This study examines the memory functioning of 25 children who sustained a traumatic brain injury (TBI) and who had prior learning problems, 48 children with TBI who did not have prior learning problems, and 23 noninjured controls. The children with TBI and prior learning problems displayed significantly worse memory abilities than both the control participants and the children with TBI and no prior learning problems. They differed significantly from these 2 groups on measures of general memory, verbal memory, sound-symbol learning, and attention. The results suggest that children with premorbid learning problems who sustain TBI have less cognitive reserve and a lower threshold for the expression of cognitive impairments in areas that reflect preexisting learning and language problems, compared to children without premorbid learning problems.
In autism, glutamate may be increased or its receptors up-regulated as part of an excitotoxic process that damages neural networks and subsequently contributes to behavioral and cognitive deficits seen in the disorder. This was a double-blind, placebo-controlled, parallel group study of lamotrigine, an agent that modulates glutamate release. Twenty-eight children (27 boys) ages 3 to 11 years (M = 5.8) with a primary diagnosis of autistic disorder received either placebo or lamotrigine twice daily. In children on lamotrigine, the drug was titrated upward over 8 weeks to reach a mean maintenance dose of 5.0 mg/kg per day. This dose was then maintained for 4 weeks. Following maintenance evaluations, the drug was tapered down over 2 weeks. The trial ended with a 4-week drug-free period. Outcome measures included improvements in severity and behavioral features of autistic disorder (stereotypies, lethargy, irritability, hyperactivity, emotional reciprocity, sharing pleasures) and improvements in language and communication, socialization, and daily living skills noted after 12 weeks (the end of a 4-week maintenance phase). We did not find any significant differences in improvements between lamotrigine or placebo groups on the Autism Behavior Checklist, the Aberrant Behavior Checklist, the Vineland Adaptive Behavior scales, the PL-ADOS, or the CARS. Parent rating scales showed marked improvements, presumably due to expectations of benefits.
The published intervention research on the remediation of challenging behavior of persons with developmental disabilities was reviewed. A total of 179 studies over a recent 5-year period (1 988 through 1992) were reviewed for adherence to certain standards of practice, including the use of functional assessment, function-treatment matching, level of intervention intrusiveness, monitoring of collateral behaviors, follow-up, and generalization. Results are presented with regard to each standard of practice and the relations among practices. The results largely support meaningful improvements in the state of the intervention literature since the time of several previous reviews. Areas of progress are noted and continuing dejcits are discussed.DESCRIPTORS: applied behavior analysis, behavior management, challenging behavior, collateral effects, developmental disabilities, functional assessment, nonaversive procedures, punishment, research, standards of practice Certain methodological practices consistently have been described as being important in the implementation and evaluation of behavioral interventions. Foremost among these practices is the performance of a This research was funded by a grant to the first author from the West Virginia Developmental Disabilities Planning Council, which is gratefully acknowledged. Portions of this manuscript were presented at the 1994 (May) convention of the Association for Behavior Analysis, Atlanta, GA. A bibliography of the articles reviewed here is available from the Educational Resources Information Center (ERIC; Scotti et al., 1995). The authors would like to acknowledge the assistance of Andrea Magruda, and the helpful comments of the reviewers.Correspondence should be directed to
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