communication Disorders in Children and Adults. By D. Beukelaian&P. MirendaA Practical Guide to Working with People with Learning Disabilities: a Handbook for Care Assistants and Support Workers. Edited by HilaryBrown&SueBensonMental Retardation, Definition, Classification, and Systems of Supports, 9th edn. By RuthLuckasson, DavidL. Coulter, EdwardA. Polloway, StevenReiss, RobertSchalock, MarthaE. Snell, DeborahM. Spitalnik&JackA. StarkWorkshop on Bioethics and Mental Handicap. Foreword by DR SandorNemethDown Sydrome and Sports. By M. J. G. CremerDown Syndrome Advances in Medical Care. Edited by IraT. Lott&ErintestE. Mccoy

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1994.tb00377.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY