Environmental Evaluations and Modifications to Support Aging at Home With a Developmental Disability

ABSTRACT

Increasing numbers of people with developmental disabilities are living into old age and are now residing in community-based housing, largely due to the deinstitutionalization movement. The overlay of age-related impairments onto pre-existing, lifelong disabilities puts this population at a magnified risk for premature behavioral limitations and loss of independence. This article describes a demonstration project designed to enable people with developmental disabilities to age in place. Interviews and observational assessments with 45 older adults with developmental disabilities were conducted in their community-based homes to identify potential barriers to aging in place. An Individualized Environmental Intervention Plan was developed for each study participant, recommending ways to solve problems and eliminate potential barriers. Individualized Environmental Intervention Plans were implemented to the extent possible through home modifications and assistive technology. Pre- and post-modification task performance and self-report revealed the positive impact that home modifications and assistive technology can have. The study demonstrates the need for ongoing evaluation and assessment sensitive to the needs of people with developmental disabilities and the unique characteristics of supported living settings.     

Viewing the differential responses of boys and girls in treatment through a feminist lens

Present day knowledge of gender differences challenges clinical social workers to become more sensitive to these distinctions in both the assessment and treatment of children. Clinical material from drawings and from explanations of moral choices gathered in a social work research study is presented. The themes in boys' and girls' responses are analyzed by gender and found to support the thinking of Chodorow (1974) and Gilligan (1979, 1982) that for girls a sense of responsibility comes through relationships of caring, while boys are oriented towards rights and rules. Implications of the findings suggest modifications of treatment programs for young children to better reflect the differential development of boys and girls.     

COULD STABLE MONEY HAVE AVERTED THE GREAT CONTRACTION?

We test the hypothesis that the Great Contraction would have been attenuated had the Federal Reserve not allowed the money stock to decline. We simulate a model that estimates separate relations for output and the price level and assumes that output and price dynamics are not especially sensitive to policy changes. The simulations include a strong and a weak form of Friedman's constant money growth rule. The results support the hypothesis that the Great Contraction would have been mitigated and shortened had the Federal Reserve followed a constant money growth rule.     

Impacts of Home Modifications on Aging-in-Place

The purpose of this study is to analyze the relationship between home modifications and aging-in-place. Using the ENABLE-AGE United Kingdom sample (N = 376), the authors hypothesize that seniors who have modified their housing are likely to have stayed longer in their current housing. There is a positive relationship between home modifications and aging-in-place. The results underscore the importance of supportive environment to prolong living in housing settings.     

GROWTH, WELFARE, AND THE SIZE OF GOVERNMENT

Using an endogenous growth model in which government purchases directly affect aggregate productivity and utility, fiscal policy experiments conducted here indicate that the macroeconomic effects of changes in fiscal policy are at least as sensitive to the mix of spending cuts as they are to the mix of tax cuts. In fact, reducing the size of the government actually reduces growth and welfare freductions in government expenditures are heavily weighted towards reductions in public capital or if the proceeds are not used to reduce capital taxation. In addition, across-the-board spending cuts are not likely to significantly improve growth and welfare. ( JEL E62, 041)     

Problems and Issues in Social Casework,by Scott Briar and Henry Miller. New York,Columbia University Press, 1971. 274 Pages, $9.00. Hardbound

Abstract

The rapid growth and increasing visibility of ethnic and racial groups has vigorously challenged social work to educate students for ethnic-competent practice in cross-cultural settings. This article examines an approach to teaching effective intervention involving ethnic and racial groups and helping students integrate cultural factors and society's concerns into clinical practice. Pedagogical issues and classroom processes of teaching culturally sensitive and competent interpersonal practice are discussed. Implications are drawn for culturally sensitive education and issues are raised for critical examination.     

Healthy Dating: A Mixed-Gender Date Rape Workshop

Abstract

College communities are increasingly being called upon to institute date rape prevention programs. This article describes a mixed-gender workshop sponsored by a university's Program for Rape Education and Prevention that was given to more than 1,400 undergraduate students in more than 80 presentations. In order to guide modifications of the workshop, formative evaluation data collected from 330 male (mean age 20.3 years) and 314 female (mean age 20.5 years) university students were collected. Results were largely positive. Despite the sensitive nature of the topic, only 10.2% of the men and 8.2% of the women reported being uncomfortable discussing date rape in mixed-gender groups. Furthermore, students were virtually unanimous in their agreement that date rape is a topic worthy of a workshop.     

TRADE LIBERALIZATION AND FIRM PRODUCTIVITY: ESTIMATION METHODS MATTER

In this paper, we show that the relationship between trade liberalization and firm productivity is sensitive to the method used to estimate the production function. We estimate the productivity of Colombian manufacturing plants using the methods of Levinsohn and Petrin, Ackerberg et al., and Gandhi et al. and at times come to surprisingly different conclusions about firm productivity growth after the liberalization. Results from a growth decomposition exercise and from a quantile regression model reinforce the dissimilarity of results across methods. (JEL F13, 14, D24, C14)     

Long-run trends in top income shares: The role of income and population growth

This paper studies the sensitivity of long-run trends in top income shares to differences in top-share measures. While the standard measure fixes a share of the population, we define alternatives that allow variation in both incomes and size of the top group based on defining absolute income thresholds. In an application to United States data, we find that top income share trends over the past century vary somewhat depending on the measure used. Allowing top groups to increase in size after 1980 along with overall economic growth results in a larger increase of top income shares. The historical drops before WWII are sensitive to the choice of income deflator: using GDP inflates interwar top income shares but using CPI deflates them. Altogether, these results recommend using complementary approaches to defining top income groups when measuring long-term top income share trends.

     

RACE AND HOME OWNERSHIP: IS DISCRIMINATION DISAPPEARING?

Racial differentials in home ownership rates are examined using data on households in the twenty-four largest metropolitan areas. considerable recent reduction in racial discrimination is indicatd, in contrast to the findings of a previous analysis of the St. Louis housing market. The results are maintained under a number of modifications of the model and estimation technique.     

ACCESSING CHILDREN'S PERCEPTIONS OF THEIR FAMILY: CIRCULAR QUESTIONING REVISITED

Children are sometimes excluded from family therapy because of the lack of techniques for fully incorporating children in family sessions. Circular questioning, a technique developed by the Milan team of family therapists, is modified for use with children of varying developmental levels. Five types of circular questions are presented and modifications of each type are discussed. Each modification is further illustrated with a case study. Practical considerations when conducting circular questioning sessions with children are addressed. These modifications of circular questioning with children facilitate the participation and inclusion of children in family therapy.     

Pathways to Pathological Gambling: Component Analysis of Variables Related to Pathological Gambling

Research examining cognitive perceptions among children has suggested the importance of perceived skill and luck in initiating and maintaining gambling behavior. Using an experimentally manipulated gambling paradigm modifying rates of reinforcement the results suggest, in general, that one can modify these cognitions. More importantly, the results from the gambling task were found to generalize to multiple forms of gambling and were maintained over a relatively short period of time. The modifications of these perceptions appear to be easier for younger children (age 10 vs 12), with differential effects being found for boys and girls. The results are discussed in light of our current prevention initiatives and programs.     

Age‐Related Changes in Prosodic Features of Maternal Speech to Prelingually Deaf Infants with Cochlear Implants

This study investigated prosodic and structural characteristics of infant‐directed speech to hearing‐impaired infants as they gain hearing experience with a cochlear implant over a 12‐month period of time. Mothers were recorded during a play interaction with their HI infants (N = 27, mean age 18.4 months) at 3, 6, and 12 months postimplantation. Two separate control groups of mothers with age‐matched normal‐hearing infants (NH‐AM) (N = 21, mean age 18.1 months) and hearing experience‐matched normal‐hearing infants (NH‐EM) (N = 24, mean age 3.1 months) were recorded at three testing sessions. Mothers produced less exaggerated pitch characteristics, a larger number of syllables per utterance, and faster speaking rate when interacting with NH‐AM as compared to HI infants. Mothers also produced more syllables and demonstrated a trend suggesting faster speaking rate in speech to NH‐EM relative to HI infants. Age‐related modifications included decreased pitch standard deviation and increased number of syllables in speech to NH‐AM infants and increased number of syllables in speech to HI and NH‐EM infants across the 12‐month period. These results suggest that mothers are sensitive to the hearing status of their infants and modify characteristics of infant‐directed speech over time.     

Implementation fidelity in a teacher-led alcohol use prevention curriculum

There is now ample evidence that teachers tend to make substantial modifications to both the prescribed content and methods of the curricula they administer, and that such modifications are likely to attenuate curricula effects. We examine the fidelity with which teachers implement "Protecting You, Protecting Me," an underage alcohol use prevention curriculum. Findings suggest that while teachers attempted to implement most sections of a lesson, the lessons taught were consistently--and often extensively--adapted. We conclude that since teachers are likely to continue to modify lessons, curriculum developers and trainers should enhance their understanding of how prevention curricula are taught under real world conditions, help teachers to reinforce key curriculum concepts, and consider modifying those curricular sections that teachers are adapting with greatest frequency.     

A Descriptive Study of Home Modifications for People with Dementia and Barriers to Implementation

This study describes home environmental features, safety issues, and health-related modifications in a community dwelling sample of 82 elderly people with dementia. Main barriers to the accessibility of the homes were steps, both inside and outside the house. The majority of the caregivers had made home modifications, which pertained mainly to physical limitations. Home modifications to support cognitive deficits were made to a lesser extent. The main barrier to the implementation of home modifications to accommodate the care recipient's memory loss was skepticism about their usefulness. Regarding the removal of physical barriers, financial constraints were most frequently mentioned.     

A Descriptive Study of Home Modifications for People with Dementia and Barriers to Implementation

This study describes home environmental features, safety issues, and health-related modifications in a community dwelling sample of 82 elderly people with dementia. Main barriers to the accessibility of the homes were steps both inside and outside the home. The majority of the caregivers had made home modifications that pertained mainly to physical limitations. Home modifications to support cognitive deficits were made to a lesser extent. The main barrier to the implementation of home modifications to accommodate the care recipient's memory loss was skepticism about their usefulness. Regarding the removal of physical barriers, financial constraints were most frequently mentioned.     

Barriers to returning to work for people with spinal cord injuries: a focus group study

The rate of employment for people with spinal cord injuries is relatively low, especially among Asians. To help individuals with spinal cord injuries return to work or retain employment, rehabilitation professionals must understand the barriers to employment and intervene to reduce or remove them. Hence, a focus group study was administered to 16 people with spinal cord injuries to explore return to work barriers. Various ideas, beliefs, responses, and values at different stages of work resettlement were elicited from both employed and unemployed participants, and then summarized. According to the results, several modifications of existing forms of rehabilitation intervention are necessary, as are further research directions.     

The Lost Letter Technique as a Measure of Community Attitudes Toward a Major Social Issue*

A test of the validity of Milgram's lost letter technique (LLT) to measure community attitudes toward a sensitive social issue about which there are strong emotional feelings was conducted. This was accomplished by comparing the lost letter return rates with the results of a questionnaire study which measured the same attitudes in the same community. The sensitive social issue used in this study was busing to achieve a racial balance. The data from the questionnaire study indicated strong support for busing by blacks and strong opposition to busing by whites. The results of the lost letter technique were significantly different from those of the questionnaire. The LLT found approximately the same attitudes toward busing among both blacks and whites with almost half opposed to busing while just over half supported busing. The ability of the lost letter technique to provide a reliable unobtrusive attitudlnal measure on a sensitive social issue thus appears doubtful.     

STICKY PRICE AND STICKY INFORMATION PRICE‐SETTING MODELS: WHAT IS THE DIFFERENCE?

Using a partial equilibrium framework, Mankiw and Reis show that a sticky information model can generate a lagged and gradual inflation response after a monetary policy shock, whereas a sticky price model cannot. Our study demonstrates that the finding is sensitive to their model's parameterization. To determine a plausible parameterization, we specify a general equilibrium model with sticky information. In that model, we find that inflation peaks only one period after a monetary disturbance. A sensitivity analysis of our results reveals that the inflation peak is delayed by including real rigidities when the monetary policy instrument is money growth, whereas inflation peaks immediately when the policy instrument is the nominal interest rate. ( JEL E31, E32, E52)