Carolyn S. Schroeder

Prevalence of self-injurious behaviors in a large state facility for the retarded: A three-year follow-up study

A combined informant questionnaire and interview survey of self-injurious behavior (SIB) at a large state facility for the retarded was conducted independently three times over a 3-year period. Prevalence consistently was about 10% of the population. SIB cases tended to be younger and institutionalized longer than the rest of the population. Severe cases had a longer history of chronic SIB. SIB cases had more seizure disorders, severe language handicaps, visual impairments, and severe or profound retardation than the rest of the population. They appeared to fulfill most of the Rutter (1966) criteria for autism. But unlike the severely autistic, there was little relation of sex to incidence of SIB. Over 90% of SIB cases changed status over 3 years, suggesting that SIB was amenable to behavior modification in most cases (94%). Psychotropic behavior control medications helped in some intervention programs (52%). SIB remitted spontaneously in 27% of SIB cases where there had been no behavioral or drug intervention.

Standardized Playroom Measures as Indices of Hyperactivity.

A group of 16 children from a normal community population was compared with two groups of 16 children referred for clinical evaluation of hyperactivity. These three groups were matched on age, sex, and race. One of the clinic groups was matched with the community sample on IQ and social class as well, while the children in the other clinic group were mentally retarded and of somewhat lower social class. All children were observed in a standardized playroom for two 15-minute sessions, one under free play instructions and the other under instructions restricting activity and toy-changing behavior. The two groups of children referred for evaluation of hyperactivity had significantly higher playroom activity scores than controls under both instructional conditions and significantly higher toy-change scores under restrictive instructions. Parental ratings of activity were also significantly higher in both clinic groups than in the community group. The mentally retarded clinic sample did not differ from the other clinic sample on any of the measures of activity or toy switching.

Normal Sexual Development

Even the most sophisticated parents and professionals have difficulty acknowledging (much less discussing) the sexuality of children. This is illustrated by the following situation that occurred in the family of a physician, his wife, who was a nurse, and their three children. The mother was expecting their fourth child, but despite repeated requests from the children for information about the birth process, the parents had avoided discussing the topic. Finally, when the baby was obviously due to arrive at any minute, the children (in the father’s absence) said, “Mother, please tell us how this baby is going to get out.” At this point, the mother gave them a detailed explanation and the children asked her to repeat it a second time, saying, “We’ve got to get this just right so we can tell Daddy. He doesn’t know a thing about this!”

Effects of methylphenidate on hyperactive children's sleep

EEG sleep patterns recorded from 6 hyperactive boys taking methylphenidate daily were compared to those of 6 normal boys. For these hyperactive subjects significant increases in latency to both sleep onset and the first REM period were obtained. Other sleep measures were normal. The hypothesis that the therapeutic effects of stimulants upon hyperactive children are independent of any pathological disruption of sleep was supported.

Self-Injurious Behavior

Defining self-injurious behavior (SIB) presents some difficulties. It has been broadly defined as behavior that produces injury to the individual’s own body (Tate & Baroff, 1966a), and thus could be seen as including suicide, self-neglect, substance abuse, malingering, and so forth—all terms that infer some intent on the part of the client. The research literature on modification of SIB, however, has settled on a narrower definition: overt acts directed toward oneself that have restricted spatial and temporal topographies, whose rate of occurrence is reliably observable, and whose consequences are actual or threatened physical damage. Even this definition is not satisfactory, though. S. R. Schroeder, Mulick, and Rojahn (1980) have pointed out that it suffers from three flaws: (1) the consequences specified by the term do not pertain functionally to the reinforcing stimuli responsible for maintaining the behaviors; (2) researchers disagree about the membership of various topographies in the response class of SIB; and (3) no single intervention strategy is indicated for the particular “class” of SIB as opposed to other behaviors.

The future of children is now

A community resource network, Annie Sullivan Enterprises, Inc., is described as a system for community integration of children and youth who have developmental disabilities and mental health problems. A brokerage model is espoused for accessing and delivering services. The model is based on Hobbs (1975) view that organization of human services must be based primarily on the clients needs rather than on the needs of the service agency. Lessons and recommendations based upon 7 years of successful operation are described.

Sexuality and Mental Retardation

A discussion of sexual issues related to children and adolescents with mental retardation is included in this book because of the critical need to acknowledge their sexuality and to support their psychosexual development. We hope it will provide clinicians with useful information and encourage them to provide services in the area of sexuality for children and adolescents with mental retardation. This chapter includes a brief historical review of myths and attitudes about sexuality of people with mental retardation, discussion of sexual development and sexual education, and a review of the research on sexual abuse and other sexual problems, with an emphasis on assessment and treatment issues that are unique to this population.

Suggestions to Parents about Common Behavior Problems in a Pediatric Primary Care Office

Studies by Clarke-Stewart (1978) and Schroeder and Wool (1979) have shown that the pediatrician is the professional most parents initially contact when they have concerns about their child’s development or behavior. How pediatricians have managed these concerns has varied with their perceived role and interest in this area, their skills, and their time limitations. The pediatric psychologist would appear to have much to offer parents and pediatricians in primary health care settings (Wilson, 1964).

Sleep disturbance in children with visual-motor deficits

The sleep patterns of 6 normals and 6 boys with visual-motor deficits were compared. While none of the usual symptoms of sleep pathology, e.g., insomnia, enuresis, night terrors, or somnambulism, were present in either group, the visual-motor boys showed a marked increase in Stage REM and correlated decrease in Stage 2 sleep. Results were interpreted as in accord with Bergers theory that the biological function of REM sleep is the innervation of anatomical pathways necessary for oculomotor control during waking.

Mental retardation in the United States: Assessment, program development, and applied research

Abstract Recent history of mental retardation in the United States reveals a prodigious growth in establishing the right to education, treatment, work, due process, and fair wage. New public laws guarantee a right to a free, appropriate, individualized education. Trends in applied biomedical research show new data in medical and biochemical genetics, neurotoxicology of environmental pollutants, neurobiology of developmental behavior disorders, nutrition, and the developmental psychophysiology of mental retardation. New and important data have emerged with early intervention programs for high risk infants, in sociobehavioral studies of mental retardation, and research on the quality of life of severely and profoundly retarded persons. Behavior modification has had a major influence on instructional technology in mental retardation.