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Web Posted on: August 4, 1998


COMPUTERS HELP CHILDREN WITH MENTAL RETARDATION

Stefano Vicari
Edoardo Chiodi
Alessandro Cecconi
Giancarlo Ruscitti

I.R.C.C.S. Ospedale Pediatrico
Bambino Ges&ugrave
Lungomare G. Marconi
I-00058 Santa Marinella
Rome, Italy
tel: +39.766.5244258
fax: +39.766.5244259
e-mail: vicari@obg-irccs.rm.it

 

1. Summary

Mental Retardation is characterised principally by cognitive deficits in relation to the normal population. In our Institute a centre on the development of cognitive functions in children with MR is working. The principle aims of our department are: to evaluate and describe the neuopsychological abilities of children with MR, to provide educational and rehabilitative supports to improve cognitive development of these children. To these aims specific computer supports are utilised.


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2. Introduction

Mental Retardation (MR) represents a widespread and heterogeneous condition, characterised principally by cognitive deficits in relation to the normal population (Zeaman & House, 1963; Ellis, 1963; Milgram, 1982; Anderson, 1986). The nature of this deficit is yet to be described and there is a great deal of debate as to whether persons with MR display slower development of cognitive abilities (Zigler, 1969; Zigler & Balla, 1982) or, alternatively, develop their cognitive system as the result of different processes, one or more of which may be deficient (Ellis, 1969; Ellis & Cavalier, 1982). More recently Detterman (1987) proposed a possible solution to this historical controversy: MR should be characterised by a deficit of a complex cognitive system of independent but interrelated parts. So, the different theories on MR -delayed versus deviant development- were interpreted as a function of the measurements used (molar versus molecular). Vicari et al. (1992), describing different patterns of cognitive abilities in a neuropsychological test battery from persons with the same IQ and Chronological Age, confirmed Detterman's point of view. According to this conceptual framework, MR would arise not from a homogeneous involvement of mental functions, but rather from a deficit of one or more cognitive abilities. Thus, children with MR of similar significance may show different cognitive profiles. Neuropsychological evaluation may highlight individual differences providing important suggestions for educational and rehabilitative programs.

In our Institute a centre on the development and ageing of cognitive functions in persons with MR is working. The principle aims of our department are: to evaluate and describe the neuopsychological abilities of subjects with MR, to provide educational and rehabilitative supports to improve cognitive development of these persons. It is important to note that life expectancy in these persons is now completely different in comparison with that of the past two decades and, consequently, ageing is now one of the most important perspectives in research focused on developmental disabilities. Longitudinal follow up studies are crucial and these necessitate the collection of many data for this special population. Informatic support for clinical records may be a very important instrument to allow us to follow persons with developmental disabilities from childhood to adulthood.


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3. Presentation body

To these aims specific computer supports are utilised. Namely, we have developed a system that permits us to collect data (medical history, symptoms and diagnosis, according to the criteria of the American Association on Mental Retardation), manage the data in order to undertake statistical analysis and to control the population we are following. Thus, our informatic support is an "Oriented Problems" clinical record, including codes and descriptive, space to a more complete compilation of data on anamnesis (familiar, obstetric, pregnancy and prenatal), clinical examinations as results of different types of instrumental evaluation. It's possible to associate to the patient clinical data, "Images" taken from the external environment (X-ray, CT scan, MNR), from video tape recorder and from scanner. In this way, we obtain a complete picture of a single person and it is also possible to compare each person with a group of patients using different codes. In our clinic, we are following with this system a group of 7000 persons. Informatic support is necessary to monitor so large a follow up study.

The informatic system is based up on a LAN (Token Ring) with a local server and seven clients. Connected to two of the clients are a camera for images capture and two colour TV monitors (PAL system) which act as second workstation. In a general environment where physicians work in team is very important to have a real time information sharing. Originally based on the IBM LAN manager the network has been recently updated to the Novel Netware software.

In this way there is no need to let paper circulate inside the department.

Many functions are available for the professionals.
The most peculiar are:

a) Schedules. The possibility to define the workload of the department in terms of consultancies, clinical examinations, etc. and consequently fix the details for future incoming of the patients.

b) Statistical Analysis. Each field of the clinical record can be used as search field. Further, using logic operators, up to ten fields can be linked together for specific analysis of the data base.

c) Data processing. A function is available to extract data from the data base in a ASCII format. The reason is to export data in whatever different statistical system.

d) Windowing. The procedure allows the end user to define his own software to manage particular areas of the clinical records. There is no need to change the software. You have only to add the .exe statement in the parameters table and the new software will be automatically activated when required.


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4. Conclusion

In the last three years our system was developed and it allow us to record clinical information about the subjects we are following in our department. In this time we have verified that our system help us in our clinical work, improving the quality of assistance.


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Literature:

Anderson M (1986). Annotation understanding the cognitive deficit in mental retardation. Journal of Child Psychology and Psychiatry 27, 297-306.

Detterman (1987). Theoretical notions of intelligence and mental retardation. American Journal of Mental Deficincy 92, 2-11.

Ellis NR (1963). The stimulus trace and behavioral inadequacy. In: Handbook of Mental Deficiency, N.R. Ellis (ed.), pp.134-58. McGraw-Hill, New York, NY.

Ellis NR (1969). A behavioural research strategy in mental retardation: defence and critique. American Journal of Mental Deficincy 73, 557-67.

Ellis NR & Cavalier AR (1982). Research perspectives in Mental Retardation. In: Mental Retardation: The Development-Difference Controversy, E. Zigler & D. Balla (eds), pp.121-52. Lawrence Erlbaum Associates, Hillsdale, NJ

Milgram N.A. (1982) The rational and irrational in Zigler's motivational approach to mental retardation. In: Mental Retardation: The developmental Difference Controversy, E. Zigler & D. Balla (Eds.), pp. 155-62. Lawrence Erlbaum Associates, Hillsdale, NJ.

Vicari S, Albertini G, Caltagirone C (1992). Cognitive profiles in adolescents with mental retardation. Journal of Intellectual Disability Research, 36, 415-423.

Zeaman D. & House B. (1963) The role of attention in retarded discrimination learning. In: Handbook of Mental Deficiency, N.R. Ellis (Ed.), pp. 159-223. McGraw-Hill, New York, N.Y.

Zigler E. (1969) Developmental versus difference theories of mental retardation and the problem of motivation. American Journal of Mental Deficincy 73, 536-56.

Zigler E. & Balla D. (1982) Introduction: the developmental approach to mental retardation. In: Mental Retardation: The developmental Difference Controversy, E. Zigler & D. Balla (Eds.), pp. 3-8. Lawrence Erlbaum Associates, Hillsdale, NJ.



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