Associations between Mobility Restriction and Motor and Intellectual Impairments, and the Impact of Environmental Factors in Children with Disabilities

The present study was conducted to clarify associations between motor and intellectual impairments and mobility restriction, and the impact of environmental factors on the mobility of children in residential institutions for children with motor impairments. Mobility restriction was assessed using the 1^st and 4^th qualifiers defined in the International Classification of Functioning, Disability and Health (ICF). Motor and intellectual impairments were characterized by gross motor function and intelligent quotient, respectively. The relationship between mobility restriction and the two impairments was examined using Spearman\u27s rank correlation analysis. The 1^st and 4^th qualifiers in mobility were moderately correlated to both motor and intellectual impairments. The correlation coefficient for the 1^st qualifier was somewhat smaller than that for the 4^th qualifier. The Wilcoxon signed-rank test indicated that the 1^st qualifier was significantly smaller than the 4^th qualifier in mobility (p<0.001). The present results suggest that mobility restriction is influenced not only by motor impairments, but also by intellectual impairments. The contextual assistances are considered to play an important role in reducing the impact of motor and intellectual impairments and improving mobility

Survival Prognosis of Japanese With Severe Motor and Intellectual Disabilities Living in Public and Private Institutions Between 1961 and 2003

Background: Although the prognosis for survival in people with severe functional disabilities is a serious concern for their families and health care practitioners, there have been few reports on survival rates for this population. Every year, the Japanese Association of Welfare for Persons with Severe Motor and Intellectual Disability collects anonymous records of individual registrations and deaths from all private and public institutions, excepting national institutions. We used these data to estimate the prognosis for survival. Methods: We reviewed the records of 3221 people with severe motor and intellectual disabilities (SMID); all subjects had lived in one of 119 public or private institutions in Japan between 1961 and 2003. Kaplan–Meier survival estimates were calculated according to disability type and birth year range. Results: Of the 3221 persons, 2645 were alive and 576 had died. The survival rate at the age of 20 for all subjects was 79% (95% confidence interval, 78%–81%). Among people who were unable to sit, those with lower intelligence quotients had lower survival rates. Conclusions: The survival rate among people with SMID housed in public and private institutions in Japan was much worse than that of the general population, and has not improved since the 1960s