Attachment in adults with intellectual disabilities: preliminary investigation of the psychometric properties of the manchester attachment scale-third party observational measure.

BACKGROUND: The Manchester Attachment Scale-Third party observational measure (MAST) was developed to assess secure attachment style for adults with intellectual disabilities. The psychometric properties of the MAST were examined. MATERIALS AND METHODS: Professional carers (N = 40) completed the MAST and measures related to the construct of attachment theory [Edward Zigler-Yale Personality Questionnaire (EZPQ), Emotional Rating Scale (ERS) and the Learning Disability Casemix Scale (LDCS)] regarding individuals with an intellectual disability (N = 57). Individuals with an intellectual disability (N = 14) completed the Self-report Assessment of Attachment Security (SRAAS). RESULTS: The MAST was found to have good internal consistency, test-retest reliability and convergent validity. MAST scores were negatively correlated with level of intellectual disability and challenging behaviour (CB) as measured by LDCS. CONCLUSIONS: Support was provided for the reliability and validity of the MAST and a relationship between attachment security, level of intellectual disability and CB. The results of the study and implications of attachment theory for service provision are discussed.

Effect of partial foot anaesthesia on normal gait.

The role of cutaneous sensation during gait is controversial. Hence this double-blind study investigated the effect of partial foot anaesthesia on gait velocity. Twenty healthy female subjects were randomly allocated to treatment or control groups. Velocity was determined from three walking trials over a compliant foam walkway. Eutectic Mixture of Local Anaesthetics (EMLA) or Vitamin E Cream was applied to the undersurface of the feet of subjects in treatment or control groups respectively. All subjects rested in sitting for 60 minutes and gait was reassessed. Mean velocity significantly decreased by 6.06m/min following EMLA, which suggests that cutaneous input is important for gait in less predictable environments, and that loss of cutaneous sensation may contribute to gait deficits.

An investigation into social information processing in young people with Asperger syndrome.

Deficits in social functioning are a core feature of autistic spectrum disorders (ASD), being linked to various cognitive and developmental factors, but there has been little attempt to draw on normative models of social cognition to understand social behaviour in ASD. The current study explored the utility of Crick and Dodge's (1994) information processing model to studying social cognition in ASD, and examined associations between social information processing patterns, theory of mind skills and social functioning. A matched-group design compared young people with Asperger syndrome with typically developing peers, using a social information processing interview previously designed for this purpose. The Asperger syndrome group showed significantly different patterns of information processing at the intent attribution, response generation and response evaluation stages of the information processing model. Theory of mind skills were found to be significantly associated with parental ratings of peer problems in the Asperger syndrome group but not with parental ratings of pro-social behaviour, with only limited evidence of an association between social information processing and measures of theory of mind and social functioning. Overall, the study supports the use of normative social information processing approaches to understanding social functioning in ASD.

Circuit class therapy versus individual physiotherapy sessions during inpatient stroke rehabilitation: a controlled trial.

OBJECTIVE: To compare the effectiveness of circuit class therapy and individual physiotherapy (PT) sessions in improving walking ability and functional balance for people recovering from stroke. DESIGN: Nonrandomized, single-blind controlled trial. SETTING: Medical rehabilitation ward of a rehabilitation hospital. PARTICIPANTS: Sixty-eight persons receiving inpatient rehabilitation after a stroke. INTERVENTIONS: Subjects received group circuit class therapy or individual treatment sessions as the sole method of PT service delivery for the duration of their inpatient stay. MAIN OUTCOME MEASURES: Five-meter walk test (5MWT), two-minute walk test (2MWT), and the Berg Balance Scale (BBS) measured 4 weeks after admission. Secondary outcome measures included the Iowa Level of Assistance Scale, Motor Assessment Scale upper-limb items, and patient satisfaction. Measures were taken on admission and 4 weeks later. RESULTS: Subjects in both groups showed significant improvements between admission and week 4 in all primary outcome measures. There were no significant between group differences in the primary outcome measures at week 4 (5MWT mean difference, .07m/s; 2MWT mean difference, 1.8m; BBS mean difference, 3.9 points). A significantly higher proportion of subjects in the circuit class therapy group were able to walk independently at discharge (P=.01) and were satisfied with the amount of therapy received (P=.007). CONCLUSIONS: Circuit class therapy appeared as effective as individual PT sessions for this sample of subjects receiving inpatient rehabilitation poststroke. Favorable results for circuit classes in terms of increased walking independence and patient satisfaction suggest this model of service delivery warrants further investigation.

Between-days reliability of H-reflexes in human flexor carpi radialis.

OBJECTIVES: To assess between-day reliability of the latency and peak-to-peak amplitude of a technique to elicit the H-reflex and M response of the flexor carpi radialis (FCR) and the ratio of maximum H-reflex and M-response amplitude (Hmax/Mmax). DESIGN: Test-retest reliability study. SETTING: Electrophysiology laboratory at a university. PARTICIPANTS: Fifteen consecutively recruited healthy volunteers (8 men, 7 women; age range, 22-65y). INTERVENTION: Volunteers were tested on 2 separate days at the same time of day for H-reflex and M response by stimulating the median nerve in the cubital fossa in the presence of a standardized voluntary contraction of the FCR muscle. MAIN OUTCOME MEASURES: Onset latencies, peak-to-peak amplitudes, and Hmax/Mmax. RESULTS: Latency measurements of H-reflex and M response showed excellent reliability between days, as did the maximum amplitude of the M response. The maximum amplitudes of the H-reflex and Hmax/Mmax ratio were less reliable but still within acceptable limits. CONCLUSIONS: The H-reflex and M response can be reliably elicited in the FCR. This technique provides a useful clinical tool for diagnostic purposes during the course of neurologic disorders and in preclinical and postclinical intervention studies.