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INTRODUCTION: The major research data and findings related to aging among persons with developmental disabilities are discussed. Topics addressed include prevalence and mortality rates, as well as the effects of aging on the sensory systems, the neuromusculoskeletal system and the cardiopulmonary system. The discussion also focuses on the clinical implications of these changes among aging individuals with developmental disabilities. CONCLUSION: Although the individual needs of persons with developmental disabilities vary greatly, knowledge of the effects of aging on this group of individuals can facilitate more effective healthcare by physical therapists for all adults with developmental disabilities.

INTRODUÇÃO: Os dados de pesquisa mais importantes e seus resultados relacionados ao envelhecimento de pessoas com incapacidades prévias são aqui discutidos. Os tópicos abordados incluem a prevalência e os índices de mortalidade, bem como os efeitos do envelhecimento sobre os sistemas sensitivos, músculo-esquelético e cardiopulmonar. A discussão também aborda as implicações clínicas destas mudanças no indivíduo que envelhece sendo portador de uma incapacidade prévia. CONCLUSÃO: Embora as necessidades individuais de pessoas com incapacidades variem muito, o conhecimento dos efeitos do envelhecimento neste grupo de indivíduos pode promover o uso de cuidados de saúde mais eficientes pelos fisioterapeutas que cuidam de adultos com incapacidades prévias.

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BACKGROUND AND PURPOSE: The physical therapy profession, through its published educational accreditation standards and its normative model of professional education, has addressed the importance of educating physical therapist students in the basic principles and application of research. The purpose of this study was to conduct a longitudinal study of students relative to (1) their perception of knowledge with respect to research, (2) their perception of what source should be used (evidence-based practice or traditional protocols) for clinical decision making, and (3) their perception of what should be used in a clinical setting for patient management. SUBJECTS: Thirty-six students during the final year of their professional program from a sample of 115 physical therapist students who requested 2 consecutive physical therapist classes completed the entire sequence of pretest and posttest survey administrations. Seventy-nine students did not complete the entire sequence. METHODS: A 10-item 5-point Likert-type questionnaire was designed by the authors to probe the students' attitudes and perceptions about research, their level of comfort and confidence in reading and applying research findings published in the literature, and their personal habits regarding reading the professional literature. An expert panel consisting of internal and external reviewers was used for construction of the questionnaire. The questionnaire was completed by the students immediately preceding their research methods course, immediately after the completion of that course, and following the second research course, which included statistics and development of a research proposal. The subjects also completed the questionnaire after 1 year of physical therapy practice. Friedman's analysis of variance was used as an omnibus test to detect differences across time. In addition, a follow-up analysis using the Wilcoxon signed-rank procedure to examine differences between baseline data and data obtained during each follow-up was done for all items to determine whether a difference occurred at a time other than at the final posttest survey administration. RESULTS: The students showed differences on 5 of the 10 items on the questionnaire during the study. DISCUSSION AND CONCLUSION: These items related to reading peer-reviewed professional journals, critically reading professional literature, relevance and importance of evidence-based clinical practice, and level of comfort with knowledge in research.

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The major research data and findings related to aging among persons with developmental disabilities are discussed. Differences between the aging processes noted in the general population and individuals who have developmental disabilities are highlighted. Topics addressed include prevalence of developmental disabilities and mortality rates for individuals with developmental disabilities. The effects of aging on the senses, the neuromusculoskeletal system, and the cardiopulmonary system are presented along with the clinical implications of these changes in individuals with developmental disabilities who are aging.

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BACKGROUND AND PURPOSE: The long-term motor, cognitive, and adaptive functioning of a sample of adolescents with Down syndrome who experienced an early intervention program was examined in this descriptive study. SUBJECTS: Ten children with Down syndrome (7 girls, 3 boys) who had participated in an early intervention program constituted the early intervention (EI) group. An age-matched group of children with Down syndrome (6 girls, 4 boys) who had not experienced an early intervention program served as a comparison group. METHODS: The EI group's motor functioning was compared with that of a normative sample used in the development of the Bruininks-Oseretsky Test of Motor Proficiency. The cognitive and adaptive skills of the EI group were compared with those of the comparison group. The children were assessed using the Stanford-Binet Intelligence Scale, the Vineland Social Maturity Scale, and the Bruininks-Oseretsky Test of Motor Proficiency. RESULTS: The EI group subjects fell below their chronological age levels in gross and fine motor skills; however, their mean gross motor skill levels exceeded their mean fine motor skill levels. The specific deficits in gross motor and fine motor skills, which were documented in a previous follow-up study on the same sample, continued to be areas of deficits (visual motor coordination, running speed, balance, and reaction time). The EI group subjects had significantly higher scores on measures of intellectual and adaptive functioning than did the children in the comparison group. The EI group subjects did not show the decline typically seen with age in adaptive functioning in individuals with Down syndrome. CONCLUSION AND DISCUSSION: Because of the design limitations, the differences between the groups should be interpreted with caution.

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The purposes of this article are 1) to compare the similarities and differences between norm-referenced and criterion-referenced tests and 2) to summarize how each should be used in the assessment of developmental performance in children. Specific developmental assessments, the populations they address, and the information they provide are described briefly. The need for additional criterion-referenced tests in physical therapy is discussed, and an example of how task analysis can be applied to movement or motor skills in the development of a criterion-referenced test is provided. Physical therapists can enhance the credibility of their assessments by appropriate use of norm-referenced and criterion-referenced tests.

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The purpose of this study was to examine the gross motor and fine motor abilities of children with mental retardation using the Bruininks Oseretsky Test of Motor Proficiency. We compared the motor skills of 24 mentally retarded children, 12 with Down syndrome and 12 without Down syndrome. The children ranged in chronological age from 7.6 years to 11 years and were of comparable mental age. Within each group, there were no significant sex differences nor were there differences between the two groups in motor performance for the male subjects. The female subjects with Down syndrome, however, scored significantly lower than female subjects without Down syndrome on running speed, strength, visual motor ability, speed, and dexterity and fine motor composite scores. As a group, the children with Down syndrome scored significantly lower than the children without Down syndrome in the areas of running speed, balance, strength, and visual motor control. The gross motor and fine motor skill composite scores were also significantly lower for the children with Down syndrome than for the children without Down syndrome.

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The purpose of this paper is to provide an overview of assessment techniques used by physical therapists in the assessment of the neonate. An additional purpose is to provide a review of prenatal and postnatal development in the areas of muscle tone, range of motion, somatosensory skills, and reflex development. The role of the physical therapist on the neonatal team is discussed relating to the types of assessments physical therapists might use in evaluating the neonate. General considerations for assessment are provided, and specific areas including physical examination, behavioral assessment, evaluation of muscle tone, reflex assessment, oral motor evaluation, and sensory systems assessment are discussed. Physical therapy for the neonate has been considered as a specialty area of pediatrics. Physical therapists, however, are being asked to function in neonatal units in hospitals as a part of their practice in the general hospital setting. This article provides information for the inexperienced clinician who is interested in working with the neonate and for the experienced clinician.

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The long-term effects of an early intervention program (EIP) on the motor, cognitive, and adaptive functioning of children with Down syndrome were examined. The cognitive and adaptive functioning was compared with a group of children with Down syndrome who had not participated in an EIP. The motor functioning was compared with the normative sample used in the development of the Bruininks Oseretsky Test of Motor Proficiency. The children were assessed using the Stanford-Binet Intelligence Scale, the Vineland Social Maturity Scale, and either the Bruininks Oseretsky Test of Motor Proficiency or the Gesell Schedules of Motor Development. Results revealed that the children in the EIP earned significantly higher scores (p less than .0005, p less than .05) on the measures of intellectual and adaptive functioning than did the children of comparable age who did not participate in an EIP. The children in the EIP did not show the decline typically seen with age in intellectual and adaptive functioning in children with Down syndrome. The children in the EIP were below expected age levels in gross (77.7%) and fine motor skills (58.3%) but had mean fine motor skill levels that exceeded their mean gross motor skill levels (50%). Based on the results, EIPs for children with Down syndrome appear to provide a foundation for subsequent learning and development.

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The purpose of this study was to determine the relationship between the asymmetrical tonic neck reflex (ATNR) and the occurrence of scoliosis in healthy children. One hundred eighty-four children, between the ages of 10 years, 5 months to 13 years, 10 months, who attended a rural elementary school were selected for the study. The quadruped reflex-inhibiting posture was used to assess the ATNR. A standard orthopedic screening tool was used for assessment of scoliosis. The occurrence of the ATNR in children tended to increase the rate of referral for further testing for scoliosis. In those children who were assessed for scoliosis using roentgenograms and who had a positive ATNR, a relationship occurred between the convex side of the curvature and the side of the ATNR. Results did not show significant differences in the occurrence of the ATNR or scoliosis in regard to sex. Based on the results of this study, the addition of the ATNR testing to scoliosis screening may prove beneficial in the early identification of scoliosis.

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The purpose of the study was to investigate the occurrence of lateral dominance problems in a sample of children with learning disabilities. Ninety-one children (62 boys, 29 girls) who attended a school for children with learning disabilities were selected for the study. The Harris tests of lateral dominance were administered individually, and the children were rated as having right, left, or mixed dominance for hand, eye, and foot. When compared with normative data on dominance in children, the results showed that the occurrence of mixed hand dominance was no more frequent, the occurrence of mixed eye dominance was less frequent, and the occurrence of mixed foot dominance was more frequent in the children with learning disabilities. Results also showed that the occurrence of mixed and crossed eye-hand dominance was significantly different in children with learning disabilities when compared with children without learning disabilities. However, the occurrence of mixed eye-hand dominance was found to be significantly greater in children without learning disabilities than in learning disabled children. Age and sex were not found to affect the occurrence of lateral dominance problems in children with learning disabilities.

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Recent court decisions are currently generating the need for the development of a more humane, school-based system of educational options for severely and profoundly handicapped children. This natural commitment, which includes provisions for various ancillary services, has major implications for the profession of physical therapy. This paper includes the problems, issues, and trends related to the development of public school physical therapy programs and presents some guidelines and suggestions which might be helpful in the implementation of such programs.

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