The intellectual and developmental disability shared citizenship paradigm: its cross-cultural status, implementation and confirmation

BACKGROUND

Dramatic changes in societal approaches to people with intellectual and developmental disabilities (IDD), and the services and supports they receive are reflected in a new paradigm that we name the shared citizenship paradigm. The shared citizenship paradigm (1) incorporates an updated and contemporary set of values and beliefs about people with IDD and their right to participate fully in all aspects of life and society; (2) is characterised by a holistic approach to IDD, a contextual model of human functioning, disability rights principles and person-centred implementation strategies; (3) incorporates the exponential growth in knowledge about the causes and characteristics of IDD and factors influencing the elimination of barriers to positive outcomes for people with IDD; and (4) is reflected in international covenants, such as the United Nations Convention on the Rights of People with Disabilities (UNCRPD), and in international policy goals and associated personal outcome domains.

METHOD

We conducted a preliminary survey on the cross-cultural status of the shared citizenship paradigm with a small purposefully sampled international group of professionals known to have extensive knowledge, experience, and publications regarding their country's current IDD-related policies and practices.

RESULTS

One or more paradigm components were evident to a moderate degree in the respondents' countries, and the paradigm is being used to provide individualised services and supports, to guide organisation transformation and systems change, and, to a lesser degree, to frame evidence-based inquiry.

CONCLUSIONS

Core components of the shared citizenship paradigm are present internationally. To further enhance implementation and confirmation of the paradigm, we propose implementation strategies and confirmation techniques.

Individual support plans of people with intellectual disabilities in residential services: content analysis of goals and resources in relation to client characteristics

BACKGROUND

Goals and objectives as mentioned in Individual Support Plans (ISPs) were analysed to explore what domains of quality of life they are associated with, what support resources are referenced for achieving the goals, and how domains and resources are related to clients age, gender and intellectual disability (ID) level.

METHOD

A total of 209 ISPs for persons with ID from eight residential Dutch service provider organisations were analysed. Mixed linear regression analyses were conducted to examine the relations between client characteristics and the content of goals and support resources.

RESULTS

Results showed that ISPs of people with mild and moderate ID had significantly more goals related to independence and social participation as compared to the ISPs of people with severe and profound ID. ISPs of clients with profound ID addressed quality of life factors related to 'well-being' more than ISPs of all other clients. ISPs of people aged 20-34 years had significantly more goals on independence than the two other age groups. ISPs of people under the age of 50 had significantly fewer goals with respect to well-being than found in ISPs of older people. Regarding the use of resources, 42.6% of the ISP goals were associated with resources from specialised services, 31.5% associated with natural resources and 25.9% associated with a combination of both natural and specialised services. In ISPs of people with mild ID, natural resources are more often mentioned, and specialised service-based resources are less often mentioned than for other people.

CONCLUSIONS

This study offers empirical feedback on ISP practices in the field of ID in the Netherlands. In light of current ISP practices, results suggest that attention should be paid to: (1) distinguishing between a 'service contract' and an ISP; (2) keeping a focus on the whole person in all age groups and levels of functioning and (3) involving the service recipient in ISP development and implementation.

Validity and reliability of the Diagnostic Adaptive Behaviour Scale

BACKGROUND

The Diagnostic Adaptive Behaviour Scale (DABS) is a new standardised adaptive behaviour measure that provides information for evaluating limitations in adaptive behaviour for the purpose of determining a diagnosis of intellectual disability. This article presents validity evidence and reliability data for the DABS.

METHOD

Validity evidence was based on comparing DABS scores with scores obtained on the Vineland Adaptive Behaviour Scale, second edition. The stability of the test scores was measured using a test and retest, and inter-rater reliability was assessed by computing the inter-respondent concordance.

RESULTS

The DABS convergent validity coefficients ranged from 0.70 to 0.84, while the test-retest reliability coefficients ranged from 0.78 to 0.95, and the inter-rater concordance as measured by intraclass correlation coefficients ranged from 0.61 to 0.87.

CONCLUSIONS

All obtained validity and reliability indicators were strong and comparable with the validity and reliability coefficients of the most commonly used adaptive behaviour instruments. These results and the advantages of the DABS for clinician and researcher use are discussed.

Defining and applying a functionality approach to intellectual disability

BACKGROUND

The current functional models of disability do not adequately incorporate significant changes of the last three decades in our understanding of human functioning, and how the human functioning construct can be applied to clinical functions, professional practices and outcomes evaluation.

METHODS

The authors synthesise current literature on human functioning dimensions, systems of supports and approaches to outcomes evaluation for persons with intellectual disability (ID), and propose a functionality approach that encompasses a systems perspective towards understanding human functioning in ID. The approach includes human functioning dimensions, interactive systems of supports and human functioning outcomes.

RESULTS

Based on this functionality approach the authors: (1) describe how such an approach can be applied to clinical functions related to defining ID, assessment, classification, supports planning and outcomes evaluation; and (2) discuss the impact of a functionality approach on professional practices in the field of ID.

CONCLUSIONS

A functionality approach can increase focus on the integrative nature of human functioning, provide unified language, align clinical functions and encourage evidence-based practices. The approach incorporates a holistic view of human beings and their lives, and can positively affect supports provision and evaluation.

The concept of quality of life and its role in enhancing human rights in the field of intellectual disability

BACKGROUND

The changed societal views of persons with disabilities are reflected in the 2006 United Nations Convention on the Rights of Persons with Disabilities. However, what is not specified in the Convention is how to operationalise and measure the Articles composing the Convention, and how to use that information to further enhance the human rights of persons with disabilities.

METHOD

The authors analyse the relationships between eight core quality of life domains and the 34 Articles contained in the Convention.

RESULTS

There is a close relationship between the core quality of life domains and the 34 Articles contained in the Convention. Furthermore, the current status of these Articles can be evaluated through the assessment of indicators associated with the eight core quality of life domains.

CONCLUSIONS

Based on the assessment of these quality of life-related outcomes, three strategies can be used to enhance the human rights of persons with intellectual disability. These three are to employ person-centred planning, publish provider profiles and implement a system of support.

Initial validation of the Chinese Quality of Life Questionnaire-Intellectual Disabilities (CQOL-ID): a cultural perspective

BACKGROUND

In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire - Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith.

METHODS

People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity.

RESULTS

A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40-item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self-determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P<0.000, P<0.01 and P<0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α=0.79).

CONCLUSIONS

Initial validity tests indicated that the Chinese Quality of Life Questionnaire - Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made.

Evaluating the inter-respondent (consumer vs. staff) reliability and construct validity (SIS vs. Vineland) of the Supports Intensity Scale on a Dutch sample

BACKGROUND

Despite various reliability studies on the Supports Intensity Scale (SIS), to date there has not been an evaluation of the reliability of client vs. staff judgments. Such determination is important, given the increasing consumer-driven approach to services. Additionally, there has not been an evaluation of the instrument's construct validity on a non-English speaking sample. This is important as the SIS is currently translated into 13 languages.

METHOD

Data were collected in two different samples, using the Dutch translation of the SIS and the Vineland-Z.

RESULTS

There was a significant correlation between ratings of staff and consumers on the SIS; however, the relationship between the mean scores of consumer and staff responses indicated significant differences in staff and consumer scores. All correlations between the Vineland-Z domains and the SIS subscales were significant and negative, ranging from -0.37 to -0.89.

CONCLUSIONS

Analyses of the inter-respondent reliability suggest that one needs to consider the source of information regarding needed supports carefully. The significant negative correlations between SIS and Vineland-Z reflect that the SIS is measuring a different construct (needed support) than the Vineland-Z (adaptive behaviour). The results of the two studies provide additional support for the etic (universal) properties of the SIS, as both hypotheses were confirmed. In conclusion, SIS users are provided with a wealth of information that can be used for multiple purposes.

Quality of life of adults with intellectual disabilities who live with families in Taiwan

BACKGROUND

Little research has been conducted about the quality of life (QOL) of people with intellectual disabilities (ID) in Taiwan, particularly their subjective QOL. This study examined the personal perceptions of these individuals as measured on internationally recognized core QOL domains and indicators.

METHODS

A census interview survey was conducted in Hsin-Chu City in Taiwan; 233 adults aged over 16 years with mild ID and living with their families participated in the study. Data were collected using the Cross-Cultural QOL Indicators (CCQOLI) together with socio-demographic data that included 'activities of daily living' and 'instrumental activities of daily living' (IADL). The CCQOLI were based on the three most commonly reported indicators of each of the eight QOL domains: emotional well-being, interpersonal relations, material well-being, personal development, physical well-being, self-determination, social inclusion and rights. Each indicator has two sets of questions related to the indicator's 'importance' and 'use'. These are answered by the respondent using a 4-point Likert scale.

RESULTS

The importance and use of the QOL indicators were evaluated positively by the respondents. The adults' individual characteristics, namely IADL and educational level, were significant predictors for the 'importance' while the adults' perceptions of 'use' for overall QOL were significantly affected by his/her socio-economic data, that is, residence location and father's educational level.

CONCLUSIONS

The present study addressed the issue of self-reported QOL in people with ID in Taiwanese society, becoming a possible benchmark for similar measurements carried out by disability movements there. These results contribute to current advocacy efforts towards creating a supportive environment for people with ID.

Trends in residential policies and services for people with intellectual disabilities in Taiwan

BACKGROUND

In Taiwan, 92-95% of people with an intellectual disability (ID) live with their families, with the remaining residing in residential facilities. Instead of funding community-living alternatives, the Taiwanese Government funds only registered facilities as part of its residential policies and services. The purpose of this study was to evaluate current policies and services trends regarding people with an ID in Taiwan.

METHODS

Both documentary research, such as an analysis of policies, services programmes, official statistics, surveys, reports and funding provision reports, and a mail survey, were conducted to examine current trends and characteristics of the 96 residential settings available for people with an ID in Taiwan.

RESULTS

During the 1990s in Taiwan, residential programmes for people with an ID showed the biggest growth since 1952. Since the first 'Community Home' was launched in 1990, the number of smaller scale residential settings with a unit size of less than 30 has grown significantly, particularly since 2000. However, the rate of institutionalization of people with an ID and who live in the institutions has also risen.

CONCLUSIONS

In Taiwan, unlike in Western societies, residential services for people with an ID provided by formal care systems are tending to grow in number, and these include both large and smaller residential settings.

Cross-cultural study of person-centred quality of life domains and indicators: a replication

BACKGROUND

The increased use of the quality of life (QOL) concept internationally suggests the need to evaluate its etic (universal) and emic (culture-bound) properties. This study replicated and expanded a previous cross-cultural study on QOL.

METHOD

The three respondent groups (consumers, parents and professionals; total n = 781) were from four European countries: France, Belgium, Italy and Poland. The Cross Cultural Survey of Quality of Life Indicators was used to assess the importance and use of eight core dimensions of QOL. Two hypotheses were tested: (1) the etic properties would be demonstrated if there were similar profiles for the respondent and geographical groups, and if indicators grouped into the proposed QOL domains; and (2) the emic properties would be demonstrated if there were significant differences on scores across groups.

RESULTS

Results supported both hypotheses.

CONCLUSION

The present study replicated the findings of a large cross-cultural study that the QOL construct has both etic and emic properties.

Quality of life and its measurement: important principles and guidelines

BACKGROUND

The importance of the valid assessment of quality of life (QOL) is heightened with the increased use of the QOL construct as a basis for policies and practices in the field of intellectual disability (ID).

METHOD

This article discusses the principles that should guide the measurement process, the major interrogatories (i.e. who, what, when, where, why, and how) of QOL measurement, issues and procedures in the cross-cultural measurement of QOL, and the current uses of QOL data.

RESULTS

Based on the above methods, the article presents a number of important guidelines regarding QOL measurement.

CONCLUSION

From a measurement perspective the use of the QOL construct is changing. Initially it was used as a sensitizing notion, social construct, and unifying theme. Increasingly, it is being used as conceptual framework for assessing quality outcomes, a social construct that guides quality enhancement strategies, and a criterion for assessing the effectiveness of those strategies. This new role places additional emphasis on the valid assessment of one's QOL.

The concept of quality of life: what we know and do not know

BACKGROUND

Over the past two decades the concept of quality of life (QOL) has increasingly become a focus for research and application in the fields of education/special education, health care (physical and behavioural), social services (disabilities and ageing), and families.

METHODS

This article summarizes our current understanding of the construct of individual QOL as it pertains to persons with intellectual disabilities (ID). The article's three major sections discuss what we know, what we are beginning to understand, and what we still do not know about the QOL construct.

RESULTS

We currently know the importance of the QOL construct as a service delivery principle, along with its current use and multidimensional nature. We are beginning to understand the importance of methodological pluralism in the assessment of QOL, the multiple uses of quality indicators, the predictors of assessed QOL, the effects of different data collection strategies, and the etic (universal) and emic (culture-bound) properties of the construct. We have yet to understand fully the use of QOL-related outcomes in programme change, how to best evaluate the outcomes of QOL-related services, and how to use the concept of QOL to impact public and disability reform.

CONCLUSION

The article concludes with a brief discussion of future challenges related to demonstrating the concept's social validity and positive impact on the lives of persons with ID.

The use of treatment progress scales in client monitoring and evaluation

This article describes a multiple-use patient monitoring and evaluation system, the Treatment Progress Scales (TPS), which has been used for the last six years on 4,600 psychiatric and chemically dependent patients in a state-operated mental health facility. The system has been used for patient monitoring, management information, and program evaluation purposes. The article summarizes these and offers a brief overview of the TPS, its psychometric properties, and its advantages and disadvantages.

A multivariate analysis of mental hospital recidivism

This study identifies health problems, instrumental activities of daily living, employment status, and number of previous admissions as significant factors of recidivism to a mental health residential facility. The study, conducted over a 5-year period, includes measures on 32 predictor variables collected either on admission, on discharge, or 12-15 months following discharge or on readmission. The study's results are interpreted in light of current changes in the mental health service delivery system including the interactive role of physical and mental illnesses, expanding access to community-based generic services, focusing on functional skills and their development or remediation, and the changing criteria for measuring mental health effectiveness.

The changing conception of mental retardation: implications for the field

The 1992 American Association on Mental Retardation's (AAMR) definition and classification of mental retardation is different from the previous classification system in that: (a) a single diagnostic code of mental retardation is used if the person meets the three criteria of age of onset (18 or under), significantly subaverage abilities in intellectual functioning, and related limitations in two or more adaptive skills areas; (b) the person's strengths and weaknesses are described in reference to four dimensions: intellectual functioning and adaptive skills; psychological and emotional well-being; health, physical well-being, and etiology; and life activity environments; and (c) a profile of needed supports is developed across the four dimensions. In this article we discussed six major implications of the 1992 System for the field of mental retardation.

Placement from a community-based mental retardation program: a 15-year follow-up

The current status of 85 persons placed into independent housing and competitive employment 15 years ago was evaluated. Two primary groups emerged: those in and those not in MR/DD services (19% and 59% of sample, respectively). Personal interview and observational data were used to evaluate the person's life (e.g., social and support networks, life style and role functions, activity patterns, measured quality of life, and expressed satisfaction). The two groups were compared on these data sets as well as on previously obtained behavioral skill data and family support levels. Implications of the study were discussed in reference to natural and long-term support needs, the recent paradigm shift in habilitation and evaluation strategies, and the ongoing concern about quality of life of individuals with disabilities.

State MR/DD agency information systems and available data related to day and employment programs

The current status of state mental retardation/developmental disability agency information systems related to day and employment programs for persons with disabilities was described, and data regarding the number and characteristics of persons served in different day-employment programs and the funding sources for these persons were summarized. Suggestions were made regarding data utilization and information systems design.

["Supported employment": equal opportunity for severely handicapped men and women]

This article examines the "supported employment" approach, which tries systematically to integrate severely disabled men and women into the open labour market. After describing the target population, we shall outline the specific support required, along with the benefits, risks and problems involved. Examples from a few industrialized countries, demonstrating the viability of training and employing severely disabled people, will illustrate the new approach. The activities described in this article are inn line with the goals of the ILO Vocational Rehabilitation and Employment (Disabled Persons) Recommendation, 1983 (No. 168), which calls for "research and the possible application of its results to various types of disability in order to further the participation of disabled persons in ordinary working life".

Placement into nonsheltered employment: findings from national employment surveys

Data from two (1984-1985 and 1985-1986) national surveys of facilities providing vocational services to adults with developmental disabilities were used to analyze employment placement patterns and client-referenced outcomes. Most of these adults were working in sheltered environments; however, 17 to 19% of those served were placed into nonsheltered settings during the respective survey periods. Effects of individual and environmental characteristics on a variety of individual and facility-level employment outcomes were examined. Research and policy implications were discussed.

Relationship between preexposure to prey and PCPA-induced filicidal activity in Sprague-Dawley rats

Experiments, involving para-chloro-D,L-phenylalanine-induced pup-killing (filicide), were conducted to determine the effect of preexposure to the goal entity on the initial development and long-term expression of PCPA-induced filicide. Three groups of Sprague-Dawley rats (n = 50) were either preexposed/not preexposed, or preexposed for varying periods (5, 8, or 13 days) prior to receiving PCPA. Two major results were obtained: 1) preexposed animals were less filicidal than those not preexposed; and 2) there was an inverse relationship between the number of preexposures and filicide occurrence. The results are interpreted in reference to a serotonin-depletion habituation hypothesis.

Quality of life: its measurement and use

The emerging need to view improved quality of life as an outcome measure from human service programs was described, and a Quality of Life Index was proposed that can be used as either an outcome measure or the criterion for the goodness-of-fit between persons and their environments. Data were presented from 685 adult clients within Nebraska's Community Based Mental Retardation Programs demonstrating the use of this Index as both an outcome measure and a criterion of the goodness-of-fit between persons who are disabled and their environments. Administrative and programmatic uses of such data were explored, along with a number of cautions to consider when assessing a person's quality of life.

[Development of community-based services for the mentally handicapped in the USA--on the way toward an integrated life]

Services for mentally retarded adults have undergone major changes over the past 15 years in the United States of America. Through the impact of "normalization", the calls for implementing fundamental civil rights for all citizens, and by applying methods of an essentially behavioural nature, services have gradually been moved out of the institutional sector and into the local communities. A regional service delivery model established in the state of Nebraska illustrates this development toward individualized living and competitive employment in the community.

Placement from community-based mental retardation programs: how well do clients do after 8 to 10 years?

The placement success and quality of life of 85 mentally retarded persons placed into independent housing and competitive employment 8 to 10 years ago was evaluated. Three groups emerged on the basis of the clients' current programmatic status, living-work placement, and financial status. A number of variables were found to discriminate between successful and unsuccessful living and work outcomes, including family involvement, social-emotional behavior, number of disabilities, sensorimotor functioning, symbolic operations, and auditory-visual processing. For assessed quality of life, significant correlates included family involvement, income, number of disabilities, and age. Those who were successful had a higher assessed Quality of Life Index than those who were unsuccessful.

Medication and programming in controlling the behavior of mentally retarded individuals in community settings

Behavioral outcomes of a behavioral-chemical intervention procedure on stereotypic and non-compliant behavior were evaluated. One group (n = 22) of community-based mentally retarded clients was initially on psychotropic medication (major tranquilizers). Their dosage was either increased, decreased, or kept the same following behavioral intervention. A second group (n = 19) was placed on psychotropic medication following behavioral intervention. A nonequivalent between-groups design was employed that permitted 36 outcome combinations involving Conditions X Subject X Group. The effects of behavioral intervention, the validity of drug-intervention decision rules, drug-intervention effects, and the validity of the behavioral-chemical intervention model were evaluated. Results indicated that the behavioral-chemical intervention produced expected and desirable behavioral change as well as reduced levels of psychotropic drug usage.

Effects of different training environments on the acquisition of community living skills

This study compared behavioral skill acquisition rates of 10 matched pairs of moderately mentally retarded persons who received individualized, prescriptive programming for 1 year in one of two training environments. One group received community living skills training within their staffed apartment; the other within a group home adjacent to the adult developmental center. The two groups were compared after 1 year of training on the number of skills gained and the relative contribution of 32 predictor variables. Results indicated that clients trained in their apartments gained three times the skills and maintained their placements. Significant predictor variables included one client variable (assessed number of social behavior skills) and two-training variables (number of instructional steps in the task analyses developed and programming frequency). Implications regarding stimulus control, skill training and maintenance procedures, staff utilization patterns, and social validation are discussed.

Filicidal behavior: behavioral correlates and role of sensory systems

The administration of para-chloro-D,L-phenylalanine (PCPA) produces a high incidence of filicidal (pup-killing) behavior in female rodents. The present series of experiments determined the major behavioral, sensory, and temporal correlates of filicidal behavior in nulliparous adult Sprague-Dawley female rats. In Experiment 1, behavioral episodes involving the interaction of test pups and PCPA-induced filicidal females were videotaped, and subsequent analyses of behaviors related to locating, carrying, mauling, attacking, gnawing, and consuming the prey object were performed. Analysis indicated that the primary behavioral correlates in the PCPA animals included location, initiation of the attack (mauling), and killing of the pup (filicide). Only location was observed in control animals. Experiment 2 evaluated the effects of sensory impairments on location, mauling, and filicide. Sensory impairment occurred at 24 days of age for enucleation and 62 days of age for olfactory bulbectomies and/or auditory destruction. Animals were injected either at 110 or 130 days of age with PCPA for three consecutive days and tested for filicide for five additional days. Locating of the test pup was not affected by sensory impairment. Mauling was reduced significantly in the enucleation/auditory destructed animals. Filicide was significantly lower in animals with visual/auditory destruction, and, compared to controls, was reduced in all sensory impaired groups.

Skill acquisition and client movement indices. Implementing cost-effective analysis in rehabilitation programs

This article outlines the development and implementation of a cost-effective approach to client and program evaluation. The indices presented summarize a client's acquisition of behavioral skills (Skill Acquisition Index) and progression along a continuum of becoming less dependent and more productive (Client Movement Index). Data are presented summarizing how the two non-monetary outcome measures have been used in formative program evaluation. The paper also discusses some of the problems involved in implementing cost-effective analyses in rehabilitation programs and suggests specific strategies to overcome the problems.

Independent living placement: five years later

The placement success and quality of life of 69 mentally retarded persons placed into independent housing 5 years previously was evaluated. Eighty percent (n = 55) were still in their original independent housing placement. On the basis of multiple regression analysis, the most significant predictor variables were the behavioral skill areas of personal maintenance, communication, community integration, clothing care and use, and food preparation. Unsuccessful placements were related to bizarre behavior, nutritional problems, and inadequate home maintenance. Quality of life variables analyzed included employment, finances, community utilization, leisure-time usage, and friendship patterns. Analysis of the quality of life variables presented a mixed picture: Part of the data reflected low income and possible loneliness; on the other hand, community utilization occurred frequently and involved normal activities. Clients reported that they were proud of their apartments and felt good about "doing their own thing." In light of the results, an extended assistance-training model was presented.

Perinatal methylmercury intoxication: behavioral effects in rats

Sprague-Dawley rats were subjected to perinatal (4th gestational day until Postnatal Day 21) methylmercury intoxication to determine the long-term behavioral effect of the mercury poisoning. Experimental and control animals were evaluated at 110-140 days of age. Compared to controls, the methylmercury animals demonstrated significant behavioral deficits characterized by hypoactivity and by reduced appetitive, escape, and avoidance learning.

Community integration of mentally retarded adults: community placement and program success

The extent of community and program success of 166 mentally retarded clients placed into a community-based program was evaluated over a 9-year period. Twenty predictor variables measuring institutional factors, client characteristics, training variables, and community characteristics were related to community or program success. Successful community placement was associated with sensorimotor and work skills, appropriate social-emotional behavior, gender, and family acceptance of community placement and involvement with the interdisciplinary team process. Program success was associated with language and psychomotor skills, education received prior to community placement, community and institution size, and family involvement. Sixteen percent of the clients were reinstitutionalized into either the state mental retardation facility or a mental health facility. Factors associated with successful placement and program progression were discussed as was a model for future deinstitutionalization research.

Long-term effects of propylthiouracil-induced neonatal hypothyroidism

Hypothyroidism was induced in neonatal Sprague-Dawley rats by adding propylthiouracil to the lactating female's food and water. Behavioral evaluation on a 6-item battery occurred from 70 to 114 days of age. Results indicated long-lasting behavioral changes in the neonatal hypothyroid animals characterized by increased activity and decreased performance on avoidance and escape learning. Serum thyroxine levels were reduced in the hypothyroid animals throughout the 120-day period. Experimental animals also had fewer synaptic contacts in the cerebellar cortex when analyzed at 90 days of age.

Placement from community-based mental retardation programs: how well do clients do?

Mentally retarded clients (N = 131) placed during a 2-year period from either an independent living or competitive employment training program were evaluated as to placement success. Thirteen percent returned to the training program. Successful independent living placement was related to intelligence and demonstrated skills in symbolic operations, personal maintenance, clothing care and use, socially appropriate behavior, and functional academics. Successful employment was related to sensorimotor, visual-auditory processing, language, and symbolic-operations skills. Major reasons for returning from a job to the competitive employment training program included inappropriate behavior or need for more training; returning from community living placement was related to money management, apartment cleanliness, social behavior, and meal preparation.

para-Chloro-D, L-phenylalanine induced filicidal behavior in the female rat

The administration of para-chloro-D, L-phenylalanine (PCPA) produces a high incidence of aggressive (filicidal) behavior in pre-, postpartum, and nulliparious rodents. PCPA inhibits brain tryptophan 5-monooxygenase and can produce a reduction in whole brain serotonin. Apparently PCPA mediates the release of a natural latent aggressive tendency which is potentiated by the interference in, or reduction of, a suppressing system governed by serotonin. Latency of attack, intensity phases, and characteristics of the filicidal behavior were found to vary inversely with brain serotonin content, and be reversed or eliminated by replacement of serotonin i.e., via 5-hydroxytryptophan, serotonin's immediate precursor. Although aggressive tendencies were in evidence prior to filicide, filicide became evident once the apparently minimal whole brain level of serotonin reached ca 0.10 microgram/g. Neither the parturition process nor severe food deprivation are strong causative factors in the precipitation of filicidal behavior. Since not all animals become filicidal, other behavioral and/or biological variables must be involved in the mediation of this aggressive phenomenon.

Model phenylketonuria (PKU) in the albino rat: behaviroal, biochemical, and neuroanatomical effects

Model phenylketonuria was induced in albino rats by injecting (at 1-20 days of age) and feeding (at 21-80 days) L-phenylalanine and D-L-para-chloro-phenylalanine. Behavioral testing on an eight-item battery occurred twice: first, whil the animals were either receiving the excess phenylalanines or not (original); and second, following a 90-day drug-free recovery period (retention). Results indicated drug-dependent deficits in learning and activity on both original and retention tests. Serum phenylalanine, serum tryptophan, and liver phenylalanine hydroxylase activity levels were positively correlated with the behavioral deficit. Clumped dense material in some myelin sheaths and associated degeneration of axons were found in experimental subjects.

Changes in Shipley-Hartford scores with five repeated test administrations: statistical conventions vs behavioral evidence

The Shipley Hartford Scale was administered to two groups of high school students and one group of chronic, hospitalized psychiatric patients to determine whether scores improved with repeated test administration and whether any improvement found was related to S's expressed desire to do well. Findings showed that, while scores on both Vocabulary and Abstract Reasoning tasks tended to improve with student Ss, there were no consistent sequential gains over trials. No significant differences were found with high- and low-motivated students. In general, scores of psychiatric patients did not improve with repeated administrations on either task. When classed in terms of high and low motivation, however, highly-motivated patients showed a significant gain in Abstract scores. The findings suggest that multiple variables interact in determining whether scores improve with repetition.

Phenylketonuria: enduring behavioral deficits in phenylketonuric rats

The behavioral deficit in rats made "phenylketonuric" by ingestion of L-phenylalanine was evaluated 23 to 65 days following cessation of treatment. Animals treated from birth to 60 days showed significant deficit on reasoning and discrimination learning tests but not on discrimination reversal sets. Animals treated from 30 to 60 days showed significant deficit only on the reasoning test.