Abstract: Background Mental health problems are known to be hard to recognize in people with intellectual disabilities. One factor that may contribute to this is the diagnostic overshadowing bias, which describes the tendency of the clinicians to overlook symptoms of mental health problems in this client group and attribute them to being part of 'having an intellectual disability'. Although a small amount of research has investigated this in the USA, very little has taken place in the UK.Materials and methods Two clinical vignettes were produced. Both described identical clinical problems, except that one vignette described a man with an IQ of 58 and impaired social functioning (i.e. an intellectual disability) and one a man with an IQ of 108 and normal social functioning (i.e. non-intellectually impaired). Psychiatrists (n = 274) and clinical psychologists (n = 412) throughout UK were randomly assigned to either the low IQ or normal IQ condition, and sent a corresponding clinical vignette.Results One hundred and thirty-three psychologists and 90 psychiatrists responded. Diagnostic overshadowing did appear to be present. Clinicians were more likely to recognize a range of symptoms in those with IQs in the normal range than those with intellectual disabilities. Furthermore, psychiatrists appeared more likely to make this error under some circumstances than clinical psychologists.Conclusions Diagnostic overshadowing may contribute to the difficulties that mental health professionals commonly experience in identifying mental health problems in people with intellectual disabilities. However, the methodology commonly used in this type of research has a number of weaknesses, and would benefit from an alternative approach.

Abstract: Using data from 1994–95 third‐wave interviews, this study tests whether Kohn and Schooler’s findings (based on 1964 and 1974 interviews) that self‐directed occupational conditions increase intellectual functioning and self‐directed orientations hold when the respondents are 20 years older. Results confirm that even late in life self‐directedness of work continues to affect intellectual functioning and self‐directedness of orientation. These psychological characteristics, in turn, affect social‐structural position in ways that increase disparities between the advantaged and disadvantaged. From a historical and societal perspective, the findings suggest that the occupational self‐directedness of a society’s workers may affect its social norms, values, and modes of production.

Abstract: Neuropsychological functions were assessed in 174 children participating in a longitudinal study of low-level lead exposure. At age 5 1/2 years, children were administered the Working Memory and Planning Battery of the Cambridge Neuropsychological Testing Automated Battery. Measures of sociodemographic characteristics of the family, prenatal and perinatal risk, quality of caregiving and crowding in the home, and maternal and child intelligence were used as covariates to test the hypothesis that children with higher lifetime average blood lead concentrations would perform more poorly on tests of working memory, attentional flexibility, and planning and problem solving. The lifetime average blood lead level in this sample was 7.2 micrograms per deciliter (mug/dL; range: 0-20 mug/dL). Children with greater exposure performed more poorly on tests of executive processes. In both bivariate and multivariate analyses, children with higher lifetime average blood lead concentrations showed impaired performance on the tests of spatial working memory, spatial memory span, intradimensional and extradimensional shifts, and an analog of the Tower of London task. Many of the significant associations remained after controlling for children's intelligence test scores, in addition to the other covariates. These findings indicate that the effects of pediatric lead exposure are not restricted to global indexes of general intellectual functioning, and executive processes may be at particular risk of lead-induced neurotoxicity.

Abstract: OBJECTIVE To assess the intelligence, visuo-motor perception, motor competence and school performance of children with birth weight less than 2000 grams, at the age of 12 years. DESIGN Prospective cohort study. SETTING Infants discharged from a Neonatal Special Care Unit of a referral hospital with birth weight less than 2000 g between 1987-89 and followed up in the High Risk Clinic. METHODS The children were assessed by the Weschler's Intelligence Scale, Bender Gestalt test for visuo-motor perception, Wide Range Achievement Test for specific learning disability, Draw-a-Person screening test for emotional problems and Movement Assessment Battery for motor competence. Academic achievement was also scrutinised. RESULTS One hundred and eighty children weighing less than 2000 grams at birth and ninety control children were assessed. The mean IQ of the study group was normal (89.5 +/- 16.9), though significantly lower than that of controls (97.2 +/- 14.1; p<0.05). Pre term SGA children had the lowest mean IQ (85.4 +/- 17.7). In the 78 VLBW children, there were 12 (15.4%) mentally retarded children as compared to only 3 (3.3%) amongst controls (p<0.001). There were only 3 (3.8%) 'bright' children among the VLBW group, as compared to 20 (22.2%) in the control group (p<0.001). Visuo-motor perception and motor competence of the study group was poor, and they had writing and mathematics learning disability, especially the preterm SGA and VLBW group. Academic achievement was poor and the incidence of borderline intelligence was 24.4%, which has increased from 13.4% at 6 years. CONCLUSIONS The intelligence and academic performance of the children weighing less than 2000 grams is significantly lower than that of controls, though within normal limits. They also have poor visuo-motor perception, motor incompetence, reading and mathematics learning disability. The preterm SGA and VLBW children had the poorest cognitive abilities.

Abstract: Objective: To establish a community database for children with autism spectrum disorder (ASD) to determine prevalence and identify subgroups based on key intellectual, clinical and family parameters. Methods: Data were collected for children previously diagnosed with an ASD in the Barwon region using parental interview and review of the child's paediatric and psychological records. Preschool diagnoses were typically made by specialist psychologists and school-age diagnoses made by a multidisciplinary team. Results: One hundred and seventy-seven children in the Barwon region were identified as having ASD (82% response rate). The prevalence of ASD was one per 255 children aged two to 17 years. The prevalence increased 10 fold over a 16-year period and this increase was relatively even across all levels of child intellectual functioning. Forty-two percent of children were intellectually disabled (IQ < 70) and performance IQ was significantly higher than verbal IQ but typical block design-comprehension subtest patterns were not common. Nine sibling pair families were identified, 24% were labelled as having attention deficit hyperactivity disorder (ADHD), 6% had epilepsy, and 18.3% were macrocephalic where data were available. Family difficulty was associated with the degree of obsessions/rituals, frequency and intensity of anger/aggression, and ADHD but overall was not associated with the child's intellectual status. Conclusions: The relatively rapid increase in prevalence is consistent with overseas studies and suggests significant changes in diagnostic criteria, increasing community awareness and the need for support at all levels of intellectual functioning. Increased occurrence in siblings and relatives gives further evidence for a genetic cause.

Abstract: Numerous biological and psychological factors associated with impaired neurological functioning have been identified as common among the homeless, but there has been relatively little systematic examination of the cognitive functioning of homeless people. This study explored the neuropsychological functioning of 90 homeless men. There was great variability in their test scores, but the presence of possible cognitive impairment was detected in 80% of the sample. Average general intellectual functioning and reading abilities were found to be relatively low, and the incidence of impairments in reading, new verbal learning, memory, and attention and concentration was high. These findings suggest that the homeless men in this study had considerable assessment and treatment needs that were not being met by most of the health and social services offered to them.

Abstract: The current investigation was designed to examine the provision of cognitive stimulation to preschool-aged children from high-risk families. Participants were drawn from the Concordia Longitudinal Risk Project, a prospective, longitudinal investigation of individuals recruited in 1976–77 from lower SES neighbourhoods who were rated by childhood peers on standardised scales of aggression and social withdrawal. Based on a subsample of women followed from childhood to motherhood (N = 51), we found that childhood behaviour patterns, particularly a history of aggression, negatively predicted cognitive stimulation to preschool-aged offspring, in the context of (1) scaffolding during a structured teaching task, and (2) the quality of the home environment provided for children. In the second part of the study, concurrent analyses focusing on children’s cognitive competence (N = 80) revealed that parental stimulation predicts the intellectual functioning of preschool-aged offspring within a community-based, high-r...

Abstract: Costello syndrome is a rare congenital disorder whose diagnosis is based on clinical findings. The underlying genetic cause has not been identified. Common characteristics include failure to thrive, feeding problems, short stature, coarsening of facial features, developmental delay, mental retardation, skeletal problems, cardiac complications, and increased risk for solid tumors. Given its rarity, existing literature is limited regarding its natural course. Developmental milestones and intellectual functioning have never been systematically studied in this population, therefore this study focused on defining developmental and intellectual attributes. Data was obtained through solicited participation at the 3rd International Costello Syndrome Meeting. A total of 18 children (age 3-20 years) were administered the Leiter-R brief-IQ and the Peabody picture vocabulary test (PPVT)-III to assess nonverbal cognitive functioning and receptive vocabulary. Parents/guardians completed the child behavior checklist (CBCL) and participated in an interview process to complete the survey form of the Vineland adaptive behavior scales to assess emotional/behavioral issues and adaptive behavior. Results indicated that nonverbal cognitive functioning ranged from 1.5 to 4.3 SD below the age mean. Receptive vocabulary skills ranged from average functioning to 4 SD below the age mean. Adaptive behavior composites were all in the low range (2.0 to >5.0 SD below age mean), however there was significant variability in the range of domain scores. CBCL results ranged from normal to clinically significant across various clinical parameters. These data support a generalized descriptive pattern of developmental delay and mental retardation, with noted variability in receptive language, level of adaptive behavior functioning, and emotional/behavioral aspects. Skills and behavior are compared to existing literature of children with various syndromes.

Abstract: We report a prospective longitudinal study of cognitive development in a series of 20 clinic-referred infants with Tuberous Sclerosis. The infants were seen between the ages of 11 and 37 months and were assessed regularly at 6-month periods using a within-subjects repeated measures design. Assessment using the Mullen Scales of Early Learning, a measure of cognitive and motor showed that with the exception of one child, all children had composite developmental quotients that fell into the mentally retarded range of intellectual functioning. In general, the infants’ developmental quotients changed little between 12 and 36 months of age. Developmental progress was evident; however, with small incremental changes in raw scores for subjects over the course of the study. In three children, the developmental quotient changed by more than 20 points during the course of the study. The findings are considered in relation to the neurobiological risk factors for cognitive development in Tuberous Sclerosis.

Abstract: The aim of the study was to investigate impulse control in children with conduct disorder (CD) plus borderline intellectual functioning (BIF), in children with BIF-only, and in a control group with a normal IQ. For this purpose, a Go-No-Go test with varying inter-stimulus-intervals was used. The group CD plus BIF made more errors of commission than the group with BIF only. Therefore, it was concluded that poor impulse control in the group CD plus BIF was associated with CD, not with IQ level. Poor impulse control in the group CD plus BIF was independent of the presentation rate of the stimuli.

Abstract: The American Association on Mental Retardation (AAMR) is a very influential body in the arena of intellectual disability. It has a long and distinguished history of advocacy for individuals with an intellectual disability, of disseminating information, and of publishing work relevant to intellectual disability. One of the roles the AAMR has undertaken has been to define and classify intellectual disability. It published its first manual on definition in 1921 and its tenth in 2002. In 1992 the AAMR published the 9th edition of the manual for the definition of mental retardation (intellectual disability in Australia and learning disability in the United Kingdom). This definition varied substantially from that of the 8th edition (1983) which had remained largely unchanged from the publication in 1973 of the 6th edition. The 1992 definition states: “Mental retardation refers to substantial limitation in present functioning. It is characterized by significantly subaverage intellectual functioning, existing concurrently with related limitations in two or more of the following applicable adaptive skill areas: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work. Mental retardation manifests before age 18”

Abstract: There is abundant evidence that neurocognitive deficits are present in schizophrenic patients (Aylward et al.  ). A recent meta-analytical review of  neurocognitive test variables concluded that schizophrenia is characterized by a broadly based, moderately severe (d =  .  ) cognitive impairment, with varying degrees of deficit in all domains (Heinrichs & Zakzanis  ). In comparison with learning disability these deficits are mild, with around  % of patients scoring in the deficit range on most tests of cognitive function (Green  ). This review will summarize some of the key findings regarding the relationship of cognitive deficits to the aetiology of schizophrenia.

Abstract: Purpose of review This paper focuses on reviews and reports of psychological interventions for individuals with dual diagnosis (intellectual disability and mental health problems) from March 2003 to March 2004. Recent findings Two reviews that evaluated the psychological treatment outcome literature, but spanned different time periods, arrived at different conclusions regarding the progress of the research efforts to date. They agreed, however, on many of the limitations of the research. Case-studies of psychological treatment of aggression, elective mutism, dog phobia, bereavement, borderline personality disorder, and sleep problems appeared in the literature. Intervention techniques represented behavioral, cognitive behavioral, psychodynamic, and psycho-educational approaches. One group intervention for women's health combined psycho-educational and coping skills training. When ongoing service delivery in the community was examined, interventions were found to be non-specific. A report that detailed characteristics of treatment provided in the community was an impetus for the promulgation of standards of care in one region. A measure of sex-offending cognitions was developed and preliminary validation efforts completed. There continues to be a need for assessment instruments designed for persons with intellectual disability. The publication of a psychiatric diagnostic classification system for persons with intellectual disability may improve the reliability of diagnoses, which, in turn, will improve the quality of psychotherapy outcome research. Summary Depending on the review period and the evaluation criteria, authors proclaimed the glass either half empty or half full, that is, some progress or no progress being made in psychological interventions with persons with intellectual disability. Case-studies continue to dominate the literature and offer considerable variety in terms of the problems treated and the intervention techniques used. A significant development in psychiatric diagnosis (Diagnostic Criteria for Psychiatric Disorder for Use with Adults with Learning Disabilities) will guide future progress in intellectual disability research. Continued advances are also needed in assessment.

Abstract: The term ‘dementia’ encompasses a wide range of neurological conditions that give rise to global decline in cognitive functioning. Comprehensive neuropsychological investigations are increasingly important in dementia care, not only for their use as a diagnostic aid but also as a means for progressive monitoring of the disease state and as a basis for evaluating intervention techniques. Any meaningful approach to assessment has to consider the contribution of several conceptually distinct, but interconnecting, domains of cognitive function. This contribution looks at the most pertinent areas of neuropsychological assessment in dementia that merit exploration. It offers a number of recommendations with regards to selecting the most appropriate test battery for premorbid and current intellectual functioning, memory, executive functioning, language and visuospatial functioning. Special considerations are highlighted for conducting neuropsychological investigations within an older adult population.

Abstract: Analysis of outcome data from 305 of the 414 offspring from the Maternal Phenylketonuria Collaborative Study (MPKUCS), plus 70 control offspring, revealed significant deficits in the IQ (intelligence quotient), as measured by the Wechsler Intelligence Scale for Children--Revised (WISC-R), when maternal metabolic control during pregnancy was delayed and/or inadequate. There were, however, 23 'outliers' (7.5% of the 305) in which the offspring's intellectual IQ was worse (n =10) or better (n =13) than expected. The aim of this study was to determine whether collection parameters were incomplete or whether these subjects were true biological variants influenced by other undetected factors or, perhaps, by modifier genes. Among the 10 offspring whose intellectual functioning was worse than expected, additional complications were uncovered that could explain the poor outcome. Four of the 13 offspring with higher than expected IQ had mothers with mild variants of PKU in which the insult to the fetus would not be expected to be as profound. For the other nine offspring whose intellectual performance was better than expected, there was no explanation, based on the parameters studied. We hypothesize that modifier genes will, at times, protect the fetus despite high maternal concentrations of phenylalanine. Not all offspring from the same (untreated) PKU mother may be similarly affected. Finding the source of these modifiers might effect the treatment of MPKU.

Abstract: Publisher Summary This chapter reviews relevant standards defining psychological damages and negligence in civil litigations. The most commonly used tests for the assessment of general psychological functioning and psychiatric disorder include the Minnesota Multiphasic Personality Inventory-2, Millon Clinical Multiaxial Inventory, Rorschach, Beck Depression Inventory, Symptom Checklist-90-Revised, and Personality Assessment Inventory. The Impact Event Scale is a self-report inventory designed to assess the essential aspects of stress disorders. The Trauma Symptom Inventory is a 100-item inventory designed to evaluate acute and chronic symptoms of post-trauma stress. It contains 10 clinical scales under the three broad categories of trauma, self, and dysphoria. Identifying premorbid level of intellectual functioning is an extremely important consideration. In order to identify loss of function, the plaintiff's premorbid level of functioning is demonstrated. It is recommended that all intellectual, achievement, and neuropsychological measures need improved validation with normative groups screened for poor effort. Recent research indicates that effort plays a significant role in neuropsychological assessment of litigants.

Abstract: Literacy skills are very important in our daily life. Literacy skills help people function independently, foster relationships, develop self-esteem and interact with society. Developing literacy skills, therefore, empowers individuals with disabilities or developmental delays and facilitates their integration into communities. With increasing opportunities for inclusion in the Middle School grades, developing techniques to address the different literacy needs of individuals with developmental delays becomes more important. The literacy demands of adolescents have dramatically heightened from what was expected in the past and during elementary school; yet students' abilities are not aligned with the middle school learning requirements. This paper will provide an overview of reading techniques used with adolescents with developmental delays, although the models discussed can be modified to benefit any age group or functional level. According to the 1992 American Association on Mental Retardation's definition of developmental delay or mental retardation, it "is characterized by significantly subaverage (IQ 70 or below) intellectual functioning existing concurrently with related limitations in two or more ... adaptive skill areas", which manifest before age 18. (AAMR, 1992). Overall, and to varying degrees, the development of individuals with mental retardation is delayed as compared to their same age peers. This delay affects their cognitive, linguistic, and learning capabilities. Most do not achieve the expected chronological milestones at typical age levels. Some may never reach certain milestones (Westing, 1986). Specific literacy remediation strategies may be used to improve their ability to perform successfully in school. Characteristics that impeded adolescent academic learning include deficits in expressive language. For example, many may find it hard to articulate words and ideas clearly, and to communicate in complex syntax. Their receptive language performance is somewhat better and is usually more closely related to their intellectual "level" (Farrell & Elkins, 1994, p. 271). Individuals with developmental delays tend to have short attention spans, problems with short term memory and in generalizing information to new situations. They are also often not developmentally ready to learn how to read until middle or later childhood. Even as older students, the traditional orthographic or phonological awareness methods of teaching reading are often unsuccessful (Browder & Snall, 1993). This poses particular problems for adolescents in inclusion classes because many middle school teachers do not teach students the alphabetic principles of "how" to read. They do, however, provide instruction in how to use reading and writing to learn subject matter in a given discipline. In addition, textbooks pose additional difficulties for adolescents with developmental delays. Difficult vocabulary, specialized, content specific jargon, longer reading passages and fewer illustrations thwart a students ability to comprehend text. Some also have motor difficulties which can affect their handwriting, attention and visual-motor coordination. Many also have difficulty with frustration tolerance, especially with regard to academic learning and abstract instructional activities (Epstein, Cullinam & Polloway, 1988). As many of these students experience difficulties with literacy training in their younger school years, by the time they reach adolescence and young adulthood, the curricular shift has been towards functional academics and away from literacy skills training. Some argue that this attitude is of "literacy pessimism" (Katims, 2000, p. 2) or "this learn early or never attitude has had unfortunate outcomes for many of the older children who begin to acquire concepts about literacy at the time that the school curriculum deletes literacy in favor of vocational or daily living skills." (Farrell & Elkins, 1994, p. …

Abstract: Purpose of review This review examines papers published in the last 12 months in the area of mental health problems in children and adolescents with intellectual disability. The research is organized into the following sections: mental health investigations, specific syndromes, family/carer-related papers, treatment findings and theoretical papers. Recent findings Significant findings are presented on the nature and prevalence of psychopathology in young people with intellectual disability and some specific syndrome groups. Summary Whilst much progress has been made recently in defining the nature of mental health problems in children and adolescents with intellectual disability, further information is needed on the development of psychopathology in this population. It is now essential that more research be undertaken in developing efficacious treatments for these children and their families.

Abstract: This article aims to explore Executive Emotional System (EES) disruption as causal agent in frontal lobishness among abused children. The Revised Senior South African Individual Scale (SSAIS‐R) was used to assess a sample population of seventy‐five male and female subjects between the ages of 8 years 0 months and 16 years 11 months who were exposed to child abuse to such levels that warranted admission to a Place of Safety. The data was computerized and frequencies projected as proportions and percentages. A one‐way analysis of variance parametric technique was implemented and p values calculated to verify significant tendencies. The results proved compromised memory and verbal processing abilities (p = 0.0001), with a reduction of global intellectual functioning among all subjects (p = 0.0001). Although frontal lobishness is usually associated with neurological insult, the authors argue that abused subjects displayed very similar manifestations. In addition to acknowledged symptoms, abused subjects prese...

Abstract: Objective To characterize the premorbid cognitive and behavioral abilities in apparently healthy adolescents who at a later time will be diagnosed with schizophreniform disorder or schizophrenia. Background Clarifying the pathological relationship between subtle intellectual and behavioral abnormalities and disease could provide markers for the early prediction of future psychosis. Method Premorbid data on young male patients admitted to the Department of Psychiatry of the Central Military Hospital in Bucharest, Romania, between 1996 and 2002 and diagnosed with a first episode of psychosis or schizophreniform disorder were collected. The premorbid data consisted in the test scores of intellectual functioning and personality traits were collected by the Romanian Draft Board in order to assesses their aptitude to serve in the military. Premorbid cognitive and behavioral scores of male patients (cases=157) were compared with the scores of healthy male individuals (non-cases=169) matched for age, education, and geographic area of residence. The tests were administered when subjects were 18 years of age (initial screening) and the entire assessment was completed and concluded when subjects reached 20 years of age (actual conscription). Results As a group, apparently healthy males later admitted for a first episode of psychosis or schizophreniform disorder, obtained lower (worse) scores on the Raven Progressive Matrices test and on relevant personality traits in comparison to controls. Conclusion The results add to the accumulating body of evidence suggesting that aspects of schizophrenia manifest years before the illness is formally diagnosed. Despite these results, more studies are needed to improve the diagnosing specificity and predictive value of the premorbid cognitive and behavioral manifestations, before they can be used as markers in models of primary or secondary prevention.

Abstract: Evidence of significant impairment in cognitive functioning has always been one of the main criteria of a learning disability (Pulsifer, 1996) and intellectual assessment is, therefore, one of the tasks of clinical psychologists working within learning disability services. Such assessments are commonly used to help establish of an individual’s cognitive strengths and weaknesses, support needs and more specifically, to help determine if an individual falls within the remit of learning disability services (McKenzie & Murray, 2002, Evers & Hill, 1999). Intellectual assessments also have important implications in terms of mental health legislation, accessing benefits and services and informing legal decision-making processes (British Psychological Society, 2001, McKay, 1991). It is, therefore, crucial that the assessments are valid, reliable and used only by appropriately trained and qualified professionals. In Britain, it is emphasised that assessing an individual’s intellectual functioning requires an individually administered, standardised psychometric assessment which is reliable and valid (British Psychological Society, 2001), while in America professional mandates, such as the Standards for Educational and Psychological Testing (AERA,APA & NCME, 1985) highlight the need for high standards of administrative accuracy from psychologists. The Wechsler Adult Intelligence Scales - Third Edition (Wechsler, 1998) are commonly used in intellectual and neuropsychological assessment and are considered to be valid, reliable and well-standardised (Groth-Marnat et al, 2000). The Wechsler Scales have a long history and have undergone a number of revisions with the most recent being in 1997 with the development of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). The purpose of these revisions was to insure that the standardisation sample was representative of current demographics and performance, to update the subtests, incorporate new subtests, and refine the instructions and test materials. Each revision has been well researched and validated (Groth Marnat et al, 2000).

Abstract: This article aims to explore the influence of neglect on language development. Neglect of children does not only pose a social problem for governments and institutions that need to create facilities to care for children but also has an impact on the intellectual functioning of children. Language capabilities, in particular, play an important role in intellectual development, attention and readiness to learn, socio-emotional development, behavioural issues, and academic achievement. Research studies over the years have attempted to demonstrate a relationship between child neglect and developmental delay, including delays in language development. In this study, the influence of neglect on language development was investigated using a sample of children who were admitted during the period October 2001 to October 2002 to a Place of Safety in Pretoria, South Africa. Only children who were exposed to neglect were included in the sample (n = 38), and IQ testing was performed, using the Revised (SSAIS-R) as research instrument. Most respondents (57.9%) performed below average on the Full Scale, while 60.5% performed below average on the Verbal Scale. Subtest Comprehension of the Verbal Scale seems to be the least affected, while subtests Number Problems and Story Memory were the worst affected. These results may be linked to verbal neglect at home, where the parents or caregivers did not adequately communicate with the children when they were small. We argue that the results from this study provide evidence that neglected children have a verbal disadvantage because of lack of interaction and communication between parents or caregivers. Neglected children's language capability is therefore inadequately developed, and this impacts on intellectual development, attention and readiness to learn, socio-emotional development, behavioural issues, and academic achievement.

Abstract: EDITOR—Cooper et al discuss the differing needs of people with intellectual disabilities.1 In recent years health policy documents highlighting the needs of children with intellectual disabilities have been many. Although they recognise the different physical and emotional needs of these children, little is known about this …

Abstract: Children with disabilities that exhibit maladaptive behaviors as a result of abuse and neglect require consideration of a more comprehensive, alternative method of assessment to determine the source and patterns of the behaviors. The need exists to go beyond an assessment of the current level of intellectual functioning, individual academic achievement, and functional behavior to a more ethological approach that considers the dynamics in the home and social settings that influence development. The careful analysis of the child’s social and academic records; patterns and frequency of movement for those in out-of-home placements; interviews and records of primary care givers; along with the intellectual and academic assessments enables special educators, social workers, school staff, and health care professionals to more effectively address the individual needs of the child. This paper discusses assessment methods that utilize a more comprehensive approach to determine the factors that lead to high levels of maladaptive behavior in special needs children. Additionally, alternative intervention strategies are recommended that include establishing the child’s perceived primary care giver with the most stable environment to facilitate the child’s development of more appropriate behaviors.

Abstract: The term ‘developmental disabilities’ as used in this chapter refers to inborn, early-onset developmental delays leading to substantial impairments in mental functioning; in the case of ‘intellectual disability’ (also known widely throughout the UK as ‘learning disability’), these are consistent with performance on a test of intellectual functioning which would give an intelligence quotient (IQ) of below 70. The term is synonymous with the older terms ‘mental handicap’, ‘mental subnormality’ and ‘mental retardation’. It must be distinguished from the North American use of the term ‘learning disability’ which corresponds to what is usually described as ‘specific developmental delays’ such as dyslexia or dyscalculia. Having a marked and generalized learning difficulty is associated with an increased risk of emotional and behavioural disturbance for a variety of reasons (see Turk, 1996a for review). Having a child with severe learning difficulties also causes great problems for parents (Gath, 1977; Dupont, 1986; Romans-Clarkson et al. , 1986) and siblings (Gath and Gumley, 1987; Gath, 1989). The major determinants of familial adjustment are the associated behavioural disturbances rather than the level of intellectual impairment. However, there is good evidence that the likelihood of having a psychiatric disorder, and of its being severe, are associated with the degree of learning difficulty and the related central nervous system dysfunction (Rutter et al. , 1970; Bernal and Hollins, 1995).