Our previous studies have found that nonmobility, feeding problems, and the absence of toileting skills are the most potent predictors of mortality among people with developmental disabilities. We have also found that some individuals achieve these skills over time while others do not. Mortality rates are very high for the children who do not show gains in basic skills. Thus, one of our aims is to investigate precursors of these critical skills for children 0-12 years of age, as well as associated medical problems and interventions used, which might provide greater insight into who will survive and who will not. Among the variables to be examined are: 1) failure of early developmental sequences such as hand grasp, arm use, etc., 2) evidence of intelligence and awareness, 3) medical conditions such as the tendency to aspirate, development of scoliosis, respiratory infections, etc., 4) interventions, including special care (gastrostomy, ventilator, etc.), physical therapy, surgery, etc., and 5) placement and family involvement, including parent's education and socioeconomic status.
A second aim builds on the high mortality rates observed among older retarded people. We have verified that individuals with Down syndrome have elevated mortality rates after 40 years of age and adults who have experienced declines in mobility, feeding, or toileting skills.
Our second aim i s to determine the precursors of death among older high-risk retarded people. We wish to discover what specific medical conditions, interventions, treatments, occupational therapy, placement, and family involvement will predispose these individuals to survival vs. death after age 40. Both objectives of this project include developing more refined life tables based on different configurations of predictor variables. Finally, life tables and related research on predictors of mortality will continue to be examined for individuals between 12 to 40 years of age on our large population of disabled people.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project (R01)
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Human Development and Aging Subcommittee 3 (HUD)
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University of California Riverside
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Strauss, D; Kastner, T A; Shavelle, R (1998) Mortality of adults with developmental disabilities living in California institutions and community care, 1985-1994. Ment Retard 36:360-71
Strauss, D (1998) On Miettinen's multivariate confounder score. J Clin Epidemiol 51:233-6
Strauss, D; Shavelle, R; Baumeister, A et al. (1998) Mortality in persons with developmental disabilities after transfer into community care. Am J Ment Retard 102:569-81
Strauss, D; Anderson, T W; Shavelle, R et al. (1998) Causes of death of persons with developmental disabilities: comparison of institutional and community residents. Ment Retard 36:386-91
Strauss, D; Shavelle, R; Anderson, T W et al. (1998) External causes of death among persons with developmental disability: the effect of residential placement. Am J Epidemiol 147:855-62
Strauss, D; Ashwal, S; Shavelle, R et al. (1997) Prognosis for survival and improvement in function in children with severe developmental disabilities. J Pediatr 131:712-7
Strauss, D; Kastner, T; Ashwal, S et al. (1997) Tubefeeding and mortality in children with severe disabilities and mental retardation. Pediatrics 99:358-62
Strauss, D; Kastner, T A (1996) Comparative mortality of people with mental retardation in institutions and the community. Am J Ment Retard 101:26-40
Strauss, D; Eyman, R K; Grossman, H J (1996) Predictors of mortality in children with severe mental retardation: the effect of placement. Am J Public Health 86:1422-9
Strauss, D; Zigman, W B (1996) Behavioral capabilities and mortality risk in adults with and without Down syndrome. Am J Ment Retard 101:269-81

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