It is well known that behavior problems are a salient characteristic of children and adults with mental retardation. That is not to say that all persons with mental retardation experience behavior disorders; how ever, most studies indicate that the incidence of emotional disturbance in this population is four to six times greater than that observed in similar intellectually nonhandicapped children and adults. It is equally well known that the principal form of treatment accorded clients with mental retardation and behavior disorders is pharmacotherapy or the prescrip tion of behavior modifying drugs. Recent studies show that 6 out of every 10 individuals with mental retardation have been prescribed drugs as treatment for disorders of emotion or behavior. Unfortunately, further studies indicate that only one or 2 out of every 10 clients receiving medication are determined to be "responders," such that some thera peutic benefit is derived from their drug treatment. As noted by the title, the single major thrust of this volume is to review approaches to the treatment of behavior disorders in persons with mental retardation from a nondrug perspective. This requires the presentation of a wide range of material on treatment: basic behavior modification programming, cognitive-behavioral strategies, habilitative approaches, counseling and psychotherapy, designing therapeutic living environments, managing medical factors bearing relevance to emotional illness, intervening with families, training special education teachers and direct care staff, and supplying information on the client's rights to obtain treatment in the least restrictive and least intrusive manner.

Children living in poverty are more likely to have mental health problems, and their conditions are more likely to be severe. Of the approximately 1.3 million children who were recipients of Supplemental Security Income (SSI) disability benefits in 2013, about 50% were disabled primarily due to a mental disorder. An increase in the number of children who are recipients of SSI benefits due to mental disorders has been observed through several decades of the program beginning in 1985 and continuing through 2010. Nevertheless, less than 1% of children in the United States are recipients of SSI disability benefits for a mental disorder. At the request of the Social Security Administration, Mental Disorders and Disability Among Low-Income Children compares national trends in the number of children with mental disorders with the trends in the number of children receiving benefits from the SSI program, and describes the possible factors that may contribute to any differences between the two groups. This report provides an overview of the current status of the diagnosis and treatment of mental disorders, and the levels of impairment in the U.S. population under age 18. The report focuses on 6 mental disorders, chosen due to their prevalence and the severity of disability attributed to those disorders within the SSI disability program: attention-deficit/hyperactivity disorder, oppositional defiant disorder/conduct disorder, autism spectrum disorder, intellectual disability, learning disabilities, and mood disorders. While this report is not a comprehensive discussion of these disorders, Mental Disorders and Disability Among Low-Income Children provides the best currently available information regarding demographics, diagnosis, treatment, and expectations for the disorder time course - both the natural course and under treatment.

Mental retardation has probably existed for as long as mankind has inhabited the earth. References to seemingly retarded persons appear in Greek and Roman literature. Examination of Egyptian mummies suggests that some may have suffered from diseases associated with mental retardation. Mohammed advocated feeding and housing those without reason. There is other evidence for favorable attitudes toward the retarded in early history, but attitudes var ied from age to age and from country to country. The concept of remediation did not emerge until the nineteenth century. Earlier, in 1798, ltard published an account of his attempt to train the "wild boy of Aveyron." A rash of efforts to habilitate retarded persons followed. Training schools were developed in Europe and the United States in the 1800s; however, these early schools did not fulfill their promise, and by the end of the nineteenth century large, inhumane warehouses for retarded persons existed. The notion of habilitation through training had largely been abandoned and was not to reappear until after World War II.

The development of behavior modification principles and procedures and the ensuing research have had a dramatic impact on services for mentally re tarded persons. This book is the second edition of a volume that is designed to update readers on some of these many developments. Although many of the chapter titles and authors from the first edition remain unchanged, we have added additional chapters to reflect new areas of research. The book is thus a critical review of this literature and, as such, provides essential and important notions about what we know and what can be done to expand our current knowledge. The authors of the chapters are all recognized experts who have been active in publishing in the research areas they critique. As a result, they have a good understanding of what are the major issues in the field. And because they are also active in service provision to persons with identified handicaps, their material will be especially useful to practitioners and, it is hoped, to those_ professionals who are working in the field in estab lishing data-based treatments. One important change in the field has concerned the terminology used to We are aware that persons with mental retar describe handicapped persons. dation are no longer referred to as "the mentally retarded," and although no disrespect is intended, for the sake of continuity the original title has been retained on the advice of the publisher.

Since the 1970s, the development of normalization philosophy and the implementation of community care policies have highlighted the nature and treatment of psychiatric and behavior disorders in people with mental retardation and rekindled the interest of scientists, psychiatric practitioners, and service providers. With these changes has grown a substantial body of new research and information on the phenomenology, epidemiology, classification, and clinical features of mental illness and behavior disorders in mentally retarded persons. In response to this growing interest and awareness, the editors, together with internationally renowned contributors from the United States and Europe, have compiled the first comprehensive handbook of the current theory and practice of mental health treatment and care in mentally retarded children and adults. Both contemporary and in-depth, this multidisciplinary, multidimensional volume covers all available therapeutic methods, including psychopharmacotherapy, psychotherapy, behavior therapies, cognitive therapy, and the systems approach for all the main diagnostic disorders in people with mental retardation. Parts I and II present an overview of epidemiology and clinical presentation, including research trends, and therapeutic methods, including psychotherapy, psychopharmacology, behavioral therapies, cognitive and social learning treatments, and working with families and caregivers. Parts III and IV focus on psychotherapeutic interventions, such as rational emotive group treatment with dually diagnosed adults, pre-therapy for persons with mental retardation who are also psychotic, and systemic therapy, and how to apply these methods to the treatment of specific mental illnesses, such as schizophrenia, epilepsy, and mood and anxiety disorders. Parts V and VI discuss how to treat behavior disorders such as aggression/self-aggression (pharmacotherapy and strategic behavioral interventions) and self-injurious behaviors (multimodal contextual approach), including group therapy for sex offenders and a pedagogical approach to behavior problems, and which treatment methods, such as psychodynamically oriented psychotherapy and pharmacotherapy, are most effective with children, including developmental-dynamic relationship therapy with more severely mentally retarded children. Parts VII and VIII provide guidance on mental health services and staff training, including psychiatric treatment in community care and a model for inpatient services for mentally ill persons with mental retardation, and the editors final chapter, which draws together all the various therapeutic approaches described in previous chapters to provide a practical framework for an integrative approach. Filling a major gap in the literature, this indispensable resource for psychiatrists, psychologists, and educators working with mentally retarded persons is also intended for general practitioners, doctors, social workers, and therapists working in the same or related fields.

Current estimates suggest that between one and three percent of people living in the United States will receive a diagnosis of mental retardation. Mental retardation, a condition characterized by deficits in intellectual capabilities and adaptive behavior, can be particularly hard to diagnose in the mild range of the disability. The U.S. Social Security Administration (SSA) provides income support and medical benefits to individuals with cognitive limitations who experience significant problems in their ability to perform work and may therefore be in need of governmental support. Addressing the concern that SSA's current procedures are consistent with current scientific and professional practices, this book evaluates the process used by SSA to determine eligibility for these benefits. It examines the adequacy of the SSA definition of mental retardation and its current procedures for assessing intellectual capabilities, discusses adaptive behavior and its assessment, advises on ways to combine intellectual and adaptive assessment to provide a complete profile of an individual's capabilities, and clarifies ways to differentiate mental retardation from other conditions.

The purpose of this Handbook is to provide the researcher, clinician, teacher and student in all mental health fields with comprehensive coverage of Disruptive Behavior Disorders (Attention Deficit/Hyperactivity Disorder, Conduct Disorder and Oppositional Defiant Disorder). With over 50 contributors and 2600 references, this Handbook is the most complete resource available on this important topic.

Problem behaviors often compound the already difficult task of improving the lives of persons with severe disabilities. This important volume, representing the culmination of more than a decade of clinical research, presents the first complete description of the procedures used in Functional Communication Training--a positive approach for reducing severe behavior problems. The procedures described in this book have been validated by numerous empirical studies for use with children, adolescents, and adults who display behaviors as diverse as aggression, self-injury, tantrums, and bizarre, psychotic speech. Functional Communication Training involves teaching students how to communicate those basic wants and needs that they have previously sought to have fulfilled via their problem behavior. They are taught to replace their challenging behavior with learned communication skills. This book provides the practitioner with step-by-step instructions for implementing this effective approach. A variety of assessment strategies are reviewed and described to assist in determining appropriate interventions. The Motivation Assessment Scale--one device designed to assess the function of problem behavior--is outlined in detail and is accompanied with guidelines for its administration and interpretation. Communication training is then detailed and illustrated using speech, sign language, and augmentative systems as examples. Numerous case examples throughout illuminate both the assessment and intervention strategies. Providing clear direction for ameliorating complex behavior problems, this book will be valued by psychologists, behavior analysts, special educators, and speech and language therapists. It can be used as a text for advanced undergraduate courses on behavior management in psychology and special education, and also serves as supplementary reading for courses on behavior modification or mental retardation/developmental disabilities.

During the past several decades, the field of mental health care has expanded greatly. This expansion has been based on greater recognition of the prevalence and treatability of mental disorders, as well as the availability of a variety of forms of effective treatment. Indeed, throughout this period, our field has witnessed the introduction and the wide spread application of specific pharmacological treatments, as well as the development, refinement, and more broadly based availability of behavioral, psychodynamic, and marital and family interventions. The community mental health center system has come into being, and increasing numbers of mental health practitioners from the fields of psychiatry, psychology, social work, nursing, and related professional disciplines have entered clinical practice. In concert with these developments, powerful sociopolitical and socioeconomic forces-including the deinstitutionalization movement of the late 1960s and early 1970s and the cost-containment responses of the 1980s, necessitated by the spiraling cost of health care-have shaped the greatest area of growth in the direction of outpatient services. This is particularly true of the initial assessment and treatment of nonpsychotic mental disorders, which now can often be managed in ambulatory-care settings. Thus, we decided that a handbook focusing on the outpatient treatment of mental disorders would be both timely and useful. When we first began outlining the contents of this book, the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disor ders (DSM-III) was in its fourth year of use.