Education Articles

A neurodevelopmental disorder (NDD) is defined as a precise genetic or acquired biological brain disorder or condition that is responsible for childhood-onset brain dysfunction. If a neurodevelopmental disorder is severe enough, it may cause a “developmental disability” e.g. mental retardation, cerebral palsy, epilepsy, or autism.

This issue of R&R explores the role of research in the lives of people with disabilities. Taylor Spencer offers four potential benefits of such efforts, and the discussion warrants serious deliberation despite the complex and controversial nature of the subject. Considering we now know—medically speaking—that children are not just little adults, that women are not like men, and that older people are not like middle-aged people, it is time to recognize that people with disabilities may not be like their age- and gender-matched peers.

In this issue of the “Reviews and Reports”, Dr. Shobin discusses the risk/benefit analysis that should be applied to the decision of whether annual PAP and pelvic exams are appropriate for all individuals with intellectual disabilities. This is a difficult topic as contending issues of discomfort and trauma of the exam must be balanced against general population recommendations and personalized care and, frequently, an unreliable sexual history.

In this issue of the Reviews & Reports, Dr. Kouris reports on a neurodevelopmental disorder known as “Toxic Brain Injury.” Dr Kouris discusses several toxins whichwhen exposed to in childhood can lead to childhood-onset brain dysfunction. Examples include lead, mercury, and polychlorinated biphenyls (PCB’s). Other important examples include alcohol, cocaine, and tobacco smoke. Regarding the latter, it is not generally appreciated that there is mounting evidence that fetal exposure to maternal tobacco smoke may contribute to mental retardation, cerebral palsy, epilepsy and autism.

In this issue of the “Reviews and Reports,” authors Hood and Dill introduce us to a hidden area of medical/dental care—the patient who is no longer a minor, is clearly incompetent to make medical decisions, but has not been adjudicated incompetent, has no guardian for medical care, but requires immediate, but not emergent care. This very real case also highlights several other issues important to advancing the care of people with neurodevelopmental/intellectual disabilities.

In this issue of the AADMD Reviews & Reports, Dr Zelenski addresses the complex problem of destructive/maladaptive impulsive behaviors, which often occur in persons with severe cognitive dysfunction. Those of us who work with this patient population are intimately familiar with the various types of aggressive, self-injurious, or ritualistic-like behaviors that at times seem to “come-on-out-of-the-blue” with no obvious reason. Since it is “behavior,” it makes sense to consult with a psychologist or psychiatrist since “behavior management” is what they do; however, as Dr.

In this issue of the “Reviews and Reports,” Drs. Waldman and Perlman heighten our awareness of the unique challenges presented to individuals living in rural environments and also having a developmental disability. The old expression “out of sight, out of mind” certainly comes into play here. But there is hope; while limited, there are examples of attempts to remedy this situation (see ruralinstitute.umt.edu/). As the authors reveal, a significant disparity exists between numbers requiring care and numbers of trained caregivers available. From these authors comes a “Call to Action."

Effective health care is a partnership between a health care provider and a patient. In the community, patients have significant responsibilities with regard to their care. Responsibilities that are generally considered patient responsibilities in generic primary care practices include: