The PAS-ADD-10 is a useful tool for standard psychiatric assessment of people with ID; however, CATEGO codings show low validity and a series of modifications should be considered before this instrument is used extensively in Spain. In this regard, a study on the clinical usefulness of the PAS-ADD-10 in patients with ID and severe mental disorders has been undertaken.
Introducción
Estudios internacionales demuestran que existe un patrón diferenciado de salud y una disparidad en la atención sanitaria entre personas con discapacidad intelectual (DI) y población general.
Objetivo
Obtener datos sobre el estado de salud de las personas con DI y compararlos con datos de población general.
Pacientes y métodos
Se utilizó el conjunto de indicadores de salud P15 en una muestra de 111 sujetos con DI. Los datos de salud encontrados se compararon según el tipo de residencia de los sujetos y se utilizó la Encuesta Nacional de Salud 2006 para comparar estos datos con los de la población general.
Resultados
La muestra con DI presentó 25 veces más casos de epilepsia y el doble de obesidad. Un 20% presentó dolor bucal, y existió una alta presencia de problemas sensoriales, de movilidad y psicosis. Sin embargo, encontramos una baja presencia de patologías como la diabetes, la hipertensión, la osteoartritis y la osteoporosis. También presentaron una menor participación en programas de prevención y promoción de la salud, un mayor número de ingresos hospitalarios y un uso menor de los servicios de urgencia.
Conclusiones
El patrón de salud de las personas con DI difiere del de la población general, y éstas realizan un uso distinto de los servicios sanitarios. Es importante el desarrollo de programas de promoción de salud y de formación profesional específicamente diseñados para la atención de personas con DI, así como la implementación de encuestas de salud que incluyan datos sobre esta población.
The aim of this study was to compare the advantages and disadvantages of different behavioral assessment procedures with the purpose of design a long-term assessment procedure that brings together the benefits observed. The study involved four adults with severe and profound intellectual disabilities and severe behavioral problems. A behavioral assessment has been carried out with Scatter Plot, Antecedent-Behavior-Consequence record sheets and, finally, The Observer XT. We conducted a comprehensive assessment of challenging behavior of each participant, by reviewing bio-psychosocial records, interviewing family and direct caregiver staff, as well as direct observation. A large inter-subject behavior variability and instability of intra-subject behavior were found, raising questions about the election of the period to evaluate. The first evaluation level highlighted information about stability of behavior, the second level stand out the context in which it occurs and the third level detailed the different topographies of each behavioral category. The results suggest the desirability of a continuous assessment by combining these three levels for adjusting to the specific characteristics of behavior. We suggest the need of designing a single behavioral assessment procedure that includes the benefits observed in each of the instruments used.
The present study aims at the functional analysis of behavior problems of a person with profound intellectual disability (ID), in order to design an effective behavioral intervention.An adult with profound ID and autistic traits belonging to a special school for adults (AFANAS-Jerez) was selected for the study. Using a methodology of functional analysis, the participant was observed under different conditions (attention, demand , tangible and alone) for three experimental sessions and three control sessions each one. In the experimental sessions differents environmental conditions were manipulated, presenting or removing different stimuli or situations and evaluating how these manipulations influenced in the behavior of the person. All sessions were collected by videotaping subsequently recorded and analyzed with The Observer XT software, obtaining systematic information concerning the frequency of problem behaviors.The results showed that the behavior problems presented by the participants were sensitive to different experimental conditions. Self-injurious behaviors were more sensitive to self-stimulation, while physical aggressive behaviors were more sensitive to the condition of attention and tangible positive reinforcement. Finally, stereotyped behaviors were more sensitive to positive social reinforcement and tangible social care by automatic reinforcement.In conclusion, the experimental sessions are a practical , simple and rapid procedure to apply, offering clear evidence about the role of problem behaviors, directing towards the design of personalized intervention programs, with The Observer XT useful tool for purposes research in functional analysis of behavior in natural contexts.
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