Influences on parent perceptions of inclusive practices for their children with mental retardation.

Influences on parent perceptions regarding the practice of integrating students with significant cognitive disabilities into general education classrooms were examined. Findings confirmed that perceptions were significantly influenced by characteristics of the parent and the child as well as by factors associated with the child's placement history. Further, factors influencing these perceptions differed according to varying dimensions of inclusion being considered. We argue that the efficacy of any specific type of educational model cannot be determined without a consideration of the complex dynamics involved in the interplay between individual child characteristics, parent and family values, and the perceived role of the school.

Measuring problem behaviors in children with mental retardation: dimensions and predictors.

Scores from the Child Behavior Checklist (CBCL; Achenbach, 1991a) and the Client Development Evaluation Report (CDER; California Department of Developmental Services, 1980) for 67 children and adolescents with mental retardation were examined to evaluate the factorial validity of the instruments. Four factor analyses were conducted. The initial factor analysis of CBCL data failed to confirm the presence of the five first-order factors previously reported for the CBCL standardization sample (Achenbach, 1991b). Second, the higher-order factors of Externalizing and Internalizing behaviors, similar to the structure reported for the CBCL standardization sample (Achenbach, 1991b), were confirmed on the present sample. Third, the two CDER factors of Personal Maladaption and Social Maladaption, previously identified by Widaman, Gibbs, and Geary (1987), were also confirmed. Finally, a higher-order factor analysis of the two factor scores from the CBCL and two factor scores from the CDER was conducted to study the congruence between the CBCL Externalizing and CDER Social Maladaption dimensions, and between the CBCL Internalizing and CDER Personal Maladaption factors. Moderate levels of congruence were found. Next, child characteristics, including level of mental retardation, age, and four dimensions of adaptive behavior, were used as predictors of problem behavior. No child characteristics were significantly related to the CBCL Externalizing dimension, but child age and level of mental retardation were significant predictors of the CBCL Internalizing dimension. CDER Cognitive Competence predicted CDER Social Maladaption, and child age predicted CDER Personal Maladaption. The findings are discussed in relation to previous studies of problem behaviors of children and adolescents with mental retardation.

Epidemiology and prevalence of psychopathology in people with mental retardation.

There is a general consensus that, for several reasons, people with mental retardation are at an increased risk of developing emotional disorders. Numerous research studies have examined the prevalence of psychiatric disorders among people with mental retardation, and a wide range of rates have been reported. Reasons for the variability in these results are discussed, including definitional and identification issues, and sampling issues. A summary of representative studies is presented and discussed in light of the above-mentioned issues. The need for updated epidemiological studies in this area is emphasized.

Construct validity of dimensions of adaptive behavior: a multitrait-multimethod evaluation.

The construct validity of four dimensions of adaptive and maladaptive behavior was investigated using the multitrait-multimethod matrix procedure of Campbell and Fiske (1959). Measures of four traits--cognitive competence, social competence, social maladaption, and personal maladaption--were obtained on a sample of 157 persons with moderate, severe, or profound mental retardation using each of three methods of measurement--standardized assessment instrument, day shift staff ratings, and evening shift staff ratings. Applying the Campbell and Fiske rules of thumb and recently proposed structural equation modeling techniques to the data demonstrated strong convergent validity, clear discriminant validity, and only moderate levels of method variance in the observed measures. Implications of the results for the assessment of adaptive behavior and its dimensional structure were discussed.

The association between psychiatric diagnoses and severe behavior problems in mental retardation.

To investigate the relationship between psychiatric disorders and severe behavior problems in mental retardation, statewide client databases from developmental disabilities services in California (N = 89,419) and New York (N = 45,683) were analyzed and juxtaposed. The study focussed on nine major DSM-III-R psychiatric categories (or their equivalents), and severe forms of aggressive behavior, property destruction, self-injurious behavior, and stereotyped behavior in individuals 45 years old and younger with mental retardation of all levels of severity. In California, 3.9% had at least one psychiatric diagnosis; in New York, 5.4%. The rate of specific psychiatric diagnoses was variable across states, suggesting local preferences in diagnostic practices. Severe behavior problems occurred in 22.1% in California and in 41.4% in New York. This difference in rates can be attributed in part to different recording criteria for behavior problems. With regard to the association between psychiatric diagnoses and problem behaviors the results were consistent across databases: No compelling correlations were found. This means that neither aggression, self-injury, destruction, nor stereotypies determine whether a person receives a psychiatric diagnosis or not.

Who are the dually diagnosed?

The evaluation of mental health problems among persons with mental retardation is complicated by difficulties in diagnosis as well as by system variables that may also determine who will be assigned a dual diagnosis. In this study a state data base of 78,603 individuals with mental retardation receiving state services was examined. The relations of observed behavior problems, other characteristics of the individual, and residential placement patterns to the likelihood of being given a dual diagnosis were examined. Extrapunitive maladaptive behaviors, cognitive abilities, and social skills were associated with diagnoses of mental health problems among persons with mental retardation. The different perspectives from which these results could be interpreted were discussed.

Prediction of mortality in community and institutional settings.

This study attempted to re-evaluate predictors of mortality based on a large sample of mentally retarded individuals. Additionally, mortality rates were compared among several types of placements including institutions after controlling for the most salient predictors of death. The findings indicated that non-mobility and the need for medical support add to the risk of an early death for these children, and are significant indicators of mortality, regardless of level of retardation and placement.

Client characteristics and residential placement patterns.

Recent emphases on deinstitutionalization and community placement have been accompanied by the development of a range of residential placement alternatives and by shifts in the control of placement decisions. In this study we examined the patterns of placement into these alternatives for 66,367 clients receiving services for mentally retarded persons from the state of California and evaluated the ability of client characteristics to discriminate among clients in four residential placement types. Results of the discriminant analyses suggest that client characteristics, including maladaptive behavior, age, ethnicity, medical problems, ambulation, toileting, and speech, are important factors in the consideration of residential placement for mentally retarded people.