ABSTRACT
The role of active treatment has been recognized as vital to the habilitation of persons with mental retardation; however, evaluating the provision of active treatment has been difficult. This study describes the development of the Active Treatment Client Rights checklist (ATCR), which was designed to facilitate the assessment, monitoring, and implementation of readily observable client active treatment services. This investigation provides an explanation of item content, initial reliability data (Phase I), and the results of implementation of the ATCR over a 2-year period in an ICF/MR facility with 29 living units serving nearly 500 clients (Phase II). The ATCR is highly reliable, valid, and useful in enhancing staff provision of active treatment. The most sensitive indicator of active treatment was shown to be related to frequency of functional interactions between clients and staff.
Subject(s)
Education of Intellectually Disabled/legislation & jurisprudence , Intellectual Disability/rehabilitation , Patient Advocacy/legislation & jurisprudence , Quality Assurance, Health Care/legislation & jurisprudence , Activities of Daily Living/psychology , Combined Modality Therapy , Expert Testimony/legislation & jurisprudence , Follow-Up Studies , Humans , Intellectual Disability/psychology , Intermediate Care Facilities/legislation & jurisprudence , Licensure/legislation & jurisprudence , Patient Care Team/legislation & jurisprudence , Professional-Patient RelationsABSTRACT
Neuroleptic-induced akathisia is a relatively common side effect of neuroleptic medication, characterized by a subjective sense of restlessness and the inability to sit still. It has been associated with aggression, anxiety, sleep disturbance, and suicide among patients who have mental illness. These side effects are fairly well-researched in the psychiatric literature but rarely addressed in the mental retardation literature. The prevalence, types of akathisia, differential diagnosis, and treatment were reviewed and a relevant case report presented. The importance of the diagnosis and treatment of neuroleptic-induced akathisia in individuals with mental retardation was discussed.
Subject(s)
Akathisia, Drug-Induced/etiology , Antipsychotic Agents/adverse effects , Intellectual Disability/drug therapy , Adult , Akathisia, Drug-Induced/diagnosis , Antipsychotic Agents/therapeutic use , Chlorpromazine/administration & dosage , Chlorpromazine/adverse effects , Chlorpromazine/therapeutic use , Clorazepate Dipotassium/administration & dosage , Clorazepate Dipotassium/adverse effects , Clorazepate Dipotassium/therapeutic use , Diagnosis, Differential , Female , Humans , Intellectual Disability/complications , Lorazepam/administration & dosage , Lorazepam/adverse effects , Lorazepam/therapeutic use , PrevalenceABSTRACT
The extent of use and effectiveness of special treatment options (in-house behavior shaping units, specialized outside referral agencies, and mobile intensive treatment teams) in dealing with behavior problems of persons with mental retardation was determined. A survey was completed by 144 institutions throughout the United States; 86% of all facilities recognized a need for special treatment options to deal with clients who had severe behavior problems. Sixty-eight percent of the institutions had presently or in the recent past used at least one of the three treatment options. Comparisons of these options in terms of perceived effectiveness, length of intervention, and type of problem addressed were reported.
Subject(s)
Affective Symptoms/rehabilitation , Institutionalization , Intellectual Disability/rehabilitation , Social Behavior Disorders/rehabilitation , Affective Symptoms/psychology , Behavior Therapy , Combined Modality Therapy , Humans , Intellectual Disability/psychology , Patient Care Team , Social Behavior Disorders/psychology , Social EnvironmentABSTRACT
Reliability and reactivity are two important aspects of self-recording which have been studied in school-age children and adults. Little research on reliability and reactivity of self-recording by preschool children is available. The reliability of preschool children as recorders of their own behavior and whether reactive changes (or increases in behavior) occurred as a result of self-monitoring were evaluated. Two types of training in self-monitoring (didactic instruction vs guided practice) were received by two independent groups of 6 preschool children. Reliable self-recording for children ages 4 through 5 was not attained. Reactive changes in the recorded behavior were not observed.
