Implicit and explicit learning in young adults with mental retardation

We examined intelligence-related differences in explicit and implicit learning using an artificial grammar paradigm. Young adults with and without mental retardation completed a sequence-learning and identification task. For some participants, sequences were constructed following an artificial grammar; for others, sequences were random. Explicit learning was determined by ability to learn and later identify random sequences. Implicit learning was determined by the tendency to incorrectly identify new grammatical sequences as seen before, relative to new nongrammatical sequences. Participants with mental retardation did more poorly than participants without mental retardation on explicit learning but just as well on implicit learning. Results suggest that learning of complex materials, when accomplished through implicit processing, is functionally equivalent in individuals with and without mental retardation.     

A comparison of language characteristics of mentally retarded adults with fragile X syndrome and those with nonspecific mental retardation and autism

Fragile X syndrome is a recently identified form of mental retardation that is associated with a chromosomal abnormality and inherited in an X-linked manner. Previous studies have suggested that distinctive speech and language characteristics are associated with the syndrome. Twelve adult male residents of an institution for the retarded (aged 23 to 51 years) were compared on a series of speech and language measures to 12 adult males with nonspecific forms of MR who were residents of the same institution and were matched on age and IQ. A second contrast group consisted of similarly matched autistic men. Results revealed that there were no significant differences among the groups' performance, with the exception of increased rates of echolalia in the autistic group. A nonsignificant trend toward poorer performance on expressive measures on the part of the fragile X group was noted. The implications of these findings for further research on the syndrome are discussed.We wish to express our most sincere appreciation to the staff of the Southbury Training School for their cheerful cooperation throughout this study, most especially to Edward Benjamin, Richard Witham, and Dr. Jean Gino. To our research nurse, Sharon Ort, research associate Wendy Marans, and research assistants Deborah Soriano, Elaine Algiers, and Karen Beebe, whose help in collecting, coding, and rating the data were invaluable, we also express our thanks. This research was supported by grants from the NIMH Mental Health Clinical Research Center grant no MR30929-09, the Children's Clinical Research Center grant no. RR00125-05, NICHD grant no. HPO3008-18, the MacArthur Foundation, the Merck Foundation and U.S. Public Health Service grant no. HD-11624.     

Vigorous,aerobic exercise versus general motor training activities: Effects on maladaptive and stereotypic behaviors of adults with both autism and mental retardation

Examined the effects of antecedent exercise conditions on maladaptive and stereotypic behaviors in 6 adults with both autism and moderate to profound mental retardation. The behaviors were observed in a controlled environment before and after 2 exercise and 1 nonexercise conditions. From the original group of 6 participants, 2 were selected subsequently to participate in aerobic exercise immediately before performing a community-integrated vocational task. Only antecedent aerobic exercise significantly reduced maladaptive and stereotypic behaviors in the controlled setting. Neither of the less vigorous antecedent conditions did. When aerobic exercise preceded the vocational task, similar reductions were observed. There were individual differences in response to antecedent exercise. Use of antecedent aerobic exercise to reduce maladaptive and stereotypic behaviors of adults with both autism and mental retardation is supported.The authors acknowledge the important assistance provided by the following people: The staff and management of the Behavior Development and Learning Center at Camarillo State Hospital and Developmental Center directed by Israel Perel, Ellie Kimbauer, Judy Baptista, Kristine Herman, and especially the participants.     

Walking habits of adults with mental retardation

The walking activity of men and women with mental retardation residing in community settings was described. Participants were 38 women (M age=.7, SD=9.5) and 65 men (M age=35.9, SD=11.2). They wore pedometers for 7 days. A 2 x 2 factorial ANOVA indicated no significant gender differences in total step counts or between participants with and those without Down syndrome. A post-hoc analysis revealed that participants walked less on Saturday than during the weekdays. Only 21.1% of the women and 21.5% of the men with mental retardation accumulated the recommended 10,000 steps per day.     

Screening for osteoporosis in community-dwelling adults with mental retardation

Osteoporosis screening of adults ages 40 to 60 who attended community-based adult training centers was conducted utilizing dual-energy X-ray absorptiometry (DEXA) measurements of the calcaneus. Valid measurements were obtained on 107 individuals, a response rate of 94%. One fifth of the sample (21%) had osteoporosis and 34% had osteopenia. On multiple regression analysis, the most significant predictors of BMD were Down syndrome, mobility status, and race. Future studies involving larger samples of middle-age adults with mental retardation/developmental disabilities will clarify the need and optimum age for osteoporosis screening.     

Responses and sustained interactions in children with mental retardation and autism

Sustained interactions and responses to social bids made by children with autism and verbal-age–matched children with mental retardation were recorded in two naturalistic settings. Children with autism produced fewer positive responses and more no responses than children with mental retardation; both groups were more likely to make positive responses to adults and not to respond to other children. Furthermore, although the frequency of conversations was not different for the two groups, children with autism were significantly less likely to engage in sustained play compared to children with mental retardation. Results suggest that children with autism are able to master the more rote and need-oriented social skills, such as simple conversation, but may not develop other forms of social interactions, like play.     

Development of the fear survey for adults with mental retardation

This paper describes the development of the fear survey for adults with mental retardation (FSAMR) and provides initial evidence of its psychometric properties. The FSAMR was designed to be sensitive to the assessment needs of individuals with mental retardation. The items were developed through open-ended interviews, a review of existing measures, expert input, and pilot testing. The sample consisted of 138 adults with mental retardation (73 from institutional settings and 65 from community settings). Cronbach's alpha internal consistency coefficients were 0.97 for the scale, and above the 0.60 threshold set for the study for all but the acquiescence response set (ARS) subscale. Significant concurrent validity coefficients with anxiety measures were in the moderate range (r=0.32 and 0.40) and are comparable to other similar studies. Implications for using the FSAMR are discussed.     

Later-life planning for older adults with mental retardation: a field experiment

A quasi-experimental design was used to assess the efficacy of a leisure education-based later-life planning model for 10 older adults with mental retardation. Prior to the initiation of the planning process, they were interviewed and completed three standardized scales designed to assess life and leisure satisfaction and leisure constraints. A comparison group completed these scales but did not participate in the planning process. At the completion of the study, both groups completed the same scales. Results demonstrated that the planning-process group had significantly higher life and leisure satisfaction at the end of the study. Many participants also made changes to their lifestyles consistent with plans made during the study. Results suggest that a later-life planning process may contribute to the quality of life of older adults with mental retardation.     

Deinstitutionalization for older adults with severe mental retardation: results from Australia

A deinstitutionalization research project in which residents from the largest institution in Queensland, Australia, were relocated after a government decision to close the center was described. Outcomes of relocation into community living for adults with severe mental retardation, many of whom were older (over 40 years) and had been institutionalized for much of their lives, was addressed within the Australian context. Results from the relocation and outcomes for people aged 20 to 39 years (n = 37), 40 to 59 years (n = 39), and over 60 years (n = 24) were described. Group results focused on adaptive and maladaptive behavior, choice-making, and objective life quality were discussed together with the implications for service provision.     

Validity of the PAS-ADD for detecting psychiatric symptoms in adults with learning disability (mental retardation)

The Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD) is a semi-structured interview for use with respondents who have learning disability and for key informants. This report investigates the ability of the instrument to detect symptoms that had been found to exist during routine clinical assessment of the patients. Field trials involved 95 referred patients with learning disability and a key informant for each sample member. Clinical opinions of the referring psychiatrists were sought using a symptom checklist. Referrer checklist symptoms and PAS-ADD data were both factor analysed. Validity testing involved (a) computation of correlations between PAS-ADD factors and checklist data and (b) comparison of PAS-ADD and referrers' diagnoses. Results indicated good validity for the PAS-ADD in relation to psychotic symptoms and depressive symptoms. Anxiety symptom identification was not well validated, probably due to small numbers. Expansive mood identified by the referrers was not detected by the PAS-ADD because there is currently no corresponding section in the interview. Where the PAS-ADD produced a diagnosis (in 58 members of the sample), 44 were in agreement with the referrer. Probability of diagnosis by PAS-ADD increased with the number of relevant active symptoms identified by the referrer. The PAS-ADD has been shown in a previous report to have the sensitivity to detect mental disorders not known to psychiatric services. For psychotic and depressive conditions, our results showed that symptom detection was in good agreement with the information provided by the referring psychiatrists on their patients. The PAS-ADD needs a section on hypomania and further investigation of its detection of anxiety disorders.     

Weight gain in a controlled study of risperidone in children, adolescents and adults with mental retardation and autism

As part of an ongoing, prospective, ABA design, double-blind crossover study of risperidone versus placebo for the treatment of aggressive, destructive and self-injurious behavior in persons aged 6-65 years with mental retardation (MR) and autism, we measured the weight of 19 subjects at each study visit. We compared mean weight gain during the 16-week acute phase and 24-week open maintenance phase with that during the initial and middle placebo phases statistically, using a linear mixed model procedure. Results of the linear mixed model analysis showed that relative weight gain observed during the acute and maintenance drug phases was significantly greater than that observed during the initial and middle placebo phases respectively (p = .0001 and p = .0001). Over approximately a year, children aged 8-12 (n = 5) gained a mean of 8.2 kg (range = 2.7-17.7 kg); adolescents (n = 6) aged 13-16 gained a mean of 8.4 kg (range 3.6-15.5 kg); adults aged 21-51 (n = 8) gained a mean of 5.4 kg (range 0-9.5 kg). Weight gain observed in this controlled study of risperidone treatment in children, adolescents, and adults with MR and autism was significant. It may be greater in this population than in others reported and in this study was not limited to an acute effect only. Rate of weight gain diminished rapidly on tapering and stopping the drug. Further studies are urgently needed, including those incorporating diet and exercise programming.     

Diathesis-stress and depressed mood among adults with mental retardation

The impact of diatheses, stress, and their interaction on depressed mood was evaluated to determine the appropriateness of cognitive diathesis-stress models of depression for adults with mental retardation. We also tested hopelessness as a mediator in the prediction of depressed mood to evaluate the hopelessness theory of depression. Seventy-three adults with mental retardation and adequate receptive vocabulary participated in semi-structured interviews. Experiencing life stressors and possessing a negative attributional style, but not their interaction, served as predictors of depressed mood. Similar results were obtained using frequency or impact ratings of life stress. Conditions were not met to test hopelessness as a mediator. Treatment implications for depression among adults with mental retardation are highlighted.     

Implicit learning in children and adolescents with mental retardation

The literature on implicit learning in persons with mental retardation is scarce and contradictory with respect to the relationship between degree of intellectual disability and impact of implicit-learning processes on performance. We examined children and adolescents with mild or moderate mental retardation and typically developing children matched on MA with regard to their implicit learning. Individuals with mental retardation modified their behavior after an implicit training procedure in a way similar to MA- or CA-matched controls. The impact of implicit learning did not vary as a function of IQ or age. However, some differences appeared between groups in their explicit remembering of the training conditions. The theoretical implications of these results are discussed.     

Quality of life for young adults with mental retardation during transition

The quality of life of 188 young adults with moderate or severe mental retardation was examined. Schalock and Keith's (1993) Quality of Life Questionnaire (QOL-Q) was used as the primary outcome measure. Young adults who had exited high school had significantly higher overall quality of life scores than did those who were still attending school. Individuals who had jobs in the community also had significantly higher levels of quality of life. Although young adult adaptive functioning was the single largest indicator of the QOL-Q index total score and three of the four subscales, it was not related to scores on the Satisfaction subscale. Here, family- and environment-related variables played a greater role. Implications and directions for future research are discussed.     

Deletion 2q37: an identifiable clinical syndrome with mental retardation and autism

Terminal deletion of the long arm of chromosome 2 is a rare chromosomal disorder characterized by low birth weight, delayed somatic and mental development, craniofacial defects, short neck, heart and lung congenital defects, and autistic features. We report on a girl with 46,XX.ish del(2)(q37.1) de novo karyotype, mental retardation, dysmorphic features, gastrointestinal anomalies, and autistic traits and compare her clinical manifestations with patients with the same deletion previously described in literature.     

Occupational and leisure preferences of older adults with mental retardation

This article presents baseline information on the occupational and leisure preferences of a statewide sample of older adults with mild to moderate mental retardation who reside in the State of Oregon, USA. Data were collected through an interview with the older person with mental retardation and through a questionnaire sent to a knowledgeable other who was matched to each older adult. Findings are presented on the types of occupational and leisure activities that were participated in by these older adults, on the level of satisfaction experienced with these activities, and on their preferences for continued participation as they grow older. Results indicate an overwhelming desire for continued participation in occupational and leisure pursuits that are personally meaningful. Strong preferences are expressed for greater variety, frequency, and choice in these activities. Implications of the findings for designing retirement options for older adults with mental retardation are discussed.     

Parent-implemented natural language paradigm to increase language and play in children with autism

Three parents of children with autism were taught to implement the Natural Language Paradigm (NLP). Data were collected on parent implementation, multiple measures of child language, and play. The parents were able to learn to implement the NLP procedures quickly and accurately with beneficial results for their children. Increases in the overall rate of vocalizations were observed for all three children with a shift from imitative language at the beginning of intervention to spontaneous language at the end of intervention. Clear improvements in play were observed for two of three children while ceiling effects were observed for a third child who already played effectively. In response to a social validity questionnaire, parents indicated that they found the study useful and the NLP procedures simple to implement and that that they would continue to use NLP at home following the conclusion of the study.