Development and evaluation of the Active Treatment Client Rights Checklist.

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.

Acute and chronic effects of hypoglycemia on cognitive and psychomotor performance.

The acute and chronic effects of hypoglycemia on cognitive and psychomotor performance are reviewed. Studies involving pediatric and adult subjects, both with and without diabetes were evaluated. The preponderance of studies suggest that hypoglycemia can be an unintended yet frequent result of treatment of patients with IDDM. Significant cognitive and psychomotor deficits were reported even with mild episodes of hypoglycemia. Early age of diabetes onset and frequent episodes of hypoglycemia were found to be highly related to significant deficits in intellectual and academic performance. Patients evidencing performance deficits did not always report symptoms of hypoglycemia. Recovery of cognitive functioning lagged restoration of euglycemia but typically returned to baseline levels of performance. Recommendations for improved patient care are provided.

Specialized treatment for behavior problems of institutionalized persons with mental retardation.

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.

Eliminating ill-founded eliminations in handwriting comparison cases.

Document examiners sometimes eliminate writers on the basis of differences which are given too much weight. This article is an attempt to explain some conditions whereby differences in the writing of one individual are misinterpreted as significant differences, when they are actually caused by conditions which are unknown to the examiner.