Types of seizures
Seizures take many forms. Before your doctor can prescribe the right treatment, he or she must
figure ou...
Secondarily generalized seizures
Absence seizures
What are they like?
Here's a typical story: Frank, a 7-year-old boy, oft...
Absence seizures can resemble some complex partial seizures or episodes of
daydreaming:
Questions to ask Daydreaming Seizu...
Images of the brain such as CT and MRI scans are usually normal, so they are seldom
needed.
Tonic-clonic seizures
What are...
is gradually stopped. The risk that an individual will have more seizures depends on
factors such as whether his or her EE...
Doctors often divide simple partial seizures into categories depending on the type of
symptoms the person experiences:
• M...
some time. Whether they represent simple partial seizures depends on how often they
occur and whether they are associated ...
Some of these seizures (usually ones beginning in the temporal lobe) start with a simple
partial seizure. Also called an a...
partial seizures begin slowly with
a warning.
Can they be interrupted? Yes No
How long do they last? Until something
inter...
The AAMR Definition of Mental Retardation
Mental retardation is a disability characterized by significant
limitations both...
American Association on Mental Retardation
444 North Capitol Street
Washington, DC 20001-1512
Phone: 202/387-1968
Fax: 202...
What factors must be considered when determining if a person has mental
retardation and developing an individualized suppo...
measurement, appropriateness, and consistency with administration
guidelines.
Since the standard error of measurement for ...
Social Skills
Interpersonal
Responsibility
Self-esteem
Gullibility (likelihood of being tricked or manipulated)
Naiveté
Fo...
teacher, psychologist, doctor or by any appropriate person or agency.
Why are supports important?
Providing individualized...
· Preparing and eating food
· Housekeeping and cleaning
· Dressing
· Bathing and taking care of personal hygiene and groom...
· Socializing outside the family
· Making and keeping friends
· Communicating with others about personal needs
· Engaging ...
inter-generational causes, appropriate supports can be used to prevent and
reverse the effects of risk factors.
What is th...
Page last updated July 29, 2002 12:52 AM
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  1. 1. Types of seizures Seizures take many forms. Before your doctor can prescribe the right treatment, he or she must figure out which type (or types) you have. That's the purpose of all the tests discussed in Making the Diagnosis of Epilepsy -- not just to tell whether you have epilepsy but also to tell what kind. There are so many kinds of seizures that neurologists who specialize in epilepsy are still updating their thinking about how to classify them. But usually they classify seizures into two types, primary generalized seizures and partial seizures. The difference is in how they begin: • Primary generalized seizures begin with a widespread electrical discharge that involves both sides of the brain at once. Hereditary factors are important in many of these seizures. • Partial seizures begin with an electrical discharge in one limited area of the brain. Some are related to head injury, brain infection, stroke, or tumor, but in most cases the cause is unknown. One question that is used to further classify partial seizures is whether consciousness (the ability to respond and remember) is "impaired" or "preserved." The difference may seem obvious, but really there are many degrees of impairment or preservation of consciousness. See the article on Impairment of consciousness for more information. Identifying certain seizure types and other characteristics of a person's epilepsy (the age at which it begins, for instance) allows doctors to classify some cases into epilepsy syndromes. This kind of classification helps us to know how long the epilepsy will last and the best way to treat it. Click on the names below for descriptions and details about each type: Primary Generalized Seizures Absence seizures Atypical absence seizures Myoclonic seizures Atonic seizures Tonic seizures Clonic seizures Tonic-clonic seizures Partial Seizures Simple partial seizures (Consciousness is preserved.) Complex partial seizures (Consciousness is impaired.)
  2. 2. Secondarily generalized seizures Absence seizures What are they like? Here's a typical story: Frank, a 7-year-old boy, often "blanks out" anywhere from a few seconds to 20 seconds at a time. During a seizure, Frank doesn't seem to hear his teacher call his name, he usually blinks repetitively, and his eyes may roll up a bit. During shorter seizures, he just stares. Then he continues on as if nothing happened. Some days Frank has more than 50 of these spells. How long do they last? Usually less than 10 seconds, but it can be as long as 20. They begin and end suddenly. Tell me more Absence seizures are brief episodes of staring. (Although the name looks like a regular English word, your neurologist may pronounce it ab-SAWNTZ.) Another name for them is petit mal (PET-ee mahl). During the seizure, awareness and responsiveness are impaired. (See Impairment of consciousness.) People who have them usually don't realize when they've had one. There is no warning before a seizure, and the person is completely alert immediately afterward. Simple absence seizures are just stares. Most absence seizures are considered complex absence seizures, which means that they include a change in muscle activity. The most common movements are eye blinks. Other movements include slight tasting movements of the mouth, hand movements such as rubbing the fingers together, and contraction or relaxation of the muscles. Complex absence seizures are often more than 10 seconds long. Who gets them? Absence seizures usually begin between ages 4 and 14. The children who get them usually have normal development and intelligence. What's the outlook? In three-quarters of cases, absence seizures stop by age 18. Children with absence seizures do have higher rates of behavioral, educational, and social problems. What else could it be?
  3. 3. Absence seizures can resemble some complex partial seizures or episodes of daydreaming: Questions to ask Daydreaming Seizures How frequent are the episodes? Not frequent Complex partial: Rarely more than several times per day or week Absence: Could be many times per day In what situations do they occur? Boring situation Any time, including during physical activity; often with hyperventilation (deep or rapid breathing) Do they begin abruptly? No Usually yes. Some complex partial seizures begin slowly with a warning. Can they be interrupted? Yes No How long do they last? Until something interesting happens Complex partial: Up to several minutes Absence: Rarely more than 15-20 seconds Does the person do anything during the episode? Probably just stares Complex partial: Automatisms are common. Absence: Just stares What is the person like immediately after the episode? Alert Complex partial: Confused Absence: Alert How is the diagnosis made? The EEG (electroencephalogram), which records brain waves, is helpful in diagnosing absence seizures. Having the child breathe very rapidly often will produce a seizure.
  4. 4. Images of the brain such as CT and MRI scans are usually normal, so they are seldom needed. Tonic-clonic seizures What are they like? Here's a typical story from a parent's view: "These seizures frighten me. They only last a minute or two but it seems like an eternity. I can often tell Heather's going to have one because she acts cranky and out of sorts. It begins with an unnatural shriek. Then she falls, and every muscle seems to be activated. Her teeth clench. She's pale, and later she turns slightly bluish. Shortly after she falls, her arms and upper body start to jerk, while her legs remain more or less stiff. This is the longest part of the seizure. Finally it stops and she falls into a deep sleep." How long do they last? Generally, 1 to 3 minutes. A tonic-clonic seizure that lasts longer than 5 minutes probably calls for medical help. A seizure that lasts more than 30 minutes, or three seizures without a normal period in between, indicates a dangerous condition called convulsive status epilepticus. This requires emergency treatment. Tell me more This type is what most people think of when they hear the word "seizure." An older term for them is "grand mal." As implied by the name, they combine the characteristics of tonic seizures and clonic seizures. The tonic phase comes first: All the muscles stiffen. Air being forced past the vocal cords causes a cry or groan. The person loses consciousness and falls to the floor. The tongue or cheek may be bitten, so bloody saliva may come from the mouth. The person may turn a bit blue in the face. After the tonic phase comes the clonic phase: The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees. After a few minutes, the jerking slows and stops. Bladder or bowel control sometimes is lost as the body relaxes. Consciousness returns slowly, and the person may be drowsy, confused, agitated, or depressed. Who gets them? They affect both children and adults. What's the outlook? It depends on many factors. Some children will outgrow their epilepsy. Often, tonic- clonic seizures can be controlled by seizure medicines. Many patients who are seizure- free for a year or two while taking seizure medicine will stay seizure-free if the medicine
  5. 5. is gradually stopped. The risk that an individual will have more seizures depends on factors such as whether his or her EEG shows any epilepsy waves, or whether the doctor finds any abnormalities on a neurological exam. Among children with no epilepsy waves and a normal exam, about 70% of those who have had tonic-clonic seizures will stay seizure-free without medication. The comparable number is less than 30% for children with epilepsy waves and an abnormal exam. All these figures are more favorable than those for partial seizures. What else could it be? Some nonepileptic (psychogenic) seizures resemble tonic-clonic seizures. The surest way to tell the difference is with video-EEG monitoring. In some cases, the same person may have both tonic-clonic and nonepileptic seizures. How is the diagnosis made? The typical appearance of a tonic-clonic seizure is usually easy to recognize. The doctor will want a detailed description of the seizures. An EEG and other tests may help to confirm the diagnosis or suggest a cause. Simple partial seizures What are they like? They are remarkably different from person to person, depending on the part of the brain where they begin. The one thing they all have in common is that the person remains alert and can remember what happens. Here are a couple of experiences: • "I almost enjoy them. The feeling of déja vu, as if I've lived through this moment and I even know what's going to be said next. Everything seems brighter and more alive." • "It is a pressure that starts in my stomach, then rises to my chest and throat. When it reaches my chest, I smell an unpleasant odor of something burnt. At the same time I feel anxious." Sometimes the seizure activity spreads to other parts of the brain, so another type of seizure follows the simple partial seizure. This is called a secondarily generalized seizure. How long do they last? Only a short time. Tell me more
  6. 6. Doctors often divide simple partial seizures into categories depending on the type of symptoms the person experiences: • Motor seizures: These cause a change in muscle activity. For example, a person may have abnormal movements such as jerking of a finger or stiffening of the body. These movements may spread, either staying on one side of the body (opposite the affected area of the brain) or extending to both sides. Other examples are weakness, which can even affect speech, and coordinated actions such as laughter or automatic hand movements. The person may or may not be aware of these movements. • Sensory seizures: These cause changes in any one of the senses. People with sensory seizures may smell or taste things that aren't there; hear clicking, ringing, or a person's voice when there is no actual sound; or feel a sensation of "pins and needles" or numbness. They may feel as if they are floating or spinning in space. They may have visual hallucinations, seeing things that aren't there (a spot of light, a scene with people). They also may experience illusions -- distortions of true sensations. For instance, they may believe that a parked car is moving farther away, or that a person's voice is muffled when it's actually clear. • Autonomic seizures: These cause changes in the part of the nervous system that automatically controls bodily functions. These common seizures may include strange or unpleasant sensations in the stomach, chest, or head; changes in the heart rate or breathing; sweating; or goose bumps. • Psychic seizures: These seizures change how people think, feel, or experience things. They may have problems with memory, garbled speech, an inability to find the right word, or trouble understanding spoken or written language. They may suddenly feel emotions like fear, depression, or happiness with no outside reason. Some may feel as though they are outside their body or may have feelings of déja vu ("I've been through this before") or jamais vu ("This is new to me" -- even though the setting is really familiar). Who gets them? Anybody can get them. They may be more likely in people who have had a head injury, brain infection, stroke, or brain tumor but most of the time the cause is unknown. What's the outlook? These seizures often can be controlled by seizure medicines. Many people who have them eventually will become seizure-free without medication. What else could it be? Medical disorders (for example, stomach disorders or a pinched nerve) can cause some similar symptoms. Hallucinations can accompany psychiatric illness or the use of certain drugs. And some symptoms (such as déja vu) are experienced by almost everyone at
  7. 7. some time. Whether they represent simple partial seizures depends on how often they occur and whether they are associated with other episodic changes or other seizure types. How is the diagnosis made? A complete medical history and physical examination can help to rule out other possible causes of the symptoms and assess the likelihood of epilepsy. Complex partial seizures What are they like? Here's a typical story: "Harold's spells begin with a warning; he says he's going to have a seizure and usually sits down. If I ask him how he feels, he just says 'I feel it.' Then he makes a funny face, a mixture of surprise and distress. During the seizure he may look at me when I call his name but he never answers. He just stares and makes odd mouth movements, as if he's tasting something. Sometimes he'll grab the arm of the chair and squeeze it. He may also pull at his shirt as though he's picking lint off of it. After a few minutes, when he's coming out of it, he asks a lot of questions. He never remembers his 'warning' or these questions. The seizures make him tired; if he has two in the same day, he often goes to sleep after the second one." And another story: "Susan's seizures usually occur while she's asleep. She makes a grunting sound, as if she's clearing her throat. Then she'll sit up in bed, open her eyes, and stare. She may clasp her hands together. If I ask her what she's doing, she doesn't answer. After a minute or so, she lies down and goes back to sleep." How long do they last? They usually last between 30 seconds and 2 minutes. Afterward, the person may be tired or confused for about 15 minutes and may not be fully normal for hours. Tell me more These seizures usually start in a small area of the temporal lobe or frontal lobe of the brain. They quickly involve other areas of the brain that affect alertness and awareness. So even though the person's eyes are open and they may make movements that seem to have a purpose, in reality "nobody's home." If the symptoms are subtle, other people may think the person is just daydreaming. Some people can have seizures of this kind without realizing that anything has happened. Because the seizure can wipe out memories of events just before or after it, however, memory lapses can be a problem.
  8. 8. Some of these seizures (usually ones beginning in the temporal lobe) start with a simple partial seizure. Also called an aura, this warning seizure often includes an odd feeling in the stomach. Then the person loses awareness and stares blankly. Most people move their mouth, pick at the air or their clothing, or perform other purposeless actions. These movements are called "automatisms" (aw-TOM-ah-TIZ-ums). Less often, people may repeat words or phrases, laugh, scream, or cry. Some people do things during these seizures that can be dangerous or embarrassing, such as walking into traffic or taking their clothes off. These people need to take precautions in advance. Complex partial seizures starting in the frontal lobe tend to be shorter than the ones from the temporal lobe. The seizures that start in the frontal lobe are also more likely to include automatisms like bicycling movements of the legs or pelvic thrusting. Some complex partial seizures turn into secondarily generalized seizures. Who gets them? Anybody can get them. They may be more likely in people who have had a head injury, brain infection, stroke, or brain tumor but most of the time the cause is unknown. What's the outlook? As for many other kinds of seizures, the outlook depends on whether the cause is known. They may be outgrown or controlled with medication. If medication is not effective, some can be eliminated by epilepsy surgery. What else could it be? Complex partial seizures sometimes resemble daydreaming or absence seizures: Questions to ask Daydreaming Seizures How frequent are the episodes? Not frequent Complex partial: Rarely more than several times per day or week Absence: Could be many times per day In what situations do they occur? Boring situation Any time, including during physical activity Do they begin abruptly? No Usually yes. Some complex
  9. 9. partial seizures begin slowly with a warning. Can they be interrupted? Yes No How long do they last? Until something interesting happens Complex partial: Up to several minutes Absence: Rarely more than 15-20 seconds Does the person do anything during the episode? Probably just stares Complex partial: Automatisms are common. Absence: Just stares What is the person like immediately after the episode? Alert Complex partial: Confused Absence: Alert How is the diagnosis made? Careful observation should make the diagnosis pretty certain in most cases. DEFINITION OF MENTAL RETARDATION Mental retardation is not something you have, like blue eyes, or a bad heart. Nor is it something you are, like short, or thin. It is not a medical disorder, nor a mental disorder. Mental retardation is a particular state of functioning that begins in childhood and is characterized by limitation in both intelligence and adaptive skills. Mental retardation reflects the "fit" between the capabilities of individuals and the structure and expectations of their environment.
  10. 10. The AAMR Definition of Mental Retardation Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before age 18. Five Assumptions Essential to the Application of the Definition 1. Limitations in present functioning must be considered within the context of community environments typical of the individual's age peers and culture. 2. Valid assessment considers cultural and linguistic diversity as well as differences in communication, sensory, motor, and behavioral factors. 3. Within an individual, limitations often coexist with strengths. 4. An important purpose of describing limitations is to develop a profile of needed supports. 5. With appropriate personalized supports over a sustained period, the life functioning of the person with mental retardation generally will improve. ©2002 American Association on Mental Retardation. Founded in 1876, AAMR is an international multidisciplinary association of professionals. The Association has had responsibility for defining mental retardation since 1921.
  11. 11. American Association on Mental Retardation 444 North Capitol Street Washington, DC 20001-1512 Phone: 202/387-1968 Fax: 202/387-2193 Fact Sheet: Frequently Asked Questions About Mental Retardation Where can I find detailed information about the 2002 AAMR definition of mental retardation? The newly released 10th edition of Mental Retardation: Definition, Classification, and Systems of Supports discusses the 2002 AAMR definition and classification system in great detail. It presents the latest thinking about mental retardation and includes important tools and strategies to determine if an individual has mental retardation along with detailed information about developing a personal plan of individualized supports. It is available from AAMR through the Website. What is the official AAMR definition of mental retardation? Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before the age of 18. A complete and accurate understanding of mental retardation involves realizing that mental retardation refers to a particular state of functioning that begins in childhood, has many dimensions, and is affected positively by individualized supports. As a model of functioning, it includes the contexts and environment within which the person functions and interacts and requires a multidimensional and ecological approach that reflects the interaction of the individual with the environment, and the outcomes of that interaction with regards to independence, relationships, societal contributions, participation in school and community, and personal well being.
  12. 12. What factors must be considered when determining if a person has mental retardation and developing an individualized support plan? When using the AAMR definition, classification and systems of supports professionals and other team members must: 1. Evaluate limitations in present functioning within the context of the individual's age peers and culture; 2. Take into account the individual's cultural and linguistic differences as well as communication, sensory, motor, and behavioral factors; 3. Recognize that within an individual limitations often coexist with strengths; 4. Describe limitations so that an individualized plan of needed supports can be developed; and 5. Provide appropriate personalized supports to improve the functioning of a person with mental retardation. What is a disability? A disability refers to personal limitations that represent a substantial disadvantage when attempting to function in society. A disability should be considered within the context of the environment, personal factors, and the need for individualized supports. What is Intelligence? Intelligence refers to a general mental capability. It involves the ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn quickly, and learn from experience. Although not perfect, intelligence is represented by Intelligent Quotient (IQ) scores obtained from standardized tests given by a trained professional. In regard to the intellectual criterion for the diagnosis of mental retardation, mental retardation is generally thought to be present if an individual has an IQ test score of approximately 70 or below. An obtained IQ score must always be considered in light of its standard error of
  13. 13. measurement, appropriateness, and consistency with administration guidelines. Since the standard error of measurement for most IQ tests is approximately 5, the ceiling may go up to 75. This represents a score approximately 2 standard deviations below the mean, considering the standard error of measurement. It is important to remember, however, that an IQ score is only one aspect in determining if a person has mental retardation. Significant limitations in adaptive behavior skills and evidence that the disability was present before age 18 are two additional elements that are critical in determining if a person has mental retardation. What is Adaptive Behavior? Adaptive behavior is the collection of conceptual, social, and practical skills that people have learned so they can function in their everyday lives. Significant limitations in adaptive behavior impact a person's daily life and affect the ability to respond to a particular situation or to the environment. Limitations in adaptive behavior can be determined by using standardized tests that are normed on the general population including people with disabilities and people without disabilities. On these standardized measures, significant limitations in adaptive behavior are operationally defined as performance that is at least 2 standard deviations below the mean of either (a) one of the following three types of adaptive behavior: conceptual, social, or practical, or (b) an overall score on a standardized measure of conceptual, social, and practical skills. What are some specific examples of Adaptive Behavior Skills? Conceptual Skills Receptive and expressive language Reading and writing Money concepts Self-directions
  14. 14. Social Skills Interpersonal Responsibility Self-esteem Gullibility (likelihood of being tricked or manipulated) Naiveté Follows rules Obeys laws Avoids victimization Practical Skills Personal activities of daily living such as eating, dressing, mobility and toileting. Instrumental activities of daily living such as preparing meals, taking medication, using the telephone, managing money, using transportation and doing housekeeping activities. Occupational skills Maintaining a safe environment What are supports? The concept of supports originated about 15 years ago and it has revolutionized the way habilitation and education services are provided to persons with mental retardation. Rather than mold individuals into pre-existing diagnostic categories and force them into existing models of service, the supports approach evaluates the specific needs of the individual and then suggests strategies, services and supports that will optimize individual functioning. The supports approach also recognizes that individual needs and circumstances will change over time. Supports were an innovative aspect of the 1992 AAMR manual and they remain critical in the 2002 system. In 2002, they have been dramatically expanded and improved to reflect significant progress over the last decade. Supports are defined as the resources and individual strategies necessary to promote the development, education, interests, and personal well-being of a person with mental retardation. Supports can be provided by a parent, friend,
  15. 15. teacher, psychologist, doctor or by any appropriate person or agency. Why are supports important? Providing individualized supports can improve personal functioning, promote self-determination and societal inclusion, and improve personal well-being of a person with mental retardation. Focusing on supports as the way to improve education, employment, recreation, and living environments is an important part of person-centered approaches to providing supports to people with mental retardation. How do you determine what supports are needed? AAMR recommends that an individual's need for supports be analyzed in at least nine key areas such as human development, teaching and education, home living, community living, employment, health and safety, behavior, social, and protection and advocacy. What are some specific examples of supports areas and support activities? Human Development Activities · Providing physical development opportunities that include eye-hand coordination, fine motor skills, and gross motor activities · Providing cognitive development opportunities such as using words and images to represent the world and reasoning logically about concrete events · Providing social and emotional developmental activities to foster trust, autonomy, and initiative Teaching and Education Activities · Interacting with trainers and teachers and fellow trainees and students · Participating in making decisions on training and educational activities · Learning and using problem-solving strategies · Using technology for learning · Learning and using functional academics (reading signs, counting change, etc.) · Learning and using self-determination skills Home Living Activities · Using the restroom/toilet · Laundering and taking care of clothes
  16. 16. · Preparing and eating food · Housekeeping and cleaning · Dressing · Bathing and taking care of personal hygiene and grooming needs · Operating home appliances and technology · Participating in leisure activities within the home Community Living Activities · Using transportation · Participating in recreation and leisure activities · Going to visit friends and family · Shopping and purchasing goods · Interacting with community members · Using public buildings and settings Employment Activities · Learning and using specific job skills · Interacting with co-workers · Interacting with supervisors · Completing work-related tasks with speed and quality · Changing job assignments · Accessing and obtaining crisis intervention and assistance Health and Safety Activities · Accessing and obtaining therapy services · Taking medication · Avoiding health and safety hazards · Communicating with health care providers · Accessing emergency services · Maintaining a nutritious diet · Maintaining physical health · Maintaining mental health/emotional well-being Behavioral Activities · Learning specific skills or behaviors · Learning and making appropriate decisions · Accessing and obtaining mental health treatments · Accessing and obtaining substance abuse treatments · Incorporating personal preferences into daily activities · Maintaining socially appropriate behavior in public · Controlling anger and aggression Social Activities · Socializing within the family · Participating in recreation and leisure activities · Making appropriate sexual decisions
  17. 17. · Socializing outside the family · Making and keeping friends · Communicating with others about personal needs · Engaging in loving and intimate relationships · Offering assistance and assisting others Protection and Advocacy Activities · Advocating for self and others · Managing money and personal finances · Protecting self from exploitation · Exercising legal rights and responsibilities · Belonging to and participating in self-advocacy/support organizations · Obtaining legal services · Using banks and cashing checks Has AAMR always had the same definition of mental retardation? No. AAMR has updated the definition of mental retardation ten times since 1908. Changes in the definition have occurred when there is new information, or there are changes in clinical practice or breakthroughs in scientific research. The 10th edition of Mental Retardation: Definition, Classification and Systems of Supports contains a comprehensive update to the landmark 1992 system and provides important new information, tools and strategies for the field and for anyone concerned about people with mental retardation. What are the causes of Mental Retardation? The causes of mental retardation can be divided into biomedical, social, behavioral, and educational risk factors that interact during the life of an individual and/or across generations from parent to child. Biomedical factors are related to biologic processes, such as genetic disorders or nutrition. Social factors are related to social and family interaction, such as child stimulation and adult responsiveness. Behavioral factors are related to harmful behaviors, such as maternal substance abuse. And educational factors are related to the availability of family and educational supports that promote mental development and increases in adaptive skills. Also, factors present during one generation can influence the outcomes of the next generation. By understanding
  18. 18. inter-generational causes, appropriate supports can be used to prevent and reverse the effects of risk factors. What is the AAMR Mission? Founded in 1876, AAMR is the world's oldest and largest interdisciplinary organization of professionals concerned about mental retardation. With headquarters in Washington, DC, AAMR has a constituency of more than 50,000 people and an active core membership of 7,500 in the United States and in 55 other countries. The mission of AAMR is to promote progressive policies, sound research, effective practices, and universal rights for people with intellectual disabilities. American Association on Mental Retardation 444 North Capitol Street Washington, DC 20001-1512 Phone: 202/387-1968 Fax: 202/387-2193 Website: http://www.aamr.org Other Fact Sheets Mental Retardation Leisure Aging Person & Family Centered Planning The Death Penalty What is Self-Advocacy? Home Ownership The Self-Advocacy Movement The Home of Your Own Initiative Supported Employment Human Rights Transition Leadership & Self-Advocacy
  19. 19. Page last updated July 29, 2002 12:52 AM

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