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Mental retardation (MR) is a manifestation of a heterogeneous set of impairments and conditions that result in cognitive limitation. It is a condition of medical, educational, and social importance. Physicians identify profound, severe, and moderate MR but rarely diagnose mild MR unless it is associated with a genetic or medical syndrome. From a medical perspective, the quest for etiology and the possibility of medical or surgical intervention to minimize deterioration are paramount. Educators, on the other hand are less concerned with causation than with academic achievement and school success. The majority of cases of mild MR is identified in school settings. Finally, the public uses the label to describe poor adaptive skills. Adults with MR who hold jobs, live independently, and participate in society are not always described as having MR. Thus some individuals characterized in childhood or adolescence as having mild MR become indistinguishable from the general population in adulthood.

Autism was first delineated as a syndrome of childhood onset by Leo Kanner in the United States in the 1940s (Kanner, 1943). Long before that—at the turn of the 18th century—classic autism cases had been described by John Haslam in the United Kingdom and Jean Itard in France. The word autism (from the Greek autos for self) was introduced by Eugen Bleuler to depict the self-cantered thinking believed to be typical of schizophrenia. Believed by Kanner to be a discrete disease entity, early infantile autism was conceptualized as an extremely rare disorder, and one that would be easy to identify and diagnose. It was only in the early 1980s that the concept of an autism spectrum was introduced by Wing (Waterhouse, Wing, & Fein, 1989; Wing, 1981, 1988) and Gillberg (Gillberg & Steffenburg, 1987). Wing put forward the notion of a fairly specific triad of impairments of social, communicative, and imaginative functioning as being at the basis of all autism spectrum disorders. She also coined the term Asperger’s syndrome for the kind of “high-functioning” autism spectrum disorder originally described by Hans Asperger (1944) (who used the term ) at about the same time that Kanner described his more “low-functioning” variant of autism.

Cerebral palsy (CP) is a handicapping condition that can present with such vastly different expressions that it is easy to question the appropriateness of the term. Despite these misgivings, CP does exist. There are common understandings of its definition, a generally accepted classification system, increasing knowledge about its etiology, a body of knowledge about its epidemiology, and increasing numbers of treatment options.

Epilepsy is a tendency of occurrence of transient recurrent abnormal electrical discharges in the brain affecting one or more of the following brain functions: motor, sensory, cognitive, speech, behavioral, emotional, and psychological. The lifetime prevalence of epilepsy in the general population is between 2 and 3%. The prevalence of epilepsy among people who have mental retardation is much higher. Although it is difficult to determine the exact figure, the reported prevalence of lifetime epilepsy among people with mental retardation (IQ< 70) varies between 13 and 24% (Deb, 1997a; Forsgren, Edvinsson, Blomquist, Heijbel, & Sidenvall, 1990; Goulden, Shinnar, Koller, Katz, & Richardson, 1991; McGrother, Hauck, Bhaumik, Thorp, & Taub, 1996; Rutter, Tizard, Yule, Graham, & Whitmore, 1976).

Brain injury is a health problem of major proportion. Affecting physical, cognitive, and behavioral function, brain injuries can occur as a result of a number of circumstances. For example, it is estimated that each year 1.5 million Americans sustain a traumatic brain injury (TBI) resulting from such causes as injury, accident, toxic exposure, or assault. According to the Brain Injury Association of America (2002), more people experience TBI each year than breast cancer, HIV/AIDS, multiple sclerosis, and spinal cord injuries combined.

In the humanities and in the social sciences, it is almost a truism to say that one cannot escape the influence of one’s own historical time. Certain novelists of the past, for example, are highly valued during one historical period, “lost” to another, only to be reembraced at a later time. Similarly in a field like history, we see changes over the decades in how society views the accomplishments of certain individuals. Are Jefferson, Adams, Franklin, and other of America’s “Founding Fathers” omniscient visionaries, as portrayed in many recent books, or instead should they be criticized for leaving unresolved such basic national issues as slavery (Brands, 2003)? Fields, like people, reflect the times in which they exist.

Fifty years ago, people with intellectual disability (ID) were “out of the sight and mind of the general public” (Perske, 2003). Little attention was given to this group in popular culture or in scientific research. However, following on the heels of the civil rights movement, and with strong parent advocacy, the doors of the public arena began to open to this once isolated group. Previously, few would have imagined that children with ID would be going to their neighborhood school and sitting in regular classrooms with their peers, or that adults with ID would be working next to their fellow, nondisabled employees. As the movement toward inclusion gained momentum, research in the field of ID began to focus on societal attitudes that act as implicit and often explicit barriers to success. In fact, over the past 50 years, well over 500 studies have been carried out to examine the attitudes of children, teachers, service providers, employers, and the general pubic toward people with ID. Given that the inclusion movement has been most evident in the schools, researchers have focused most of their attention on children and teachers. Therefore, this chapter will provide a review of research that specifically addresses the attitudes of children and teachers toward children with ID and the interventions designed to influence those attitudes.

This chapter focuses on contemporary program evaluation activities in adult developmental disabilities (DD) services. Program evaluation is best understood as a:

Education—more specifically, special education—plays a unique and central role in addressing the problems of students with developmental disabilities. Proposed reforms of general and special education are thus critically important issues for developmental disabilities. Failure at school is tantamount to failure at life for children and youths, as school is the occupation of the young. The primary purpose of educational service interventions is to help youngsters with developmental disabilities have a successful school experience. Reforms that advance this purpose are beneficial; those that undermine or preclude it are misguided at best. We explain the central role of education in children’s lives, the necessity of special education and the nature of it, popular but misanthropic proposals for reform, and needed improvements in special education.

In this chapter, we review the psychological needs and service provisions for older adults with an intellectual disability (ID). The reader will be directed toward research that identifies an increasing longevity, concomitant increases in aging-related morbidities, and psychosocial factors. Specific aging-related conditions will be discussed, along with their impact on functional status and mental health, including a discussion of the complexity of differential diagnosis and the usefulness of comprehensive assessment.