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Biomedical subjects

J Coplan

Publications and source records attributed to J Coplan.

31 records · Page 2Linked to original sources

Wrongful life and wrongful birth: new concepts for the pediatrician.

Over the past two decades, numerous suits for damages have been brought against physicians for the injury of wrongful life, or wrongful birth. Within the past 5 years, several precedents have been set that broaden the physician's legal obligation to recognize and act upon foreseeable or potentially recurrent genetic, teratogenic, or chromosomal disorders. These precedents may be expected to affect all physicians, but particularly pediatricians, because of the increased frequency of such disorders in the pediatric population.

Abortion, Therapeutic

Motor disorders of voice and speech in Reye's syndrome survivors.

Disorders of voice and speech were studied in 43 survivors of Reye's syndrome (RS). During hospital convalescence 26 (60%) of 43 were aphonic, hoarse, or had other alterations of speech production. These disorders occurred in those patients with the worst severity of RS. Four patients (9% of survivors) had a persistent motor voice or speech disorder at follow-up examination 1 1/2 to five years after recovery. All of the patients have breathy, low-intensity voice quality, whereas three of the four exhibit rapid and slurred speech. These four children have no difficulty with the symbolic aspects of language and their motor voice and speech impairment cannot be ascribed to global intellectual deficit. Although other neurologic deficits are present in three of these four children, the disorders of voice and speech are the major permanent disabling handicap in our RS survivors.

Adolescent

Parental estimate of child's developmental level in a high-risk population.

Forty-six children referred for developmental assessment underwent formal testing of language and intellectual development, and for each child a formal developmental quotient (FDQ) was obtained. Each child's mother was asked to provide a subjective estimate of her child's level of function, which was converted to a developmental quotient by dividing by the child's chronological age. The correlation coefficient between this derived parental developmental quotient estimate (DPDQE) and the FDQ was .85 (P less than .001). The DPDQE displayed 75% sensitivity and 100% specificity in detecting children with an FDQ of 69 or less. The DPDQE may be useful as one component of the routine office examination for preschool children.

Child Development

Validation of an early language milestone scale in a high-risk population.

Detailed language evaluations were obtained by interviewing the parents of 191 healthy children aged 0 to 3 years, and by testing the children themselves. From these data, normative values were derived for 41 language milestones in the first 36 months of life. These values were used to construct the Early Language Milestone Scale (ELM Scale), a brief language assessment tool suitable for use by general pediatricians. Physician use of the ELM Scale in a population of 119 children considered at high risk for the presence of developmental disability yielded 97% sensitivity and 93% specificity for the ELM Scale as a detector of developmentally delayed children, when compared with more formal developmental measures as applied by a clinical psychologist or speech pathologist. Early language milestones are a sensitive indicator of developmental integrity; delayed achievement of early language milestones strongly suggests the presence of a significant underlying developmental disability. The ELM Scale may be adopted as a valid measure of developmental status among children considred at high risk for the presence of developmental disabilities.

Cerebral Palsy

Test-retest and interobserver reliability of the Early Language Milestone Scale, second edition.

Test-retest and interobserver reliability are reported for the Early Language Milestone Scale, second edition, a language assessment tool for infants and children from birth to 36 months of age. Reliability data are presented for two scoring methods: the pass-fail method that yields a global rating of "pass" or "fail," and the point-scoring method that yields percentile scores. Both scoring methods showed good reliability. The clinical applicability of each scoring system is discussed.

Child, Preschool

The high-functioning autistic experience: birth to preteen years.

A retrospective chart review of 15 children with high-functioning autism was conducted for the years 1981 through 1992. The purpose of the study was to describe the experience of children with high-functioning autism from infancy through preadolescence. Chart data included clinic staff records, parent letters, academic program records, service records, and comments from the children themselves. The findings of this study support the proposition that children with autism who have an IQ above 70 follow a varied but improving course over time. All 15 children met the DSM-III-R criteria for autism when first evaluated. By middle elementary school, however, none of the children in this study met the DSM-III-R criteria for autism, although they continued to have various language disturbances, social skill deficits, and unique behavioral qualities.

Adaptation, Psychological

Cardiac profile and disruptive behavior in boys at risk for delinquency.

The objective of this study was to examine associations in youth between antisocial behavior and cardiovascular profile. Younger brothers of adjudicated delinquents (N = 120) received a standardized psychiatric assessment and an assessment of three factors often studied in behavioral cardiology research: family history of hypertension, resting blood pressure, and obesity. As a group, relative to population norms, these youth exhibited signs of obesity and elevated blood pressure, with 30% of the sample appearing clinically obese and 24% having a blood pressure above the 90th percentile for national norms in their age cohort. Within the sample, score on the Child Behavior Checklist (CBCL) Delinquency scale correlated with blood pressure (r = .29-.34) and an index of obesity, weight/height3 (r = .20). Further, scores on the CBCL Delinquency, Aggression, and Externalizing scales were elevated in boys with a positive family history of hypertension. Among boys at risk for delinquency, disruptive psychopathology relates to factors often studied in behavioral cardiology research. Relationships between risk factors for ischemic cardiovascular disease and hostile behavior may be manifested with measures of disruptive psychopathology.

Adolescent