Mortality and the acquisition of basic skills by children and adults with severe disabilities

OBJECTIVE: To determine normative data on age-related probabilities of children with severe disabilities acquiring mobility or self-feeding skills, or dying during a 5-year follow-up period. RESEARCH DESIGN: A 5-year follow-up study of three mutually exclusive subgroups formed on the basis of severe, profound, or suspected levels of retardation and incontinence and the following combinations of feeding and mobility skills. PARTICIPANTS: The sample was made up of 7836 children and adults distributed among the three subgroups being served in California between January 1981 and December 1985. MEASUREMENTS/MAIN RESULTS: Subjects who were tube-fed and immobile showed very little likelihood of becoming mobile or feeding themselves and had a high probability of death. Individuals who had some mobility experienced a better outcome. CONCLUSIONS: After age 6 years, the most probable outcome for children who are immobile and cannot feed themselves is death or no improvement in self-help skills.