Psychoeducational assessment of students with intellectual disability: professional-action framework analysis.

BACKGROUND: The right to educational inclusion for students with intellectual disability (SWID) requires the development of good assessment and intervention practices from holistic perspectives not exclusively focused on the academic limitations that SWID may present. These practices are settled in Spain, via regulations drawn up by each Autonomous Community (AC). The variety of existing regulations demands a critical review of the decisions taken to promote the inclusion of those students. METHOD: current regulations-in-force in each AC that regulate attention to diversity (AD) have been were analyzed by using a checklist that includes the variables that defining each stage of the AD process and the ways of providing supports that favor the development, learning and participation of SWID. RESULTS: attention to diversity measures in each AC emphasize organizational and curricular issues, with no AC following holistic approaches in both assessment and intervention, but rather neglecting self-determination and the promotion of quality of life for SWID. CONCLUSIONS: guidelines for the development of new legal frameworks and professional practices based on the latest evidence-based models of attention to SWID and on the results are discussed.

Evaluación económica del impacto de la prohibición de plomo en las gasolinas en el cociente intelectual de los niños de 7 y 8 años de la Comunidad de Madrid / Economic vappraisal of the impact of the ban on the use of lead in gasolina on the intellectural quotient of 7-8 years old in the Community of Madrid

Fundamentos: la evaluación económica de las repercusiones sanitarias de las políticas públicas es difícil y escasa. El objetivo del presente estudio fue cuantificar monetariamente los beneficios de la reducción del plomo en la sangre de los niños de 7-8 años en la Comunidad de Madrid (España), derivada de la prohibición del plomo en las gasolinas. Métodos: se calculó la disminución de puntos de cociente intelectual (CI), utilizando dos estudios realizados en niños de 7 a 8 años según los valores de plomo en sangre que presentaban: media geométrica de 3,8 μg/dL en 1995 y 0,9 μg/dL en 2010. La mejoría neta de CI se midió en términos de capacidad de producción ganada a lo largo de la vida laboral, siguiendo los métodos de Schwartz y Salkiver. Resultados: la reducción de los niveles de plomo en sangre de estos niños evitó perder entre 135.391 y 144.153 puntos de CI. La valoración económica actual de estos puntos en términos de capacidad de producción ganada a lo largo de la vida laboral de estos sujetos se estimó en un rango entre 626,4 y 865,4 millones de euros (valor 2009). Conclusiones: las cifras de beneficios económicos encontradas derivadas de la medida de prohibición de uso de plomo en las gasolinas son importantes en términos sociales (AU)

Background: The repercussions on health of public policies are hard to assess from an economic point of view, which is why this is rarely done. The purpose of this study was to financially quantify the benefits of reducing blood lead levels in children aged 7-8 years in the Community of Madrid (Spain) as a result of the ban on the use of lead in gasoline. Methods: the decrease the intellectual quotient (IQ) points was calculated through two studies on children aged 7-8 years according to their blood lead levels. A geometric mean of 3.8 μg/dl was obtained in the 1995 study and of 0.9 μg/dl in the 2010 study. The net increase in IQ was measured in terms of productivity gained throughout the working life as per the methods of Schwartz and Salkever. Results: the decrease in blood lead levels in these children prevented a loss of between 135,391 and 144,153 IQ points; the current economic valuation of these points in terms of the productivity gained throughout the working life of this cohort of children was estimated to fall within the €626.4m-€865.4m range (2009). Conclusions: the figures of the economic benefits derived from the decision to ban leaded gasoline are very high (AU)

The right to appropriate and meaningful education for children with ASD.

This paper will explore from a 'child's rights perspective' the 'right' of children with autistic spectrum disorder (ASD) to appropriate and meaningful education. Human 'rights' principles within international law will be evaluated in relation to how they have been interpreted and applied in relation to achieving this 'right'. The International Convention of the Rights of the Child (United Nations in Convention on the rights of the child, office of the high commissioner, United Nations, Geneva, 1989) and the convention on the rights of the person with disability (United Nations in Convention on the rights of person's with disabilities and optional protocol, office of the high commissioner, United Nations, Geneva, 2006) amongst others will be utilised to argue the case for 'inclusive' educational opportunities to be a 'right' of every child on the autistic spectrum. The efficacy of mainstream inclusion is explored, identifying the position that a 'one size fits all' model of education is not appropriate for all children with ASD.

'A disease that makes criminals': encephalitis lethargica (EL) in children, mental deficiency, and the 1927 Mental Deficiency Act.

Encephalitis lethargica (EL) was an epidemic that spread throughout Europe and North America during the 1920s. Although it could affect both children and adults alike, there were a strange series of chronic symptoms that exclusively affected its younger victims: behavioural disorders which could include criminal propensities. In Britain, which had passed the Mental Deficiency Act in 1913, the concept of mental deficiency was well understood when EL appeared. However, EL defied some of the basic precepts of mental deficiency to such an extent that amendments were made to the Mental Deficiency Act in 1927. I examine how clinicians approached the sequelae of EL in children during the 1920s, and how their work and the social problem that these children posed eventually led to changes in the legal definition of mental deficiency. EL serves as an example of how diseases are not only framed by the society they emerge in, but can also help to frame and change existing concepts within that same society.

La simulación en el servicio de urgencias de un hospital general. A propósito de un caso / Malingering in the emergency department of a general hospital. A case report

La simulación consiste en la producción y presentación voluntaria de síntomas físicos o psicológicos falsos o muy exagerados, motivada por incentivos externos, como eludir el servicio militar, evitar el trabajo, obtener una compensación económica, evadir un proceso judicial u obtener drogas. Por su baja frecuencia de presentación en el ámbito asistencial, describimos un caso que se ajusta al cuadro en el servicio de urgencias de nuestro centro (AU)

Malingerers intentionally and purposefully feign illness to achieve some recognizable goal. They may wish to get drugs, win a lawsuit, get financial compensation or avoid work or military service. Due to its low frequency of occurrence in the healthcare field, we describe a case that fits the picture in the emergency department of our hospital (AU)

¿Hándicap mental, intelectual o cognitivo? Hacia una terminología y una evaluación funcional en sintonía con las ciencias cognitivas / No disponible

Las publicaciones recientes de la American Association on Intellectual and Developmental Disabilities y de la American Psychiatrical Association siguen empleando una nomenclatura obsoleta cuando se refieren a las personas que poseen un hándicap cognitivo. Las etiquetas lexicales y las nociones que bajo ellas subyacen llevan a una concepción psicométrica desfasada del funcionamiento cognitivo. La interpretación evaluativa da prioridad a las estadísticas de grupo en lugar de procurar caracterizar los individuos en su diversidad con sus relativas fortalezas y debilidades. En este artículo, proponemos y justificamos un enfoque alternativo más en sintonía con las ciencia cognitiva contemporánea

The recent publications of the American Association on Intellectual and Developmental Disabilities and of the American Psychiatric Association persist in proposing obsolete lexical labelling regarding the persons with a cognitive handicap. These labels and the underlying notions mainly relate to an outdated conception of cognitive functioning. Furthermore, they attribute unjustified priority to group comparisons over personalized characterizations that would recognize the individual subject in all its diversity with its particular strengths and weaknesses. We herein propose an alternative approach more in line with contemporary cognitive science

A quantitative assessment of educational integration of students with Down syndrome in the Netherlands.

BACKGROUND: In the Netherlands, as in many other countries, there are indications of an inclusive school policy for children with Down syndrome. However, there is a lack of studies that evaluate to what extent this policy has actually succeeded in supporting the mainstreaming of these students. METHOD: For the period 1984-2011, the number of children with Down syndrome entering regular education and the percentage of children still in regular education after 1-7 years were estimated on basis of samples from the database of the Dutch Down Syndrome Foundation. These estimations were combined with historical demographic data on the total number of children with Down syndrome in primary school age. Validity of the model was examined by comparison of the model-based estimations of numbers and percentages in regular education with relevant available empirical data from the Dutch Ministry of Education and from Dutch special schools. RESULTS: The percentage of all children with Down syndrome in the age range 4-13 in regular primary education has risen from 1% or 2% (at the very most about 20 children) in 1986-1987, to 10% (about 140 children) in 1991-1992, to 25% (about 400) in 1996-1997, to 35% (about 650) in 2001-2002 and to 37% (about 800) since 2005-2006. The proportional increase stopped in recent years. CONCLUSION: During the 1980s and 1990s, clearly more and more children with Down syndrome were in regular education, being supported by the then existing ad hoc regulations aimed at providing extra support in regular education. In the Netherlands, in 2003, these temporary regulations were transformed into structural legislation for children with disabilities. With regard to the mainstreaming of students with Down syndrome, the 2003 legislation has consolidated the situation. However, as percentages in regular education stayed fairly constant after 2000, it has failed to boost the mainstreaming of children with Down syndrome. The results of this study are discussed in the context of national and international legislation and educational policy.

Beyond terminology: the policy impact of a grassroots movement.

This article discusses the history of the grassroots movement led by self-advocates and their families to replace the stigmatizing term "mental retardation" with "intellectual disability" in federal statute. It also describes recent and pending changes in federal regulations and policy to adopt the new terminology for Social Security and Medicaid.

Providing sex education to persons with learning disabilities in the era of HIV/AIDS: tensions between discourses of human rights and restriction.

Research suggests that disabled people may be at increased risk for HIV infection, yet are excluded from HIV prevention campaigns. Historically people with learning disabilities have been constructed as either being asexual or sexually uninhibited, and sex education considered to be unnecessary or potentially harmful. This article reports on findings of a qualitative study exploring the challenges expressed by participants who provide sex education for persons with learning disabilities, revealing a tension between a human rights discourse and a discourse of restriction of sexual behaviours. Sex education, in the context of HIV/AIDS, may potentially construct sex as dangerous, echoing past constructions of disabled people's sexuality as problematic.

Pushing the employment agenda: case study research of high performing States in integrated employment.

Organizational variables, including policies, practices, collaborations, and funding mechanisms resulting in high performance in integrated employment, were described through case study research in 3 states. Findings address how contextual factors, system-level strategies, and goals of the system are related as well as how they sustain systems change. Strategies such as flexibility in funding and practices; communication of values through data, rewards, and funding incentives; and innovation diffusion through relationships and training were most successful when they were embedded within the context of a solid values base, a network of dedicated stakeholders, and clarity about systemic goals. Implications are presented with respect to state systems, community rehabilitation providers as partners in planning, and future leadership in the field.

Importancia del retraso mental en la conducta delictiva / Delinquent behavior and mental deficiency

Se estudiaron 82 retrasados mentales que, en concepto de acusados, fueron evaluados en la Comisión Provincial de Psiquiatría forense de Pinar del Río en el año 2003, presumiblemente autores de algún delito de la competencia de tribunales municipales y provinciales. Se realizó una investigación descriptiva y retrospectiva y por el método clínico-epidemiológico se diagnosticó el grado de retraso mental (RM), así como el deterioro del comportamiento social; se observó que la actividad delictiva fue más frecuente en aquellos con RM ligero. Las principales figuras delictivas fueron contra los derechos patrimoniales (robo con fuerza y hurto), delitos contra la economía (HSIGM) y delitos sexuales (abusos lascivos). Más de las tres quintas partes tenían antecedentes penales lo que evidencia un deterioro de sus patrones éticos. Las tres cuartas partes recibieron educación especializada y se explica la relación existente entre la criminalidad y la comorbilidad asociada donde se destaca el alcohol(AU)