The challenge of pain assessment in children with cognitive disabilities: Features and clinical applicability of different observational tools

Children with cognitive disabilities are at greater risk of experiencing pain. It has been shown that this paediatric population often receive inadequate pain management. Pain may be very difficult to assess, especially in a defined subgroup with non‐communicating intellectual disability or severe cognitive disability. Accordingly, several observational pain assessment tools have been proposed to overcome this issue. Due to the absence of an ideal measurement tool, accurate pain assessment requires, after a case‐by‐case analysis, selecting the more appropriate tool or a variety of combined instruments. The aim of this work is to provide a comprehensive review of the pain assessment tools commonly used in cognitively impaired children. Critical discussion on features and clinical applicability may suggest how to overcome this difficult challenge. Furthermore, this review will help further research aiming to design new instruments and to improve already‐in‐use tools.     

Positive aspects of the coping of mothers of adolescent children with developmental disability in the Bedouin community in Israel

This research examines the positive aspects of coping experienced by 270 mothers of adolescent children with and without a developmental disability in the Bedouin community. The mothers completed the Sociodemographic Data Questionnaire, the Grandparents Functional Support Assessment, the Gratitude Questionnaire, and the Posttraumatic Growth Inventory. Mothers of adolescent children with developmental disability reported higher levels of social support, gratitude, and personal growth than did mothers of adolescent children without developmental disability. Additionally, mothers demonstrated a higher level of gratitude toward their spouse's parents. Positive correlation was also found between gratitude and personal growth and between gratitude and support from the husband's parents. The findings highlight the important need to develop awareness and culturally appropriate intervention programs based on these positive aspects, to enhance these mothers’ coping abilities.     

Developmental needs and early childhood education: evolutionary,my dear Watson

Examining the processes of natural selection, described by Darwin in The Origin of Species, casts light on our own species’ fundamental needs and on the far greater role that early childhood educators can play in their fulfillment. The second section of this paper analyzes how our fundamental needs emerge in a sequence underpinned by the processes of natural selection (goodness‐of‐fit, variation and replication), are thus developmental in a new sense and are fulfilled only as organisms interact with their immediate environment. The subsequent section presents a model of how, in accordance with natural selection, adults can practise collaborative behaviors that facilitate this developmental sequence throughout life. The fourth section shows how early childhood educators who practise this model in interaction with their immediate environment (which includes parents) help to fulfill the fundamental needs and increase the internal resources of all participants—themselves, parents and children. Substantiating evidence comes from the author’s studies.     

Tackling stigma associated with intellectual disability among the general public: A study of two indirect contact interventions

Although evidence abounds that people with intellectual disabilities are exposed to stigma and discrimination, few interventions have attempted to tackle stigma among the general public. This study set out to assess the impact of two brief indirect contact interventions on lay people's inclusion attitudes, social distance and positive behavioral intentions, and to explore emotional reactions towards the two interventions. 925 participants completed the first online survey. Participants were randomized to watch either a 10 min film based on intergroup contact theory, or a film based on a protest message. In total, 403 participants completed the follow-up survey at one month. Both interventions were effective at changing inclusion attitudes and social distance in the short term and these effects were partially maintained at one month. The protest based intervention had a greater effect compared to the contact one on aspects of inclusion attitudes and evoked stronger emotional reactions. Despite small effect sizes, brief indirect contact interventions may have a potential role in tackling public stigma associated with intellectual disability but their effects on behavioral intentions are questionable.     

IADL Ability Measured with the AMPS: Relation to two Classification Systems of Mental Retardation

The purpose of this study was to examine the relationship between the Assessment of Motor and Process Skills (AMPS) and two types of assessment of level of mental retardation. The subjects were 22 adults from the United States and 39 adults from Sweden, all diagnosed with mental retardation. The subjects in each group were divided into three subgroups according to their level of mental retardation. The level of mental retardation was determined according to established criteria used in each country. They were then assessed using the AMPS to evaluate motor and process (organizational and adaptive) skills necessary for competent IADL task performance. The results showed that different methods of determining the level of mental retardation showed patterns similar to motor and process skills. The correlations were strongest between the Swedish method of assessing level of mental retardation and the AMPS. The correlations were stronger between level of mental retardation and process skills in both the Swedish and US groups. The results indicate a relationship between level of mental retardation and IADL ability, despite differences in assessments of level of mental retardation. The study recommends the use of the AMPS as a valid and sensitive instrument of IADL ability in the development of intervention strategies in occupational therapy for persons with mental retardation. Further studies with the AMPS are suggested in order to evaluate IADL skills in this population.     

Perinatal toxicity and carcinogenicity studies of styrene-acrylonitrile trimer,a ground water contaminant

Styrene acrylonitrile (SAN) trimer is a by-product in the production of acrylonitrile styrene plastics. Following a report of a childhood cancer cluster in the Toms River section of Dover Township, New Jersey, SAN Trimer was identified as one of the groundwater contaminants at Reich Farm Superfund site in the township. The contaminants from the Reich Farm site's ground water plume impacted two wells at the Parkway well field. The National Toxicology Program (NTP) studied the toxicity and carcinogenicity of SAN Trimer in rats exposed during their perinatal developmental period and adulthood. The chronic toxicity and carcinogenicity studies in F344/N rats were preceded by 7- and 18-week perinatal toxicity studies to determine the exposure concentrations for the 2-year studies. Subsequently, Fisher 344 pregnant dams were exposed to SAN Trimer containing diet at 400, 800, or 1600 ppm concentrations during gestation, nursing and weaning periods of offspring followed by two year of adult exposures to both male and female pups. There was no statistically significant evidence of carcinogenic activity following SAN-Trimer exposure; however, rare neoplasms in the brain and spinal cord were observed in males and to lesser extent in female rats. These incidences were considered within the range of historical background in the animal model used in the current studies. Therefore, the presence of a few rarely occurring CNS tumors in the treated groups were not judged to be associated with the SAN Trimer exposure. The major finding was a dose-related peripheral neuropathy associated with the sciatic nerves in females and spinal nerve roots in males and females thereby suggesting that SAN Trimer is potentially a nervous system toxicant.