No abstract

The results of the present study show that individuals with PIMD show their reactions to stimuli only slightly, so that 'waves' might reflect the optimal alertness pattern for learning and development. Consequently, it is especially important that direct support persons follow and stimulate these individual 'waves' in the activities they provide to their clients.

This article provides a review of contemporary instruments for the developmental assessment of children aged 0–4 years and their applicability for children with special needs. The issues involved in the developmental assessment of children with special needs are discussed, and, on the basis of these issues, various instruments are then evaluated.Method:A literature search was carried out for articles about or using standardized developmental assessment instruments for children aged 0–4 years.Results:Eighteen instruments were found, of which 2 were nonverbal and 2 were designed for motor-impaired children. The instruments varied in terms of their suitability for children with special needs.Conclusion:The range of instruments is limited, especially for children younger than 2 years of age. Instruments for children with motor or hearing/language impairments are available, but their psychometric properties need to be researched and improved. For children with a visual impairment, no appropriate instrument is currently available.

Adults with congenital deafblindness and an intellectual disability are at high risk for exposure to chronic and severe stress. Sensory deprivation, separations from primary caregivers, and difficulties in communication, from birth on, make daily life stressful for them. Chronic and high stress can lead to deviancies in the cortisol curve. This, in turn, can have negative effects on mental and physical health. Nothing is known yet about the cortisol curve of adults with congenital deafblindness and an intellectual disability, but our hypothesis is that it will be deviant.In this study, the cortisol curve of six participants with congenital deafblindness was compared to the curve of 40 typical controls. Remarkably, in spite of all past and present stress factors, the cortisol curve of the participants was rather normal. Possible explanations for this finding are discussed, amongst others individual differences in experiencing stress. Implications for further research are discussed.

While alertness is widely acknowledged as one of the most important preconditions for learning and development, individuals with profound intellectual and multiple disabilities (PIMD) experience a wide range of difficulties in the contact with their environment. The aim of the present study was to identify aspects of stimulation situations that influence the alertness levels of individuals in the target population.Based on video recordings of 24 participants, alertness levels and environmental conditions were scored. Descriptive analyses and multilevel logistic regression analysis were used to identify the aspects of the stimulation situation that were related to occurrence of alertness.The results show that visual stimuli (optimally in combination with auditory stimuli) produced the highest alertness levels. Furthermore, the effects of stimuli outweighed the effect of time. The role of direct support persons is thus especially important in alertness stimulation of individuals with PIMD.