Research conducted the past 3 years on the institutionally mentally retarded using a randomized clinical trial design has demonstrated dramatic increases in abnormal movements of TD (tardive dyskinesia) when the residents are withdrawn from neuroleptic medication in comparison with control groups. The movements were assessed using trained nurses who rated the residents regularly using DIS-Co (Dyskinesia Identification System - Coldwater), a rating scale of 34 items which has been subjected to much more rigorous psychometric evaluation than any other TD scale on two samples of about 500 and 200 subjects which provide norms for the rating scale. Because there is an urgent need for a brief, practical monitoring system to assess residents regularly to provide them with good health care and to meet constitutionally required right to treatment as issued by several courts, work on revising and shortening the DIS-Co Scale for practical use will be continued. More important, however, a major effort will be undertaken to prepare good quality color videotapes and/or films of representative TD cases from a much larger pool of videotapes. Training videotapes and manuals will be prepared in an attempt to develop a package of training material for prospective raters which could be distributed widely to institutional settings and community group homes wanting the material. A presentation by the applicants in January 1984 to the National Convention of Superintendents of Institutions for the Mentally Retarded clearly showed a great interest in the monitoring system and a very receptive attitude for additional training.
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