Rehabilitation of the institutionalized mentally retarded.

"In order to determine the present status of psychology in state institutions, a questionnaire was sent to 101 institutions in the United States and Canada… . Replies were received from 72% of the total sent. Thirteen reported that they have no psychologists… . The 72 institutions which replied have 109,010 patients served by 143 full-time and 14 part-time psychologists—approximately 725 patients per psychologist." In general, the functions of psychologists in these institutions are very similar. The "role of the department of psychology, as with other services in an institution, should not be as an autonomous unit with separate function, but as an integral part of a patient-centered team." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The oral status in mentally retarded institutionalized patients

BACKGROUND AND METHODS: An epidemiological survey of dental and periodontal health status was conducted in a group of 263 institutionalized mentally retarded patients. RESULTS: The periodontal status in the study population was very poor. 66% of the subjects presented with a probing depth more than 3.5 mm (PSR = 3 or 4), 29% showed the presence of bleeding or calculus (PSR = 1 or 2) and only 5% showed a normal periodontal status (PSR = 0). No statistical relationship was found between periodontal status and age, sex, type or duration of psychiatric therapy. Concerning the dental status a total of 59 (26%) subjects was totally edentulous. A significant increase in the prevalence of edentulousness with increasing age was recorded. The incidence of edentulousness was higher among women than among men, while it was not significantly influenced by the type of psychiatric pathology, type or duration of psychiatric therapy. The mean number of remaining teeth in every subject was 12.9 +/- 9; the mean number of sound teeth was 10.8 +/- 8 and the mean number of decayed teeth was 2.1 +/- 3. The number of decayed teeth decreased with increasing age and it was influenced by the type of psychiatric pathology, but not by the type or duration of psychiatric pathology. CONCLUSIONS: Analysis of the results showed a very poor dental but especially periodontal status in mentally retarded subjects as compared to those found in studies performed in normal subjects.     

Eye gaze and dominance hierarchy in profoundly mentally retarded males

A new method to measure gastric functions after meal-stimulation without infusion of bicarbonate into the stomach is presented. Six healthy volunteers were investigated after stimulation of the gastric functions with a 300-ml fluid test meal with and without cimetidine infusion. Cimetidine reduced the acid output substantially but had no effect on gastric emptying.     

Discrimination skill as a predictor of prevocational performance of institutionalized mentally retarded clients.

Two experiments investigated whether an assessment of the discrimination skills of institutionalized mentally retarded clients would provide information regarding subsequent prevocational performance. During Exp I, the 2-choice discrimination skills of 20 Ss were assessed with 6 diagnostic tasks: imitation, position, visual, matching-to-sample, auditory, and combined auditory-visual. Following assessment, 12 (aged 19–55 yrs; IQs 17–58) of the 20 Ss were administered several criterion tasks to determine the accuracy of prediction of the assessment tasks on prevocational analog tasks. During Exp II, 9 of the 12 Ss were administered a prevocational sorting task, and the accuracy of prediction of the discrimination assessment was again evaluated. Findings indicate that the assessment was useful in predicting performance across most of the analog tasks and the prevocational sorting task. Implications for the assessment and prevocational training of moderately and severely handicapped persons are discussed. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of adaptive behavior in institutionalized mentally retarded children and adults: developmental perspective

Factor analyses were performed utilizing the subscale scores of the AAMD Adaptive Behavior Scale, Part One, for 3,354 institutionalized mentally retarded children and adults. Eight different age groups were studied to determine (a) the underlying dimensions of adaptive behavior measured by the scale, (b) similarity of factor structure across ages, (c) whether there were developmental changes revealed by factor scores, and (d) the extent to which the above findings would be related to level of retardation. Three salient factorial dimensions--Personal Self-Sufficiency, Community Self-Sufficiency, and Personal-Social Responsibility--appeared across a wide span of age ranges from childhood through senility. The implication of these factors was discussed in terms of the critical period of development, rate of growth, and maximum level of growth of subjects grouped by level of retardation.     

A PCR-based test suitable for screening for fragile X syndrome among mentally retarded males

Ever since the identification of the genetic cause of fragile X syndrome as the expansion of an unstable trinucleotide sequence, several diagnostic strategies have evolved from molecular studies. However, we still lack a simple test suitable for population screening. We have therefore developed a nonisotopic polymerase chain reaction (PCR)-based technique for the identification of fragile X full mutations among men, with easy visualization of the PCR products on silver-stained polyacrylamide gels. The technique consists of PCR amplification with primers that flank the trinucleotide repeats, with a product of 557 bp for the (CGG)29 allele. Conditions were established such that full mutations failed to amplify and were thus identified with 98% sensitivity compared with Southern blot analysis. To produce an indispensable internal control we added to the reaction a third primer, internal to this fragment, allowing the multiplex amplification of a monomorphic band corresponding to a CG-rich stretch 147 bp upstream of the polymorphic region. In trials involving 41 patients and 74 controls, the PCR-based test here described showed specificity of more than 98.6%, accuracy of 99% and a sensitivity of 98%. Thus, although not suitable for medical diagnosis, it constitutes a useful tool for screening for the fragile X syndrome in populations of mentally retarded males.     

Teaching the mentally retarded job interviewing skills.

Examined the most effective usage of videotape in job interview skill training for 24 mentally retarded young adults utilizing the microcounseling model of instruction. Seven (e.g., open- and closed-ended questions and reflection of content) skill areas were modeled to 3 experimental groups for 6 sessions where the method of videotape utilization differed for each group. Data reveal that the microcounseling model is most effective with the 2 skill areas of eye contact and body posture regardless of the method of videotape utilization. Significant differences occurred in both of these skill areas after modeling Session 2 and remained significant throughout the study. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement of personal competence of mentally retarded individuals

The development and validation of the Personal Competency Scale, a 20-item rating instrument designed to assess competence of mentally retarded adults, was described. This broad bandwidth measure provides scores on three factorially derived domain scales, which are consistent with the rationale underlying the instrument's development, and a total score. The three major dimensions of personal competence delineated were adaptive, cognitive, and affective competence. Reliability estimates in the form of interrater, test-retest, and internal consistency were high, ranging from .80 to .94 for the subscales and .90 to .97 for the total scale. Correlations between the Personal Competency Scale and criterion variables, including IQ and Adaptive Behavior Scale scores, ranged from .61 to .75. Multiple regression and canonical correlations of .85 and .87, respectively, also strongly support the validity of this new measure.     

The effect of bromantane on the physical work capacity of laboratory animals

The positive effect of bromantan (0.5-50 mg/kg) on the efficiency of physical work of mice and rats (swimming test, running on a treadmill) exceeds that of phenamine administered in optimal doses by 1.3-1.6 times. Such an effect of bromantan lasts no less than 24 h. The drug delays decrease of physical efficiency and restores it sooner in repeated extreme running loads, prevents in rats the corresponding electron-microscopic changes in the cardiomyocyte and myocyte mitochondria of the skeletal muscles. The data obtained suggest that the positive effect of bromantan on the physical efficiency is associated not only with its psychostimulating action but also with the membrane-protecting effect.     

Nurses' expectations for accomplishment of mentally retarded patients

As part of a larger study into the pattern of care delivered to hospitalized mentally retarded adults, an attitude survey was undertaken. Factor analysis on questionnaires returned by 696 nurses yielded a three factor solution. One factor, concerned with the expectations that nurses hold of the potential level of patient accomplishment, was examined. Different grades of staff were found to hold significantly different views on a scale ranging from "optimist" to "pessimist". Results from 30 hospitals showed that, after correcting for this grade effect, there were substantial institutional differences.     

Assessment of depression in mentally retarded adults: reliability and validity of the Children's Depression Inventory (CDI)

The applicability of the Children's Depression Inventory (CDI) in the informant-rating version to mentally retarded adults (> 19 years of age) of all degrees of severity is researched here for the first time. The sample (N = 798) consisted of residents in community-based group homes (56.9%) and residents of a variety of institutions (43.1%). On average, 23 of the 24 CDI items were to be assessed. Internal consistency, interrater reliability, and the item-total score correlations were adequate. The three factors derived from factor analysis were open to clear interpretation. The CDI score proved to be independent of age, sex, and degree of mental retardation. Persons with behavior problems, psychotropic drug treatment, non-Down syndrome status, as well as the residents of a psychiatric clinic, all returned a higher CDI score. Among those having a CDI score > or = 17 (n = 54), there were 57% with DSM-III-R depressive disorders. These results suggest that the CDI in an informant-rating version is suitable as a diagnostic and screening instrument for mentally retarded adults.